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Original Research Communication |
1 From the Department of Chronic Diseases Epidemiology, National Institute of Public Health and the Environment, Bilthoven, Netherlands, and the Institute for Research in Extramural Medicine, Free University, Amsterdam; the Division of Kinesiology, Department of Preventive Medicine, Laval University, Sainte Foy, Canada; the Lipid Research Center, Laval University Medical Research Center, Sainte Foy, Canada; and the Pennington Biomedical Research Center, Louisiana State University, Baton Rouge.
Background: A high waist-to-hip ratio is associated with unfavorable cardiovascular disease risk factors. This could be due to either a relatively large waist or a small hip girth.
Objective: We sought to define the separate contributions of waist girth, hip girth, and body mass index (BMI) to measures of body composition, fat distribution, and cardiovascular disease risk factors.
Design: Three-hundred thirteen men and 382 women living in the greater Quebec City area were involved in this cross-sectional study. Percentage body fat, anthropometric measurements, and abdominal fat distribution were obtained and BMI (in kg/m2) and waist-to-hip ratio were calculated. Serum blood lipids were determined from blood samples collected after subjects had fasted overnight
Results: A large waist circumference in men and women (adjusted for age, BMI, and hip circumference) was associated significantly with low HDL-cholesterol concentrations (P < 0.05) and high fasting triacylglycerol, insulin, and glucose concentrations (P < 0.01). In women alone, a large waist circumference was also associated with high LDL-cholesterol concentrations and blood pressure. A narrow hip circumference (adjusted for age, BMI, and waist circumference) was associated with low HDL-cholesterol and high glucose concentrations in men (P < 0.05) and high triacylglycerol and insulin concentrations in men and women (P < 0.05). Waist and hip girths showed different relations to body fat, fat-free mass, and visceral fat accumulation.
Conclusions: Waist and hip circumferences measure different aspects of body composition and fat distribution and have independent and often opposite effects on cardiovascular disease risk factors. A narrow waist and large hips may both protect against cardiovascular disease. These specific effects of each girth measure are poorly captured in the waist-to-hip ratio.
Key Words: Waist circumference • hip circumference • waist-to-hip ratio • body mass index • cardiovascular disease risk factors • fat distribution • cholesterol • insulin • blood pressure • Quebec Family Study
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