Abdominal obesity and cardiovascular disease risk factors within body mass index categories

Several organizations recommend the use of measures of abdominal obesity in conjunction with body mass index (BMI) to assess obesity-related health risk. Recent evidence suggests that waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) are increasing within BMI categories. This shift may have affected the usefulness of abdominal obesity measures.

Data are from respondents aged 18 to 79 to the 2007 to 2009 Canadian Health Measures Survey. Using logistic regression, this paper examines cardiovascular disease (CVD) risk factors in relation to WC, WHR and WHtR within BMI health-risk categories. CVD risk factors considered include components of the metabolic syndrome.

Among men in the normal and overweight BMI categories, WHR and WHtR were positively associated with having at least two CVD risk factors. All three abdominal obesity measures were associated with increased odds of having at least two CVD risk factors among normal-weight women. Abdominal obesity was not associated with CVD risk factors for people in obese class I.

Among men and women in the normal BMI category, measures of abdominal obesity are associated with increased odds of CVD risk factors. This underscores the importance of measuring and monitoring abdominal obesity in normal-weight men and women.