Waist and hip circumference is a predictor of chronic disease. Centrally located fat distribution is linked to both physical and mental dysfunctions. Both waist and hip size can be measured at our convenience.
There isn’t a universal agreement to define a healthy waist size or guidelines to determine an age specific size. The need for age-specific waist size cannot be known. What is known is both waist size and risk of chronic diseases increase with age.
Waist and Hip Physical Health
Excess fat is a well established risk factor for a variety of chronic diseases and early death. Total fat and fat distribution appear to affect morbidity and mortality. High amounts of visceral body fat measured by waist circumference have been found to be a better predictor of overweight related risk factors than body mass index (BMI). Waist to Hip Ratio has been found to predict health outcomes.
Research has mostly focused on waist circumference as a health predictor due to the accumulation of visceral fat. Waist to Hip ratio could also be ascribed to smaller hip circumference especially in women. Women hip circumference tend to vary more than men over time when adjustments are made for height and weight. Women with smaller hip circumference are associated with increased risk of heart disease, myocardial infarction and diabetes. At this time, no longitudinal studies have examined the effects of chronic diseases over time, as women hip size tend to change with age. Additionally, similar results have not been correlated with men where waist size is a greater health predictor.
Waist and Hip Mental Health
Dementia is a major public health concern due to our rapidly aging population. Dementia currently affects 1% to 6% of the population over 65, with the incident rate doubling for those over 75 years old. Alzheimer is the most common form of dementia, affecting approximately 4 million people in the U.S. Alzheimer risk factors include family history, genetic predisposition, and studies are beginning to examine vascular disorders like atherosclerosis, hypertension, heart disease and diabetes.
Women are 1.5 times more likely to develop Alzheimer than men. Being overweight increases the risk of vascular disorders and can increase the likelihood of dementia. Increased weight gain is a risk factor for older women developing Alzheimer and associated with poor cognitive function in men.
Studies show that higher visceral fat and waist to hip measurement is associated with higher cognitive function in older postmenopausal women. However, higher waist to hip measurement does increase women risk for heart disease, hypertension and diabetes which can increase the risk for dementia.
Waist and Hip Body Fat
There are substantial differences in body composition in men and women, with women having higher levels of body fat. Fat distribution also differs by gender; men’s fat tend to be centrally located. In both men and women, waist and waist to hip ratio increase with age. Weight gain drives the increases. Waist circumference is seen in aging adult’s absence of weight gain. Younger adult’s waist size increase more than older adults, probably due to greater weight gains during young adulthood. With weight gain, waist size and waist-to-hip ratio increase, but men have larger increases in waist circumference with weight gain than women.
One of the best tools to determine future health outcomes is available to everyone on an ongoing and regular basis. For the price of a simple tape measure, we can regularly check our progress. Of course, this does not eliminate medical or mental health professionals. In an era where patient engagement is high on everyone’s mind, measuring waist and hip circumference is patient centered.
Stevens, J., Katz, E., & Huxley, R. (2010). Associations between gender, age and waist circumference. European Journal of Clinical Nutrition, 64(1), 6-15 10p. doi:10.1038/ejcn.2009.101
Conway, B., Xiang, Y., Villegas, R., Zhang, X., Li, H., Wu, X., & … Shu, X. (2011). Hip Circumference and the Risk of Type 2 Diabetes in Middle-Aged and Elderly Men and Women: The Shanghai Women and Shanghai Men’s Health Studies. Annals of Epidemiology, 21358-366. doi:10.1016/j.annepidem.2011.02.005
Fagherazzi, G., Chabbert-Buffet, N., Fabre, A., Guillas, G., Boutron-Ruault, M., Mesrine, S., & Clavel-Chapelon, F. (2012). Hip circumference is associated with the risk of premenopausal ER−/PR− breast cancer. International Journal of Obesity, 36(3), 431-439. doi:10.1038/ijo.2011.66
Kerwin, D., Zhang, Y., Kotchen, J., Espeland, M., Van Horn, L., McTigue, K., & … Hoffmann, R. (2010). The cross-sectional relationship between body mass index, waist-hip ratio, and cognitive performance on postmenopausal women enrolled in the Women’s Health Initiative. Journal of The American Geriatrics Society, 58(8), 1427-1432 6p. doi:10.1111/j.1532-5415.2010.02969.x
Limpawattana, P., Kengkijkosol, T., Assantachai, P., Krairit, O., & Pimporm, J. (2014). The Performance of Obesity Screening Tools Among Young Thai Adults. Journal of Community Health, 39(6), 1216-1221 6p. doi:10.1007/s10900-014-9881-3
Basri, R., Shaik, M. M., Alam, M. K., Mondol, M. A., Mohammad, Q. D., & Siew Hua, G. (2013). Waist to Hip Ratio, Waist to Height Ratio and Body Mass Index Predict Stroke Risk in a Bangladeshi Population. International Medical Journal, 20(6), 740-743 4p.
Lanfer, A., Mehlig, K., Heitmann, B. L., & Lissner, L. (2014). Does change in hip circumference predict cardiovascular disease and overall mortality in Danish and Swedish women? Obesity (19307381), 22(3), 957. doi:10.1002/oby.20604
Hajian-Tilaki, K., Heidari, B., Hajian-Tilaki, A., Firouzjahi, A., & Bagherzadeh, M. (2014). The Discriminatory Performance of Body Mass Index, Waist Circumference, Waist-To-Hip Ratio and Waist-To-Height Ratio for Detection of Metabolic Syndrome and Their Optimal Cutoffs among Iranian Adults. Journal of Research In Health Sciences, 14(4), 276-281 6p.
Young-Hyo, L., Jihye, C., Kyung Rae, K., Jinho, S., Kyung Gyun, H., Seungho, R., & Seok Hyun, C. (2014). Sex-Specific Characteristics of Anthropometry in Patients With Obstructive Sleep Apnea: Neck Circumference and Waist-Hip Ratio. Annals of Otology, Rhinology & Laryngology, 123(7), 517-523 7p. doi:10.1177/0003489414526134