According to a study published in the New England Journal of Medicine, abdominal fat may be a stronger predictor of premature death than overall weight.
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Many of the past studies investigating the association between weight and risk of death have relied upon the body-mass index of the subjects. The BMI uses a person’s height and weight to calculate a score. Individuals who have a BMI of between 25 and 29.9 points are considered overweight; anyone with a higher score is considered obese.
In the past, most studies on weight gain and risk of death depended upon the BMI, but few studies examined whether the distribution of body fat contributes to the prediction of death. Now, however, two studies have shown an alarming correlation between waist circumference and mortality (death).
The latest study, published in the New England Journal of Medicine, examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries. The subjects were taking part in the European Prospective Investigation into Cancer and Nutrition (EPIC) trial and ranged in age from 25 to 70. Researchers divided participants into groups according to their BMI, waist circumference and waist-to-hip ratio. In nearly ten years of follow-up, more than 14,723 subjects died from various causes.
The results indicated that participants with large waists had an increased risk of death—even if they were considered to be normal weight based upon their BMI. Normal-weight males whose waists measured about 40 inches or more had double the risk of dying compared to those who had waists 34 inches or less. Females whose BMI was normal but who had waists 35 inches or more had a 79 percent increased chance of dying compared to female subjects whose waists were 28 inches or less.
Another finding of the study was that for every five-centimeter (about two inches) increase in waist size in subjects with any BMI score, death risk rose by 17 percent for males and 13 percent for females. Comparing waist-to-hip ratios resulted in similar findings.1
The researchers did not study why waist size increases the risk of death, but they theorize that the cause is likely visceral fat. Abdominal fat is usually visceral fat, which accumulates around organs and contributes to the development of the metabolic syndrome and heart disease.
Earlier in 2008, another study was published in the journal Circulation that reached a similar conclusion. In this study, scientists studied 44,636 women participating in the Nurses’ Health Study, to determine if there was an association between abdominal adiposity and all-cause and cause-specific mortality. During 16 years of follow-up, 3,507 deaths occurred, including 751 cardiovascular deaths and 1,748 cancer deaths. The researchers found that among normal-weight women (body mass index 18.5 to greater than 25 kg/m(2)), abdominal obesity was significantly associated with elevated cardiovascular disease mortality. Abdominal obesity also was strongly linked to death from cancer and other causes.2
The study authors concluded, “Measures of abdominal adiposity were strongly and positively associated with all-cause, CVD [cardiovascular disease], and cancer mortality independently of body mass index. Elevated waist circumference was associated with significantly increased CVD mortality even among normal-weight women.”
Abdominal fat not only is unsightly but also is dangerous to our health. Studies show that this type of fat is linked to the metabolic syndrome, cardiovascular disease and premature death.
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- Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, van der Schouw YT, Spencer E, Moons KGM, Tjønneland A, Halkjaer J, and Jensen MK, et al. General and Abdominal Adiposity and Risk of Death in Europe. New England Journal of Medicine. November 13, 2008;359(20):2105-2120. Sc.M.
- Zhang C, Rexrode KM, van Dam RM, Li TY, Hu FB. Circulation. 2008 Apr 1;117(13):1658-67. Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women.