Waist, not weight, key to long life

The size of your waist is a more important determinant of health than your weight, doctors have found.

In one of the largest studies conducted of the link between waist size and health, researchers found that having a large waist increased the likelihood of premature death, even in people not considered to be overweight or obese.

People with a large waist – more than 120cm (47.2 in) for men and 100cm (39.4 in) for women – had twice the risk of dying prematurely compared with people who had slender waists – less than 80cm for men and 65cm for women.

Excess weight around the stomach is more harmful than on the legs and hips. The type of fat and where it accumulates is more important than the amount.

The differences applied even to those whose body mass index (BMI), a composite measure of weight and height, was in the normal range. The study was conducted among 350,000 people across Europe and the findings are published in the New England Journal of Medicine.

Professor Elio Riboli, of the Department of Public Health at Imperial College, London, who led the study, said fatty tissue around the middle secreted toxins into the bloodstream that could contribute to the development of chronic conditions such as heart disease and cancer.

"We were surprised to see waist size having such a powerful effect on people's health and premature death. Our study shows that accumulating excess fat around your middle can put your health at risk even if your weight is normal, based on BMi scores. There aren't many simple individual characteristics that can increase a person's risk of premature death to this extent."

The problem is greatest among men. The typical British male has an apple shape, his stomach bulging over his trousers, whereas women tend to the traditional pear shape as they age with weight accumulating on hips and legs.

A pear shape is healthier than an apple shape but women's waists are growing, turning them from pears to apples, research suggests. Each 5cm increase in waist size raised the risk of premature death by 17 per cent in men and 13 per cent in women. The research does not reveal why some people have larger waists than others, but genetic factors are known to play a role. However, doctors say that when you lose weight, the fat around the middle tends to be the first to go.

Professor Riboli, co-ordinator of the European Prospective Investigation into Cancer and Nutrition, one of the largest studies in the world of which the latest research into waist size forms a part, said: "The good news is that it costs virtually nothing to measure your waist and hip size. If you have a large waist you probably need to increase the amount of exercise you do every day, avoid excessive alcohol consumption and improve your diet. This could make a huge difference in reducing your risk of early death."

The study also found that having a narrow waist compared to the hips was linked with health. For every 0.1 increase in the waist to hip ratio, indicating a larger waist in relation to the hips, the risk of premature death increased by a third for men and a quarter for women.

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