A large waistline doubles your risk of premature death

Having a large waistline can almost double your risk of dying prematurely even if your body mass index is within the 'normal' range, according to a new study of over 350,000 people across Europe, published in the New England Journal of Medicine.

The study provides strong evidence that storing excess fat around the waist poses a significant health risk, even in people not considered to be overweight or obese. 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.

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 120cm or 47.2in for men and more than 100cm or 39.4in for women) compared to subjects with a smaller waist (less than 80cm or 31.5in for men and less than 65cm or 25.6in for women). Body mass index is commonly used to assess if a person is of 'normal' weight.

Each 5cm 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.

Waist to hip ratio varied quite widely in the European populations in the study. In 98 percent of the study population, waist to hip ratio ranged between 0.78 and 1.10 in men and between 0.66 and 0.98 in women. Within these ranges, each 0.1 unit higher waist-hip-ratio was related to a 34% higher mortality risk in men and a 24% higher risk in women.

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.