Waist-to-Hip Ratio Is Found to Be Key Predictor of Death

It’s not how much you weigh, but where you carry the weight that is the greatest predictor of death, a study published Tuesday in the Journal of the American Medical Assn. said.

In a study of 41,837 Iowa women ages 55 to 69, researchers at the University of Minnesota found that having an apple shape--having a bigger waist than hips--was a better predictor of mortality than weight. For every six-inch increase in waist measurement in a woman with 40-inch hips, the risk of death increased 60%, the study found.

The researchers found that lean women with a higher waist-to-hip ratio were at most risk of death. The findings were essentially the same for smokers and nonsmokers. Previous studies have found the same results in men.

“It’s hard to say without additional study what’s going on here,” said Dr. Thomas A. Sellers, one of the researchers who followed the Iowa women for five years. “We don’t know if it’s cause and effect or if there may be some other underlying abnormality and waist-to-hip ratio is just a marker for some other process.”

In any case, Sellers said, most studies have shown that people cannot alter their basic body shape even if they lose weight--a “not very comforting” finding, he said. Nevertheless, doctors should routinely measure patients’ waist-to-hip ratio to be aware of possible risk, the researchers said. The ratio is waist circumference divided by hip circumference.