title: Dietary determinants of changes in waist circumference adjusted for body mass index - a proxy measure of visceral adiposity.
abstract: BACKGROUND
  Given the recognized health effects of visceral fat, the understanding of how diet can modulate changes in the phenotype "waist circumference for a given body mass index (WC(BMI))", a proxy measure of visceral adiposity, is deemed necessary. Hence, the objective of the present study was to assess the association between dietary factors and prospective changes in visceral adiposity as measured by changes in the phenotype WC(BMI).
  
  
  RESULTS
  We analyzed data from 48,631 men and women from 5 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthropometric measurements were obtained at baseline and after a median follow-up time of 5.5 years. WC(BMI) was defined as the residuals of waist circumference regressed on body mass index, and annual change in WC(BMI) (DeltaWC(BMI), cm/y) was defined as the difference between residuals at follow-up and baseline, divided by follow-up time. The association between energy, energy density (ED), macronutrients, alcohol, glycemic index (GI), glycemic load (GL), fibre and DeltaWC(BMI) was modelled using centre-specific adjusted linear regression, and random-effects meta-analyses to obtain pooled estimates. Men and women with higher ED and GI diets showed significant increases in their WC(BMI), compared to those with lower ED and GI [1 kcal/g greater ED predicted a DeltaWC(BMI) of 0.09 cm (95% CI 0.05 to 0.13) in men and 0.15 cm (95% CI 0.09 to 0.21) in women; 10 units greater GI predicted a DeltaWC(BMI) of 0.07 cm (95% CI 0.03 to 0.12) in men and 0.06 cm (95% CI 0.03 to 0.10) in women]. Among women, lower fibre intake, higher GL, and higher alcohol consumption also predicted a higher DeltaWC(BMI).
  
  
  CONCLUSIONS
  Results of this study suggest that a diet with low GI and ED may prevent visceral adiposity, defined as the prospective changes in WC(BMI). Additional effects may be obtained among women of low alcohol, low GL, and high fibre intake.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. d.romaguera-bosch@imperial.ac.uk
authors.forename: Dora
authors.initials: D
authors.lastname: Romaguera
authors.forename: Lars
authors.initials: L
authors.lastname: Angquist
authors.forename: Huaidong
authors.initials: H
authors.lastname: Du
authors.forename: Marianne Uhre
authors.initials: MU
authors.lastname: Jakobsen
authors.forename: Nita G
authors.initials: NG
authors.lastname: Forouhi
authors.forename: Jytte
authors.initials: J
authors.lastname: Halkjaer
authors.forename: Edith J M
authors.initials: EJ
authors.lastname: Feskens
authors.forename: Daphne L
authors.initials: DL
authors.lastname: van der A
authors.forename: Giovanna
authors.initials: G
authors.lastname: Masala
authors.forename: Annika
authors.initials: A
authors.lastname: Steffen
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.forename: Thorkild I A
authors.initials: TI
authors.lastname: Sørensen
mesh_terms: D050153:Abdominal Fat / Q000378:metabolism; D050154:Adiposity / Q000502:physiology*; D015992:Body Mass Index; D004043:Dietary Fiber; D002149:Energy Intake; D005260:Female; D005502:Food; D038321:Glycemic Index; D006801:Humans; D008297:Male; D055105:Waist Circumference