Increase in waist circumference over 6 years predicts subsequent cardiovascular disease and total mortality in nordic women.
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.
Department of Public Health and Community Medicine, Section for Epidemiology and Social Medicine (EPSO), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Sofia
S
Klingberg
Department of Public Health and Community Medicine, Section for Epidemiology and Social Medicine (EPSO), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Kirsten
K
Mehlig
Department of Public Health and Community Medicine, Section for Epidemiology and Social Medicine (EPSO), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Anne
A
Lanfer
Department of Public Health and Community Medicine, Section for Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Cecilia
C
Björkelund
Research Unit for Dietary Studies, the Parker Institute and the Institute of Preventive Medicine, Bispebjerg and Fredriksberg Hospitals, the Capital Region, Denmark.|Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark.|National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.|The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, the University of Sydney, Sydney, Australia.
Berit L
BL
Heitmann
Department of Public Health and Community Medicine, Section for Epidemiology and Social Medicine (EPSO), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Lauren
L
Lissner
D050218:Body Fat Distribution / Q000009:adverse effects*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009664:Norway; D011446:Prospective Studies; D016019:Survival Analysis; D013548:Sweden; D055105:Waist Circumference / Q000208:ethnology*