Separate associations of waist and hip circumference with lifestyle factors

OBJECTIVE: To study the associations of lifestyle factors with waist circumference 'Action Levels', hip circumference and body mass index.

DESIGN: Cross-sectional study in a random sample of 5887 men and 7018 women aged 20-59 years, selected from the civil registries of Amsterdam, Maastricht and Doetinchem, The Netherlands.

RESULTS: Results were compared to those in low health risk reference groups: non-smokers, occasional drinkers, highest educated, physically active, employed subjects, women who had no live births, or 20-29-year-olds. In multivariate logistic regression analysis, odds ratios (95% confidence interval) for having a waist above 'Action Level 2' (> or =102 cm in men, > or =88 cm in women) were significantly lower in smokers, and higher in heavy drinkers, inactive subjects, unemployed people, those educated below secondary level, women who had > or =3 live births, and older age. Mean waist-to-hip ratio adjusted for body mass index and age were higher in these groups. Residual analysis showed that the likelihood of having larger waist than expected from their body mass index was 1.2 times (1.1-1.4) in male smokers, 1.4 times (1.2-1.7) in male and 1.7 times (1.3-2.2) in female heavy drinkers, 1.6 times (1.5-1.8) in inactive men, and 1.3 times (1.1-1.5) in unemployed women. The risk of having smaller hips than expected from body mass index was 1.2 times (1.1-1.4) in male and 1.2 times (1.0-1.3) in female smokers, 1.2 times (1.1-1.3) in men and 1.1 times (1.0-1.2) in women who were inactive.

CONCLUSIONS: Each lifestyle factor influences the size of waist and the hips differently, and understanding these influences is important for health promotion directed at the general public. Lifestyle modifications such as smoking cessation, reduced drinking, and a more physically active lifestyle should all be encouraged, leading to an overall healthier body shape.