Increase in waist circumference increases mortality risk

Having a large waistline can almost double your risk of dying prematurely even if your body mass index is within the ‘normal’ range, revealed by researchers in a new study.

The new study of over 350,000 people across Europe, published in the New England Journal of Medicine.

The study provides strong evidence that storing excess fat around the waist poses a significant health risk, even in people not considered to be overweight or obese.

It suggests that doctors should measure a patient’s waistline and their hips as well as their body mass index as part of standard health checks, according to the researchers, from Imperial College London, the German Institute of Human Nutrition, and other research institutions across Europe.

Comparing subjects with the same body mass index, the risk of premature death increased in a linear fashion as the waist circumference increased. Each 5cm increase in waist circumference increased the mortality risk by 17% in men and 13% in women.

The ratio of waist to hips was also revealed as an important indicator of health in the study. Lower waist-hip ratios indicate that the waist is comparatively small in relation to the hips. The ratio is calculated by dividing the waist measurement by the hip measurement.

Waist to hip ratio varied quite widely in the European populations in the study. In 98 percent of the study population, waist to hip ratio ranged between 0.78 and 1.10 in men and between 0.66 and 0.98 in women. Within these ranges, each 0.1 unit higher waist-hip-ratio was related to a 34% higher mortality risk in men and a 24% higher risk in women.

Although the main new finding of this study is that waist size increases the risk of premature death independently of body mass index (BMI), the study does support earlier findings showing that a higher body mass index is significantly related to mortality. The lowest risk of death was at a BMI of approximately 25.3 in men and 24.3 in women.

The new research forms part of the European Prospective Investigation into Cancer and Nutrition (EPIC), one of the largest long-term prospective studies in the world.

Professor Elio Riboli, the European coordinator of the EPIC study from the Department of Epidemiology and Public Health at Imperial College London, said: “Although smaller studies have suggested a link between mortality and waist size, we were surprised to see the waist size having such a powerful effect on people’s health and premature death. Our study shows that accumulating excess fat around your middle can put your health at risk even if your weight is normal based on body mass index scores. There aren’t many simple individual characteristics that can increase a person’s risk of premature death to this extent, independently from smoking and drinking. ”

For this EPIC study the researchers looked at 359,387 participants from 9 European countries. Participants with a high BMI, compared with those in the medium range, died more often from cardiovascular diseases or from cancer. Participants with a low BMI tended to die more frequently from respiratory diseases.

Source: Imperial College London, UK



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