Body fat distribution associated with mortality risk
Wednesday, Nov. 12, 2008; 5:26 PM
According to the report in The New England Journal of Medicine for November 13, both waist circumference and the waist-to-hip ratio were independent predictors of mortality in a study that began in 1992.
Most studies have used body mass index (BMI: the ratio of height to weight) to gauge the impact of body fat on mortality, so it was unclear if the distribution of body fat per se had an effect on the risk, Dr. Tobias Pischon, from the German Institute of Human Nutrition, Potsdam-Rehbruecke, and colleagues explain.
To investigate this topic, the research team analyzed BMI, waist circumference and waist-to-hip ratio data from 359,387 subjects from nine countries who were enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC). During an average follow-up of 9.7 years, 14,723 of the subjects died.
A J-shaped curve was noted between BMI and mortality. A BMI of 25.3 in men and 24.3 in women carried the lowest risks of death, the report indicates.
After accounting for BMI, waist circumference and waist-to-hip ratio also showed J-shaped curves with respect to mortality. In men, those with the highest waist circumference and waist-to-hip ratio conferred a relative mortality risk of 2.05 and 1.68, respectively, compared with men with the lowest percentage. In women, the corresponding relative risks were 1.78 and 1.51.
Nonetheless, BMI was still a significant predictor of death in models that accounted for the influence of waist circumference or waist-to-hip ratio.
"The results support the use of waist circumference or waist-to-hip ratio in addition to BMI in the assessment of the risk of death, particularly among persons with a low BMI," the authors conclude.
SOURCE: The
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