Overweight and a large waist circumference increase the risk of premature death. This is the conclusion of researchers involved in the European Prospective Investigation into Cancer and Nutrition (EPIC) after following 360,000 participants between the ages of 50 and 60 over the course of ten years. They describe their findings in the November 13 issue of the New England Journal of Medicine. Epidemiologists at University Medical Center (UMC) Utrecht and the Dutch National Institute for Public Health and the Environment (RIVM) were involved in the study.
Women with a body mass index (BMI) of 24.3 and men with a BMI of 25.3 were found to have the lowest risk of early death; a lower or higher weight increases this risk. But a large waist circumference always increases the risk of premature death, independent of the BMI, which means this also applies to people with a “normal” weight. This effect is more pronounced in thinner people than it is in heavier people.
In other words, what affects health is not just being overweight but also the distribution of body fat. Abdominal fat is more harmful than other fat because it produces substances that contribute to the development of diseases. The researchers argue that in addition to calculating BMI, waist circumference should also be measured to determine the degree of overweight.
“We already knew that abdominal fat was harmful,” explains epidemiologist Professor Petra Peeters of UMC Utrecht. “But this was primarily in overweight people. Being overweight and having a large waist circumference are closely related. That’s why we needed such a large study to prove that waist circumference is harmful, also when taken on its own, independent of being overweight. Moreover, the study shows that a larger waist circumference also plays a role for thin people and people with a normal weight.”
EPIC is one of the largest long-term prospective studies in the world. The researchers analyzed the lifestyle and health of 360,000 people from ten European countries over the course of ten years. This number included 40,000 Dutch people. More than 14,000 participants died during this period, mainly from cancer, cardiovascular disease, and respiratory diseases.
Participating in the study from UMC Utrecht were Dr. Yvonne van der Schouw, Professor Karel Moons, Professor Petra Peeters, and Dr. Anne May of the Julius Center for Health Sciences and Primary Care.