Hormonal
Higher waist-hip ratio (WHR) is independently and more strongly predictive of coronary heart disease (CHD) risk than body mass index (BMI) or waist circumference alone, with risk increasing continuously across the range of WHR in both men and women.
Don't rely on BMI alone to assess your heart disease risk. Measure your waist and hip circumferences. A higher waist-hip ratio indicates a significantly higher risk of coronary heart disease, even if your BMI is normal. This is a simple, inexpensive way to assess risk that captures abdominal obesity better than weight alone.
Indices of abdominal obesity were more consistently and strongly predictive of coronary heart disease than body mass index. The risk for developing subsequent coronary heart disease increased continuously across the range of waist-hip ratio. Hazard ratios (95% CI) of the top versus bottom fifth of waist-hip ratio were 1.55 (1.28 to 1.73) in men and 1.91 (1.44 to 2.54) in women after adjustment for body mass index and other coronary heart disease risk factors.
Why this rating
Large prospective cohort (n=24,508), long follow-up (9.1 years), rigorous adjustment for confounders, but observational design limits causal inference.
Source
Body Fat Distribution and Risk of Coronary Heart Disease in Men and Women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk Cohort
Dexter Canoy et al. · Circulation · 2007
DOI 10.1161/circulationaha.106.673756
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