title: Physical inactivity, abdominal obesity and risk of coronary heart disease in apparently healthy men and women.
abstract: OBJECTIVE
  To test the hypothesis that for any given body mass index (BMI) category, active individuals would have a smaller waist circumference than inactive individuals. Our second objective was to examine the respective contribution of waist circumference and physical inactivity on coronary heart disease (CHD) risk.
  
  
  METHODS
  Prospective, population-based study with an 11.4-year follow-up.
  
  
  METHODS
  A total of 21 729 men and women aged 45-79 years, residing in Norfolk, UK.
  
  
  METHODS
  During follow-up, 2191 CHD events were recorded. Physical activity was evaluated using a validated lifestyle questionnaire that takes into account both leisure-time and work-related physical activity. Waist circumference was measured and BMI was calculated for each participant.
  
  
  RESULTS
  For both men and women, we observed that within each BMI category (<25.0, 25-30 and >or=30.0 kg m(-2)), active participants had a lower waist circumference than inactive participants (P<0.001). In contrast, within each waist circumference tertile, BMI did not change across physical activity categories (except for women with an elevated waist circumference). Compared with active men with a low waist circumference, inactive men with an elevated waist circumference had a hazard ratio (HR) for future CHD of 1.74 (95% confidence interval (CI), 1.34-2.27) after adjusting for age, smoking, alcohol intake and parental history of CHD. In the same model and after further adjusting for hormone replacement therapy use, compared with active women with a low waist circumference, inactive women with an elevated waist circumference had an HR for future CHD of 4.00 (95% CI, 2.04-7.86).
  
  
  CONCLUSIONS
  In any BMI category, inactive participants were characterized by an increased waist circumference, a marker of abdominal adiposity, compared with active individuals. Physical inactivity and abdominal obesity were both independently associated with an increased risk of future CHD.
authors.affiliation: Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada.
authors.forename: B J
authors.initials: BJ
authors.lastname: Arsenault
authors.forename: J S
authors.initials: JS
authors.lastname: Rana
authors.forename: I
authors.initials: I
authors.lastname: Lemieux
authors.forename: J-P
authors.initials: JP
authors.lastname: Després
authors.forename: J J P
authors.initials: JJ
authors.lastname: Kastelein
authors.forename: S M
authors.initials: SM
authors.lastname: Boekholdt
authors.forename: N J
authors.initials: NJ
authors.lastname: Wareham
authors.forename: K-T
authors.initials: KT
authors.lastname: Khaw
mesh_terms: D050153:Abdominal Fat / Q000473:pathology; D000368:Aged; D015992:Body Mass Index; D003327:Coronary Disease / Q000209:etiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D056128:Obesity, Abdominal / Q000150:complications*; D011446:Prospective Studies; D012307:Risk Factors; D057185:Sedentary Behavior; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D006113:United Kingdom; D055105:Waist Circumference