Re: Waist-to-Hip Ratio

[Guest guest]

Hi folks:

The following is the abstract (previously posted here I am fairly

sure) of the 52 country, 'InterHeart', case-control study which found

waist-to-hip ratio to be far superior to BMI as a measure of heart

attack risk:

" Obesity and the risk of myocardial infarction in 27,000 participants

from 52 countries: a case-control study.

BACKGROUND: Obesity is a major risk factor for cardiovascular

disease, but the most predictive measure for different ethnic

populations is not clear. We aimed to assess whether markers of

obesity, especially waist-to-hip ratio, would be stronger indicators

of myocardial infarction than body-mass index (BMI), the conventional

measure. METHODS: We did a standardised case-control study of acute

myocardial infarction with 27 098 participants in 52 countries

(12,461 cases and 14,637 controls) representing several major ethnic

groups. We assessed the relation between BMI, waist and hip

circumferences, and waist-to-hip ratio to myocardial infarction

overall and for each group. FINDINGS: BMI showed a modest and graded

association with myocardial infarction (OR 1.44, 95% CI 1.32-1.57 top

quintile vs bottom quintile before adjustment), which was

substantially reduced after adjustment for waist-to-hip ratio (1.12,

1.03-1.22), and non-significant after adjustment for other risk

factors (0.98, 0.88-1.09). For waist-to-hip ratio, the odds ratios

for every successive quintile were significantly greater than that of

the previous one (2nd quintile: 1.15, 1.05-1.26; 3rd quintile: 1.39;

1.28-1.52; 4th quintile: 1.90, 1.74-2.07; and 5th quintiles: 2.52,

2.31-2.74 [adjusted for age, sex, region, and smoking]). Waist

(adjusted OR 1.77; 1.59-1.97) and hip (0.73; 0.66-0.80)

circumferences were both highly significant after adjustment for BMI

(p<0.0001 top vs bottom quintiles). Waist-to-hip ratio and waist and

hip circumferences were closely (p<0.0001) associated with risk of

myocardial infarction even after adjustment for other risk factors

(ORs for top quintile vs lowest quintiles were 1.75, 1.33, and 0.76,

respectively). The population-attributable risks of myocardial

infarction for increased waist-to-hip ratio in the top two quintiles

was 24.3% (95% CI 22.5-26.2) compared with only 7.7% (6.0-10.0) for

the top two quintiles of BMI. INTERPRETATION: Waist-to-hip ratio

shows a graded and highly significant association with myocardial

infarction risk worldwide. Redefinition of obesity based on waist-to-

hip ratio instead of BMI increases the estimate of myocardial

infarction attributable to obesity in most ethnic groups. "

PMID: 16271645

So it would be really great if we had a larger number of waist-to-hip

measurements to look at in Francesca's database table, so we can get

an idea of the range we should all be aiming at.

Rodney.

--- In , " Rodney " <perspect1111@...>

wrote:

>

> Hi folks:

>

> From the Lancet cover story on the inadequacy of BMI:

>

> " A raised waist-to-hip ratio increased population-attributable

> [myocardial infarction] risk from obesity by more than three-fold

> compared with BMI. "

>

> PLEASE FOLKS:

>

> FOR THOSE OF YOU WHO HAVE ADDED YOUR PERSONAL DATA TO THE DATABASE

> HERE, BUT WHO HAVE NOT ENTERED YOUR WAIST-TO-HIP RATIO ........

>

> (Lot's of people haven't done that because that data column was

only

> added to the table some time after the table was first put together

> by Francesca.)

>

> So it would be really helpful if you did pleeeease!

>

> " Waist " is defined as the narrowest circumference below your neck

and

> above your hip; " hip " is defined as your greatest circumference

below

> your waist.

>

> Thanks, folks.

>

> Rodney.

>

[Guest guest]

I updated my numbers.

I seriously doubt there's anything there for me to "aim" at.

96 yo a better goal.

Regards.

[ ] Re: Waist-to-Hip Ratio

So it would be really great if we had a larger number of waist-to-hip measurements to look at in Francesca's database table, so we can get an idea of the range we should all be aiming at.Rodney.

..

[Guest guest]

Hi JW:

Well just for clarification ........... for people who are using

some easily determined benchmark as a target they are aiming for as

perhaps representing, for them, 'established CRON' - as I have been

for example - one of the easiest to calculate is BMI. I have been

targeting a BMI of 21.

Of course it is better to look at more than just one benchmark. But

what that study suggests is that, of the very-simple-to-determine

every day measures, 'waist-to-hip' ratio is much more closely

correlated than BMI with CVD incidence (which is even better than

having something which is related to CVD *risk*, because there is

always some uncertainty as to how reliably risk measures will be

related to incidence). And that may imply that using waist-to-hip

makes sense because we know for certain that CVD risk reduction is a

major benefit of CRON. So it might not unreasonably be implied that

waist-to-hip may also be more closely related to CRON than BMI.

Of course, no dispute, better still would be to use not only things

like BMI, waist-to-hip, and waist-to-height, which are trivial to

calculate, but also BF%, lipids data, measures of inflammation (which

are correlated with cancer risk) and so on. But for most people the

latter are not readily available at a moment's notice.

Rodney.

--- In , " jwwright " <jwwright@...>

wrote:

>

> I updated my numbers.

> I seriously doubt there's anything there for me to " aim " at.

> 96 yo a better goal.

>

> Regards.

>

> [ ] Re: Waist-to-Hip Ratio

>

>

>

> So it would be really great if we had a larger number of waist-to-

hip

> measurements to look at in Francesca's database table, so we can

get

> an idea of the range we should all be aiming at.

>

> Rodney.

>

>

> .

>