Even if body mass index is "normal", having a large waistline can almost double your risk of dying prematurely according to a new study published in the New England Journal of Medicine.
Comparing subjects with the same body mass index, the risk of premature death increased in a linear fashion as the waist circumference increased. The risk of premature death was around double for subjects with a larger waist (more than 120 cm or 47.2 in for men and more than 100 cm or 39.4 in for women) compared to subjects with a smaller waist (less than 80 cm or 31.5 in for men and less than 65 cm or 25.6 in for women).
Each 5 cm increase in waist circumference increased the mortality risk by 17% in men and 13% in women.
The ratio of waist to hips was also revealed as an important indicator of health in the study. Lower waist–hip ratios indicate that the waist is comparatively small in relation to the hips. The ratio is calculated by dividing the waist measurement by the hip measurement.
An increased risk of mortality may be particularly related to storing fat around the waistline because fatty tissue in this area secretes cytokines, hormones and metabolically active compounds that can contribute to the development of chronic diseases, particularly cardiovascular diseases and cancers, suggest the authors.
The study does support earlier findings showing that a higher body mass index is significantly related to mortality. The lowest risk of death was at a BMI of approximately 25.3 in men and 24.3 in women.
Professor Elio Riboli, the European coordinator of the European Prospective Investigation into Cancer and Nutrition (EPIC) study from the Department of Epidemiology and Public Health at Imperial College London, said: "Although smaller studies have suggested a link between mortality and waist size, we were surprised to see the waist size having such a powerful effect on people's health and premature death. "
Privatdozent Dr Tobias Pischon, the lead author of the paper from the German Institute of Human Nutrition in Potsdam-Rehbrücke, said: "The most important result of our study is the finding that not just being overweight, but also the distribution of body fat, affects the risk of premature death of each individual. Abdominal fat is not only a mere energy depot, but it also releases messenger substances that can contribute to the development of chronic diseases. This may be the reason for the link."
The new research does not reveal why some people have a larger waist than others but the researchers believe that a sedentary lifestyle, poor diet and genetic predisposition are probably key factors.
It suggests that doctors should measure a patient's waistline and their hips as well as their body mass index as part of standard health checks, according to the researchers, from Imperial College London, the German Institute of Human Nutrition, and other research institutions across Europe.
Professor Riboli added: "The good news is that you don't need to take an expensive test and wait ages for the result to assess this aspect of your health - it costs virtually nothing to measure your waist and hip size. Doctors and nurses can easily identify people who need to take certain steps to improve their health by routinely monitoring these measurements. If you have a large waist, you probably need to increase the amount of exercise you do every day, avoid excessive alcohol consumption and improve your diet. This could make a huge difference in reducing your risk of an early death."
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