General and Abdominal Adiposity and Risk of Death in Europe

Moral of the story: Not only does your general BMI and fat percentage matter to your health, but abdominal fat deposits are a separate risk factor. In addition to making sure your BMI falls within the acceptable range for your gender (link here: BMI information and calculator from the CDC) you should make sure your waist size is reasonable. General aerobic exercise is excellent for your health, but spend a little extra time slimming that waist.

The full article can be accessed here

General and Abdominal Adiposity and Risk of Death in Europe
T. Pischon, M.D., M.P.H., H. Boeing, Ph.D., M.S.P.H., K. Hoffmann, Ph.D., M. Bergmann, Ph.D., M.B. Schulze, Dr.P.H., K. Overvad, M.D., Ph.D., Y.T. van der Schouw, Ph.D., E. Spencer, Ph.D., K.G.M. Moons, Ph.D., A. Tjønneland, M.D., Ph.D., Dr.Med.Sci., J. Halkjaer, Ph.D., M.K. Jensen, Ph.D., J. Stegger, M.D., F. Clavel-Chapelon, Ph.D., M.-C. Boutron-Ruault, Ph.D., V. Chajes, Ph.D., J. Linseisen, Ph.D., R. Kaaks, Ph.D., A. Trichopoulou, M.D., Ph.D., D. Trichopoulos, M.D., Ph.D., C. Bamia, Ph.D., S. Sieri, Ph.D., D. Palli, M.D., R. Tumino, M.D., P. Vineis, M.D., M.P.H., S. Panico, M.D., M.Sc., P.H.M. Peeters, M.D., Ph.D., A.M. May, Ph.D., H.B. Bueno-de-Mesquita, M.D., Ph.D., M.P.H., F.J.B. van Duijnhoven, Ph.D., G. Hallmans, M.D., L. Weinehall, M.D., Ph.D., J. Manjer, M.D., Ph.D., B. Hedblad, M.D., Ph.D., E. Lund, M.D., Ph.D., A. Agudo, Ph.D., L. Arriola, Ph.D., A. Barricarte, Ph.D., C. Navarro, M.D., Ph.D., C. Martinez, M.D., J.R. Quirós, M.D., T. Key, D.Phil., S. Bingham, Ph.D., K.T. Khaw, M.B., B.Chir., P. Boffetta, M.D., M.P.H., M. Jenab, Ph.D., P. Ferrari, Ph.D., and E. Riboli, M.D., M.P.H., Sc.M.

ABSTRACT

Background Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death.

Methods We examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). We used a Cox regression analysis, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height.

Results During a mean follow-up of 9.7 years, 14,723 participants died. The lowest risks of death related to BMI were observed at a BMI of 25.3 for men and 24.3 for women. After adjustment for BMI, waist circumference and waist-to-hip ratio were strongly associated with the risk of death. Relative risks among men and women in the highest quintile of waist circumference were 2.05 (95% confidence interval [CI], 1.80 to 2.33) and 1.78 (95% CI, 1.56 to 2.04), respectively, and in the highest quintile of waist-to-hip ratio, the relative risks were 1.68 (95% CI, 1.53 to 1.84) and 1.51 (95% CI, 1.37 to 1.66), respectively. BMI remained significantly associated with the risk of death in models that included waist circumference or waist-to-hip ratio (P<0.001).

Conclusions These data suggest that both general adiposity and abdominal adiposity are associated with the risk of death and support the use of waist circumference or waist-to-hip ratio in addition to BMI in assessing the risk of death.

Source Information

The authors' affiliations are listed in the Appendix.

Dr. Kurt Hoffmann is deceased.

Address reprint requests to Dr. Tobias Pischon at the Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany, or at pischon@dife.de.