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Waist-to-hip ratio: A risk factor for heart disease?

I know obesity is a risk factor for heart disease. But I've been told that body shape also plays a role. Is this true?

- No name / No state given

Mayo Clinic cardiologist Martha Grogan, M.D., and colleagues answer select questions from readers.

Answer

Yes, body shape can affect your heart disease risk. Obesity is a risk factor for heart disease. But people who carry most of their excess weight around their waist (often referred to as "apple" shapes) are at even greater risk of heart disease than are those who carry most of their excess weight below their waist ("pear" shapes).

There are a couple of ways to determine whether you're carrying too much weight around your abdomen:

  • Waist circumference. Use a tape measure to measure the circumference of your waist at its smallest point — usually just above your naval. A waist measurement of greater than 40 inches (102 centimeters) for men or 35 inches (89 centimeters) for women indicates increased health risks.
  • Waist-to-hip ratio. Use a tape measure to measure the circumference of your waist at its smallest point. Then measure the circumference of your hips at their widest point. To calculate your waist-to-hip ratio, divide your waist measurement by your hip measurement. A waist-to-hip ratio of greater than 0.9 for men and 0.85 for women indicates increased health risks.

The reason why body shape affects heart disease risk isn't well understood. But individuals with apple shapes are more likely to have metabolic syndrome — another risk factor for heart disease. Although it can be difficult to change your natural body shape, achieving and maintaining a healthy weight and exercising regularly are the best ways to minimize your waistline.

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Jul 6, 2008