Human physique and susceptibility to noninfectious disease

Physique is systematically associated with several important noninfectious diseases, including cardiovascular disease (CV), breast and endometrial cancer, noninsulin-dependent diabetes mellitis (NIDDM), gallbladder disease, peptic ulcer, and idiopathic mitral valve prolapse (IMVP). Of the cardiovascular diseases, hypertension is most securely associated with elevated body fatness or weight while evidence is mixed for an independent role of elevated fatness or weight in risk of coronary heart disease (CHD), miocardial infarction (MI), or sudden death. Both elevated total body fatness and an upper body fat distribution appear to be independent causal agents in the risk of NIDDM. A predominance of evidence associates elevated total body fatness or weight independently with risk of breast and endometrial cancer, as well as with disease prognosis. Some evidence exists that height-ened endomorphy and mesomorphy also influence breast, cervical, and endometrial cancer risk. Gallbladder disease is independently associated with elevated total body fatness, while peptic ulcer and IMVP may be causally related to ectomorphy or linearity of build. These findings should be evaluated with caution because of the complex or unestablished etiology of these diseases, the presence of intercorrelated causal variables such as diet, physical activity, lifestyle (including smoking), age and reproductive history, and often incomparable research designs. Moreover, the genetic components of both diseases and physique is poorly evaluated.