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Waist-Hip Ratio Better Indicator of Obesity, Mortality Risk in Elders Than BMI LOS ANGELES -- September 2, 2009 -- Body mass index (BMI) readings may not be the best gauge of obesity in older adults, according to a study published in the Annals of Epidemiology. Instead, the study showed, the ratio of waist size to hip size may be a better indicator for assessing obesity in high-functioning adults aged 70 to 80 years, presumably because the physical changes that are part of the aging process alter the body proportions on which BMI is based. “Basically, it isn’t BMI that matters in older adults, it’s waist size,” said lead investigator Preethi Srikanthan, David Geffen School of Medicine, University of California at Los Angeles, California. “Other studies have suggested that both waist size and BMI matter in young and middle-aged adults and that BMI may not be useful in older adults; this is one of the first studies to show that relative waist size does matter in older adults, even if BMI does not matter.” Using data from the MacArthur Successful Aging Study, a longitudinal study of high-functioning men and women aged 70 to 79 years, researchers examined all-cause mortality risk over 12 years by BMI, waist circumference, and waist-hip ratio. They adjusted for gender, race, baseline age, and smoking status. The average age of participants was 74. The researchers found no association between all-cause mortality and BMI or waist circumference; the link was only with waist-hip ratio. In women, each 0.1 increase in the waist-hip ratio was associated with a 28% relative increase in mortality rate in the group sampled. The relationship was not graded in men. Instead there was a threshold effect: The rate of dying was 75% higher in men with a waist-hip ratio greater than 1.0. There was no such relationship with either waist size or BMI. The study had some limitations, the authors noted. For instance, participants’ BMI may be underestimated because height and weight were self-reported and older adults tend to report those numbers from their younger, peak years. Also, waist-hip ratios, waist circumference and BMI numbers were based on single measurements, limiting the researchers’ ability to gauge how changing body size in old age can affect mortality risk. SOURCE: University of California - Los Angeles E-mail this page to a friend or colleague! To print, use this version