There they go again, trying to ruin my day. The "they" in question are my epidemiology colleagues down the hall at our American Cancer Society offices in Atlanta.
The topic a couple of weeks ago that got me going was an article they published suggesting that I had a higher chance of premature death because I sit at a desk most of the day. Today's "offense" was a report published in the Archives of Internal Medicine showing that the larger your waist size-for the most part, with a couple of exceptions-the greater your chance of premature death. And even if your body mass index (BMI) was normal-which is a measure of your height relative to your weight, and is used to classify people as normal, overweight or obese-you could still have an increased chance of death if your paunch is, uh, oversized.
The study has garnered a lot of media attention, probably because of the increasing concern surrounding the impact of obesity in this country.
As noted by the researchers, this is not a new topic. We have known for some time that an increased waist size-40 inches for men and 35 for women-is associated with poorer health outcomes. The reason for this isn't clear, but there is increasing evidence linking a number of chronic illnesses--including cancer, diabetes and heart disease to name a few-with increased abdominal fat.
There is reason to believe that fat stored in our abdomens has a worse impact on health compared to fat stored elsewhere. So if you are a man or a woman shaped like an apple-carrying your weight around your middle--you are worse off healthwise compared to a man or a woman shaped like a pear, where you carry your weight mostly around your hips (as you might have observed, men are more likely to be apples, while women are more likely to be pears).
In this report, the researchers examined information that has been collected for many years as part of an American Cancer Society research program called Cancer Prevention Study II Nutrition Cohort. They were able to examine records from about 105,000 men and women, including about 14,600 people who died from 1997 and 2006.
They found that-after adjusting for body mass index-that the larger your waist the more likely you were to die prematurely. In fact, the risk of death for people with very large waists was about doubled. The disturbing finding was that even if you had a normal BMI-which means that you would not be considered overweight or obese-the larger your waist, the greater your chances of early death. Larger waist size was more related to increased deaths from respiratory disease than cardiovascular disease and cancer.
This isn't the first time researchers have looked at this question of waist size in relation to chances of early death. There have been other studies, but this one looked at people with very large waists unlike some of the previous reports. This study also appears to be the first one that looked at the impact of waist size within each of three categories of BMI, including normal, overweight and obese.
The reason that is so important is because this study shows that you can have a normal BMI, be told by your doctor that your weight is "fine," but be at increased risk of death since your weight is carried right there around your midsection.
One other point of note: for men, the impact of waist size on death was greater for men 70 years and older compared to men under the age of 70. For women, age did not have as much of an impact on the results of the study.
Why am I so concerned about the results of this study? You may have already guessed: my waist hovers around 40 inches, give a couple of pounds or so. Eat too much, waist goes up; starve a bit, waist comes down. The center point is right there around the magical 40 inches.
Now, I would also offer the thought that a waist of 40 inches on a man (I would never, never, never comment about a waist of 40 inches on women) can mean different things in different settings.
Take for example my experience a couple of years ago when I was looking for a pair of blue jeans. I am one of those tall guys with a 40 inch waist. I quickly discovered shortly after moving down South that there were plenty of jeans that would fit me with respect to the 40 inch waist, or 42 or 44 for that matter. It was the length that was a problem. They were all 30 inches or less in the inseam.
Travelling to the west-I think it was Texas or Arizona-I walked into one of those Western wear stores looking for another pair of blue jeans. Now I was in luck-lots of long inseams. But the waist size? Try 36 and under.
The moral of the story? I figure that there are a lot of men in my hometown who are a bit on the short size with large waists, while out West they are more likely tall with smaller waists.
Based on today's report, the Western guys are probably better off than the Southern guys-even if their body mass index is normal (which is not likely with a 44 inch waist and a 30 inch inseam).
So ladies and gentleman, you now have something else to worry about when you think about your health. The size of your waist is likely directly related to the length of your years. And if you take comfort that your weight in your 70's is the same as it was in college, forget about it. The chances are your body has simply redistributed itself into the wrong places, and put you at greater risk of death. No comfort is available anymore to those who looked the other way as their muscles turned into fat while their weight remained steady.
As to my friendly research colleagues here at the American Cancer Society, I can't wait to see what piece of information they are going to analyze next. I suspect they have plenty of things to study that will not make my day (and maybe yours) any better. So far-in one month alone--they are two for two.
So, my congratulations to my colleagues on producing some interesting and timely research reports. I may not like what they tell me, but what they tell me is based on high quality evidence and research. It's up to me (and you) to take the messages and incorporate them into our everyday lives.
In the meantime can we get something positive for a change, like maybe ice cream is good for your health? Now, that would be something to talk about.
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