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Waist circumference affects cardiometabolic risk less with increasing age

Nutr Metab Cardiovasc Dis 2008; Advance online publication

A high waist circumference (WC) is associated with increased cardiometabolic risk at all ages, but the association is weakened by advancing age, say researchers.

“It has been suggested that the relatively weak relation between body mass index (BMI) and health risk in the elderly is explained in part by the fact that BMI is a poorer marker of body composition in this age group,” comments investigator Ian Jannsen (Queen’s University, Ontario, Canada).

“WC is a superior marker of abdominal and visceral fat than is BMI, and should be influenced to a lesser degree by age-related muscle loss,” he adds.

In this study, he tested whether the association between high WC and cardiometabolic risk was weakened in older age for 5222 participants of the 1999 to 2004 US National Health and Nutrition Examination Survey aged 20 years and above.

Participants were stratified into three age categories, young – 20–39 years, middle-aged – 40–59 years, and older – 60 years or above. Waist circumference ranged from 86.8 to 104.1 cm.

The cardiometabolic risk factors assessed by Jannsen included high low-density lipoprotein cholesterol, insulin resistance, high C-reactive protein, and hypertension.

As published in the journal Nutrition, Metabolism & Cardiovascular Diseases, Jannsen found that individuals in all three age categories with moderate-to-high WC were significantly more likely to have more cardiometabolic risk factors than those with the lowest WC.

However, the link between WC and cardiometabolic relative risk appeared to be weakened in older participants. The odds ratios for hypertension for individuals with high versus low WC, for example, were 11.07, 3.67, and 2.68, in the young, middle-aged, and older groups, respectively. Other factors showed similar signs of attenuation.

Contrary to expectations, the associations seen for WC were very similar to those observed for BMI. Jannsen suggests this may indicate that high WC conveys a lower health risk for the elderly compared with young people in the general population.

Read the abstract