Ray et al. sought to evaluate the association between women’s breast size in late adolescence and the risk of type 2 diabetes in adulthood. For that purpose, they quantified the risk of developing type 2 diabetes in relation to bra cup sizes among 92,106 women from the Nurses’ Health Study II followed for 10 years. The authors found a statistically significant association between bra cup size and the development of type 2 diabetes. This association held true within all BMI groups (23.1 kg/m2) and also appeared to follow a dose-response relationship. Moreover, the association persisted after adjusting for other type 2 diabetes risk factors, such as family history of type 2 diabetes mellitus, diet, and exercise. However, despite the large sample size of this prospective study, the authors acknowledged that an important limitation was that bra cup size was based on recalls. Direct measurement of breast size by physical examination would have been more accurate. The authors also noted that these findings should be reproduced in other settings and in studies involving women of different ethnic backgrounds. They concluded that further research is needed to better understand the mechanisms underlying the potential health consequences of obesity in the upper and lower torso. This study was accompanied by an editorial by Alexander Sorisky who emphasized that the study’s findings remind us that white adipose tissue is a complex multi-depot system that should not be oversimplified. Sorisky underlined that we should think of fat as functional adipose tissue and that it is the dysfunction induced by obesity, rather than the amount of fat, that predisposes one to type 2 diabetes. Addressing the study by Ray et al., Sorisky’s editorial stated that it is too early to consider breast size a meaningful predictor of type 2 diabetes. Sorisky also concluded that a better understanding of who is predisposed to type 2 diabetes will help in the design of more effective and targeted interventions for diabetes prevention.
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