Waist Circumference and Mortality

Koster, Annemarie; Leitzmann, Michael F.; Schatzkin, Arthur; Mouw, Traci; Adams, Kenneth; Eijk, J.T.M. van; Hollenbeck, Albert R.; Harris, Tamara B.

doi:10.1093/aje/kwn079

Cited by 184 publications

(154 citation statements)

References 29 publications

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“…47,48 Regular physical activity and normal weight have been shown to be associated with a reduced risk of all-cause mortality, cardiovascular disease and cancer. 49 Increased fitness has been shown to have similar effects independently of body weight status, 50 further underlining the importance of the long-term health effects of habitual physical activity.…”

Section: Discussionmentioning

confidence: 99%

Leisure-time physical activity and high-risk fat: a longitudinal population-based twin study

et al. 2009

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Background and Objective: Exercise is thought to reduce high-risk body fat, but intervention studies are frequently limited by short follow-ups and observational studies by genetic selection. Therefore, we studied the effects of a physically inactive vs active lifestyle on high-risk (visceral, liver and intramuscular) fat in twin pairs discordant for leisure-time physical activity habits for over 30 years. Design: A longitudinal population-based twin study. Subjects: Sixteen middle-aged (50-74 years) same-sex twin pairs (seven monozygotic (MZ), nine dizygotic (DZ)) with longterm discordance for physical activity habits were comprehensively identified from the Finnish Twin Cohort (TWINACTIVE study). Discordance was initially defined in 1975 and the same co-twin remained significantly more active during the 32-yearlong follow-up. Main Outcome Measures: Magnetic resonance imaging-assessed visceral, liver and intramuscular fat. Results: In within-pair analyses carried out after the adult life-long discordance in physical activity habits, the physically inactive co-twins had 50% greater visceral fat area compared with the active co-twins (mean difference 55.5 cm 2 , 95% confidence interval (CI) 7.0-104.1, P ¼ 0.010). The liver fat score was 170% higher (13.2, 95% CI 3.5-22.8, P ¼ 0.030) and the intramuscular fat area 54% higher (4.9 cm 2 , 95% CI 1.9-7.9, P ¼ 0.002) among the inactive co-twins. All the trends were similar for MZ and DZ pairs. Peak oxygen uptake was inversely associated with visceral (r ¼ À0.46, P ¼ 0.012) and intramuscular fat area (r ¼ À0.48, P ¼ 0.028), with similar trends in intrapair difference correlations (r ¼ À0.57, P ¼ 0.021 and r ¼ À0.50, P ¼ 0.056, respectively). The intrapair difference correlation between visceral and intramuscular fat was also high (r ¼ 0.65, P ¼ 0.009). Conclusion: Regular physical activity seems to be an important factor in preventing the accumulation of high-risk fat over time, even after controlling for genetic liability and childhood environment. Therefore, the prevention and treatment of obesity should emphasize the role of regular leisure-time physical activity.

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Section: Discussionmentioning

confidence: 99%

Leisure-time physical activity and high-risk fat: a longitudinal population-based twin study

et al. 2009

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“…Abdominal obesity has been shown to be a risk factor for CVD and diabetes (Balkau et al, 2007a;Janiszewski et al, 2007). A large cohort study (Koster et al, 2008) showed that increased WC should be considered a risk factor for mortality, in addition to BMI. In our study, the prevalence of abdominal obesity in middle-aged women was obviously higher than that in young women.…”

Section: Discussionmentioning

confidence: 99%

Body mass index, waist circumference, and cardiometabolic risk factors in young and middle-aged Chinese women

Xiao

Song

Zhao

et al. 2010

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To assess the associations between body mass index (BMI), waist circumference (WC), and cardiometabolic risk factors in young and middle-aged Chinese women. Methods: A total of 3011 women (1938 young women, 1073 middle-aged women), who visited our health care center for a related health checkup, were eligible for study. BMI and WC were measured. The subjects were divided into normal and overweight/obesity groups based on BMI, and normal and abdominal obesity groups based on WC. Cardiometabolic variables included triglyceride (TG), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), and blood pressure (BP). Results: The prevalence of overweight/obesity was significantly higher in middle-aged women (32.4%) than in young women (12.0%). The prevalence of abdominal obesity was also higher in middle-aged women (60.3%) than in young women (36.2%). There were significant differences in the comparison of all related cardiometabolic variables between different BMI (or WC) categories in young and middleaged women groups, respectively. After adjustment for age, partial correlation analysis indicated that both BMI and WC were correlated significantly with all related cardiometabolic variables. After adjustment for age and WC, although the correlation coefficient r′ was attenuated, BMI was still correlated significantly with all related cardiometabolic variables in young and middle-aged women. After adjustment for age and BMI, partial correlation analysis showed that WC was correlated significantly with TG, FBG, HOMA-IR, and HDL-C in young women and significantly with TG, HOMA-IR, and HDL-C in middle-aged women. Conclusions: The prevalence of overweight/obesity and abdominal obesity was high in Chinese young and middle-aged women. BMI was a better predictor of cardiovascular disease and diabetes than WC in young and middle-aged women, and moreover, measurement of both WC and BMI may be a better predictor of cardiovascular disease and diabetes mellitus than BMI or WC alone.

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“…Although usually highly correlated with BMI, there are data to suggest that waist circumference and/or WHR may predict health problems independently of BMI, as in diabetes mellitus (Gastaldelli, 2008) and CVD (Yusuf et al, 2005). Furthermore, there is accumulating evidence for a role of waist circumference (Visscher et al, 2001;Koster et al, 2008) and WHR (Lahmann et al, 2002;Price et al, 2006) in predicting mortality independently of BMI in men. A post hoc analysis of total PCa in the present cohort shows that the increased PCa risk associated with large waist circumference seemed to be greatest at low BMI (data not shown), a finding that was not explained by prevalent asymptomatic cancer.…”

Section: Discussionmentioning

confidence: 99%

A prospective Swedish study on body size, body composition, diabetes, and prostate cancer risk

et al. 2009

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Obesity may be associated with increased risk of prostate cancer (PCa). According to one hypothesis, obesity could lower the risk of non-aggressive tumours, while simultaneously increasing the risk of aggressive cancer. Furthermore, central adiposity may be independently associated with PCa risk; it is also associated with diabetes, which itself may influence risk of PCa. We studied the associations between height, body composition, and fat distribution, diabetes prevalence and risk of total, aggressive, and nonaggressive PCa in 10 564 initially cancer-free men (aged 45 -73 years) of the population-based Malmö Diet and Cancer cohort. Anthropometric and body composition measurements, including bioelectrical impedance for estimation of fat mass, were performed by study nurses. Diabetes prevalence was self-reported. Cancer cases and clinical characteristics were ascertained through national and regional registry data. Dietary and other background data were obtained through a modified diet history method and an extensive questionnaire. During a mean follow-up of 11.0 years, 817 incidental PCa cases were diagnosed. Of these, 281 were classified as aggressive. There were 202 cases occurring before 65 years of age. Height was positively associated with total and nonaggressive PCa risk. Waist -hip ratio (WHR), a measure of central adiposity, was positively associated with PCa before age 65, and less strongly, with total PCa. This association was independent of body mass index (BMI) and other potential confounders. General adiposity, expressed as BMI or body fat percentage, and prevalent diabetes were not associated with PCa risk. In this study, WHR and body height were stronger PCa predictors than general adiposity.

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Waist Circumference and Mortality

Cited by 184 publications

References 29 publications

Leisure-time physical activity and high-risk fat: a longitudinal population-based twin study

Leisure-time physical activity and high-risk fat: a longitudinal population-based twin study

Body mass index, waist circumference, and cardiometabolic risk factors in young and middle-aged Chinese women

A prospective Swedish study on body size, body composition, diabetes, and prostate cancer risk

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