How Abdominal Fat Increases Disease RiskMore than 60 years ago, the French physician Jean Vague observed that people with larger waists had a higher risk of premature cardiovascular disease and death than people who had trimmer waists or carried more of their weight around their hips and thighs. (1) Decades later, long-term follow-up studies showed that so-called “abdominal obesity” was strongly associated with an increased risk of type 2 diabetes, cardiovascular disease and death, even after controlling for body mass index (BMI). (2,3) Show Apple- and Pear-Shaped Body TypesAbdominal obesity results in an “apple-shaped” body type, which is more common among men. Women typically accumulate fat around the hips and thighs to develop a “pear shaped” body type (although they can certainly develop “apple-shaped” body types as well).
In people who are not overweight, having a large waist may mean that they are at higher risk of health problems than someone with a trim waist.
The study found that even women at a “normal weight” BMI less than 25 were at a higher risk, if they were carrying more of that weight around their waist: Normal-weight women with a waist of 35 inches or higher had three times the risk of death from heart disease, compared to normal-weight women whose waists were smaller than 35 inches.
What is it about abdominal fat that makes it strong marker of disease risk? The fat surrounding the liver and other abdominal organs, so-called visceral fat, is very metabolically active. It releases fatty acids, inflammatory agents, and hormones that ultimately lead to higher LDL cholesterol, triglycerides, blood glucose, and blood pressure. (6) Which Is Best: Waist or Waist-to-Hip?Scientists have long debated which measure of abdominal fat is the best predictor of health risk: Waist size alone or waist-to-hip ratio.The research to date has been mixed. But adding up the evidence from multiple studies suggests that both methods do an equally good job of predicting health risks.
In practice, it is easier to measure and interpret waist circumference than it is to measure both waist and hip. That makes waist circumference the better choice for many settings. Abdominal Obesity Measurement Guidelines
References1. Vague J. La differentiation sexuelle. Facteur determinant des formes de l’obesit. Press Med. 1947;30:339-40. 2. Ohlson LO, Larsson B, Svardsudd K, et al. The influence of body fat distribution on the incidence of diabetes mellitus. 13.5 years of follow-up of the participants in the study of men born in 1913. Diabetes. 1985;34:1055-8. 3. Larsson B, Svardsudd K, Welin L, Wilhelmsen L, Bjorntorp P, Tibblin G. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. Br Med J (Clin Res Ed). 1984;288:1401-4. 4. Zhang C, Rexrode KM, van Dam RM, Li TY, Hu FB. Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women. Circulation. 2008;117:1658-67. 5. Zhang X, Shu XO, Yang G, et al. Abdominal adiposity and mortality in Chinese women. Arch Intern Med. 2007;167:886-92. 6. Despres JP. Health consequences of visceral obesity. Ann Med. 2001;33:534-41. 7. de Koning L, Merchant AT, Pogue J, Anand SS. Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. Eur.Heart J. 2007;28:850-6. 8. Vazquez G, Duval S, Jacobs DR, Jr., Silventoinen K. Comparison of body mass index, waist circumference, and waist/hip ratio in predicting incident diabetes: a meta-analysis. Epidemiol.Rev. 2007;29:115-28. 9. Qiao Q, Nyamdorj R. Is the association of type II diabetes with waist circumference or waist-to-hip ratio stronger than that with body mass index? Eur J Clin Nutr. 2009. 10. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112:2735-52. 11. International Diabetes Federation. The IDF consensus worldwide definition of metabolic syndrome. Brussels. 2006. 12. World Health Organization. Definition, Diagnosis, and Classification of Diabetes Mellitus and its Complications: Report of a WHO Consultation. Part I: Diagnosis and Classification of Diabetes Mellitus. Geneva: World Health Organization. 1999. Assessed on January 26, 2011. What is a normal size waist for a woman?The average American woman's waist size is 38.7 inches. Also, the average American woman is 63.6 inches tall and weigh 170 pounds. All of these numbers are indicators of health, but not predictors.
Is a 32 inch waist big?A woman's health is at risk if her waist circumference is 32 inches or more. A measurement of 35 or more puts you at high risk for a heart attack or stroke. People with a high level of abdominal fat have a much higher chance of developing cardiovascular disease and type 2 diabetes.
What is a healthy waist size for my height?Ideally, your waist measurement should be less than half of your height. (So if you're 5 foot 6, or 66 inches, your waist circumference should be less than 33 inches.)
Is a 28 inch waist big?There is no one "normal" waist size, as everyone's body is different. However, a 28-inch waist size for someone who is 5'1" would be considered relatively small. This does not mean that you are fat or at all at your waist; it simply means that your waist circumference is smaller than average.
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