>> The research, based on a sample of more than 418,000 workers in Spain, is one of the largest epidemiological studies on metabolic health conducted in the country and was led by ADEMA in collaboration with researchers from IDISBA and the Servei de Salut.
>>Hidden obesity and visceral fat, not just weight, are the silent enemies. In women, the formula showed a greater ability to predict diabetes risk, while in men it was more effective at predicting prediabetes.
Research conducted by the ADEMA University School, in collaboration with researchers from the Balearic Islands Health Research Institute (IDISBA) and the Balearic Islands Health Service (IB-Salut), demonstrates that the composition and distribution of body fat are decisive factors in predicting the risk of developing type 2 diabetes and prediabetes, even in people of normal weight.
The research was based on a sample of more than 418,000 workers in Spain, making it one of the largest epidemiological studies on metabolic health conducted in the country.
The ECORE-BF formula was applied to each participant and compared with the main international models for predicting the risk of type 2 diabetes: FINDRISC, Q Diabetes, CANRISK, TRAQ-D, and PRISQ. The results confirmed that ECORE-BF offers better predictive capacity than current models, with a more accurate estimate and greater ease of application in clinical and population settings.
The research, published in the scientific journal Medicina Lithuania, validates the effectiveness of the ECORE-BF equation (Cordoba Equation for Estimating Body Fat), developed by the University of Cordoba in 2019. This formula allows for the accurate estimation of body fat percentage from three basic data points: age, sex, and body mass index (BMI).
According to Dr. Arturo López, principal investigator and R&D director at ADEMA, “the results were conclusive. The ECORE-BF showed exceptional predictive capacity with an area under the curve (AUC) greater than 0.95 in all models and for both sexes. This indicates a level of accuracy close to 100 percent in identifying people at high risk of developing type 2 diabetes or prediabetes.” “Our findings confirm that not only body weight, but above all the composition and distribution of fat—especially visceral fat—are key in the development of diabetes,” Dr. López noted.
The ECORE-BF equation stands out for its simplicity of calculation: it only requires three data points (age, sex and the person’s BMI) and allows for an accurate estimate of the percentage of body fat, without the need for expensive tests such as magnetic resonance imaging or densitometry (DXA).
This ease of use makes the ECORE-BF a valuable tool for primary care, occupational medicine, public health programs, population screenings, and even personal self-assessment. Furthermore, its validation with data from such a large and diverse sample lends it significant scientific rigor.
“We have an opportunity to change the prevention paradigm. This approach can anticipate traditional clinical diagnoses and allow for early intervention with healthy habits, before the disease manifests itself,” explained Dr. Arturo López.
Hidden obesity and visceral fat: the silent enemies
The study also highlights that many people with a normal weight, according to conventional BMI, nevertheless have high levels of internal adiposity or visceral fat, the main culprit behind metabolic impairment. This phenomenon, known as “hidden obesity,” often goes undetected in routine checkups. The ECORE-BF allows for the identification of this type of silent risk, providing a more comprehensive view of patients’ metabolic health. Differences between sexes were also significant. In women, the formula showed a greater capacity to predict the risk of diabetes, while in men it was more effective at predicting prediabetes.
The authors of the study propose integrating ECORE-BF as a complementary tool in the early detection of diabetes, especially in workplaces, schools, municipal campaigns, and populations with limited access to diagnostic resources. Furthermore, they emphasize the need for longitudinal studies analyzing how reducing visceral fat through physical activity and a healthy diet can decrease the risk of diabetes in individuals with elevated ECORE-BF scores.