Predictors of increasing waist circumference in an Australian population

Abstract

Objective: To identify predictors of increasing waist circumference (WC) over a 5-year period in a contemporary population of Australian adults. Design: Longitudinal national cohort of adults participating in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Settings: Australian adults in 2000 and 2005. Subjects: A total of 2521 men and 2726 women aged $25 years at baseline who participated in AusDiab and provided anthropometric measurements at baseline (1999)(2000) and follow-up (2005). Results: A $5 % increase of baseline WC occurred in 27 % of men and 38 % of women over the 5-year period. In the multivariate analysis of the total population, there was a higher risk of $5 % gain in baseline WC in women, younger people, people with a lower baseline WC, people who never married compared with married/de facto, current smokers compared with never smokers, people with a poorer diet quality and people with a low energy intake. However, there was no significant association with many expected predictors of waist gain such as physical activity. There were some associations between other lifestyle factors and change of WC by sex, age, level of education and across WC categories, but the associations differed across these groups. Conclusions: A $5 % increase of baseline WC occurred in a significant proportion of men and women over the 5-year period. Of the behavioural factors, poor diet quality was the key predictor of the $5 % increase of baseline WC in this cohort. The findings highlight the need to understand better the causal role of lifestyle in regard to increasing WC over time. Keywords Waist circumferenceWeight gain Obesity Predictors DietRecent reports have shown faster increases in waist circumference (WC) than BMI (1,2) , suggesting that the nature of excess body weight may be changing over time to one of greater central adiposity, rather than a more peripheral distribution of body fat (1,2) . This has significant implications, considering that WC measures the central or abdominal distribution of excess body fat, which appears to be strongly correlated with metabolic and cardiovascular risk (3,4) . However, little is known about the drivers of increases in WC. Few studies have examined the predictors of increasing weight in adults, and we are not aware of any that have examined a range of behavioural lifestyle factors potentially predictive of abdominal weight gain. Table 1 summarises those studies exploring predictors of change in BMI, weight and/or WC. The only study we were able to source that explored behavioural predictors of change in WC examined a limited selection of predictors in women (5) . Previous cross-sectional analyses have found lifestyle factors such as higher television (TV) viewing time and lower levels of physical activity to be associated with higher WC (6)(7)(8)(9) , and studies analysing predictors of gain in BMI/weight have found associations with factors such as higher TV viewing time and lower levels of physical activity (5,(10)(11)(12)(13)(14) . Sternfeld et al...

Predictors of change in weight and waist circumference: 15-year longitudinal study in Australian adults

“…27 Our findings are in agreement with such a pattern. However, it is noteworthy that our data suggest that women continued to gain weight and WC until an older age compared to men, a finding which corresponds with earlier longitudinal studies 28,29 and may be partly explained by changes due to the menopausal transition in women in this age group. 30 Age-related weight gain has been shown to occur even among physically active people.…”

Joint associations of poor diet quality and prolonged television viewing time with abnormal glucose metabolism in Australian men and women

“…Previous research has also shown that diet quality is associated with risk of type 2 diabetes in women, independent of central adiposity (Fung et al, 2007). Poor diet quality has been shown to be the strongest behavioural predictor of gain in waist circumference over five years (Walls et al, 2011). Taken together, this study further highlights that improving diet quality in line with national dietary guidelines is an important public health target for improving glycemic health and preventing obesity, particularly for women.…”

Predictors of increased body weight and waist circumference for middle-aged adults

“…While consensus is forming around the role of specific dietary elements and markers of physical activity and inactivity associated with increased weight gain (1)(2)(3) , few studies have analysed predictors of increasing waist circumference (4)(5)(6)(7) and the majority of these have focused solely on dietary factors.…”

“…Further, there is evidence that waist circumference is increasing at a faster rate than BMI (7,9) , suggesting that there may be differential drivers of BMI and waist circumference. A recent analysis of cohorts in the European Prospective Investigation into Cancer and Nutrition suggested that specific dietary elements may predict changes in waist circumference independent of changes in BMI (5) .…”