Increase in waist circumference over 6 years predicts subsequent cardiovascular disease and total mortality in nordic women

• Published in: Obesity (Silver Spring, Md.) Md.), 2015-10, Vol.23 (10), p.2123-2130
• Main Authors: Klingberg, Sofia, Mehlig, Kirsten, Lanfer, Anne, Björkelund, Cecilia, Heitmann, Berit L., Lissner, Lauren
• Format: Article
• Language: English
• Subjects: Abdomen; Body Fat Distribution - adverse effects; Body Mass Index; Cardiovascular disease; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; Cohort Studies; Female; Females; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Health risk assessment; Hospitals; Humans; Longitudinal Studies; Middle Aged; Morbidity; Mortality; Norway; Prospective Studies; Public Health, Global Health, Social Medicine and Epidemiology; Studies; Survival Analysis; Sweden; Waist Circumference - ethnology; Womens health
• ISSN: 1930-7381; 1930-739X; 1930-739X
• DOI: 10.1002/oby.21203

Objective Despite solid evidence of an association between centralized body fatness and subsequent disease risk, little is known about the consequences of changes in body fat distribution. Recently it was shown that large hip circumference (HC), measured once, was protective against total and cardiovascular disease (CVD) mortality in women but that gain or loss in HC was unrelated to these outcomes. This study examines whether a 6‐year change in waist circumference (WC) predicts mortality and CVD in the same study sample. Methods Baseline WC and 6‐year change in WC as predictors of mortality and CVD were analyzed in 2,492 women from the Danish MONICA study and the Prospective Population Study of Women in Gothenburg, Sweden. Results Increase in WC was significantly associated with increased subsequent mortality and CVD adjusting for BMI and other covariates, with some evidence of a J‐shaped association. Associations between increase in WC and outcomes were restricted to women with normal weight at baseline and to ever‐smokers. Conclusions In contrast to changes in HC which did not predict mortality and CVD, a 6‐year increase in WC is strongly predictive, particularly among initially lean women and ever‐smokers. This implies the importance of developing strategies to prevent central fat deposition.