Waist Size Predicts Heart Failure (more reasons to reduce your waist size)

The main reason people over 65 wind up in the hospital is heart failure, also known as “congestive heart failure.” And the very best predictor of whether or not you’re likely to get heart failure might surprise you.

It’s waist size.

A new study published in the journal Circulation(1) tracked data from two Swedish population based studies that together included 80,000 men and women aged 45-83. All participants filled in questionnaires about their height, weight, waist circumference and other vital statistics. They were then followed for seven years.

The researchers found – not surprisingly – that weight was linked to risk for heart failure. But they also found that even within the normal weight range (BMI 25 or less), those who had an extra 10cm (about 4 inches) on their waist had about 15% higher risk of heart failure. This went up to 18% for those who were heavier (BMI of 30 or more).

The researchers measured waist size, waist-to-hip ratio, waist-to-height ratio and BMI (body mass index). All four measures were associated with heart disease, but waist circumference alone predicted heart disease risk regardless of other measures.

This study comes on the heels of a study that looked at belly fat and the risk of stroke. In that study, researchers from the University of Heidelberg found that BMI was not independently associated with the risk for stroke – but belly fat was! Women with waists greater than 35″ and men with waists greater than 40″ had four times the risk of stroke compared to people with more “typical” waistlines.(2)

In the University of Heidelberg study, the researchers calculated a common metric called “Waist-to-Hip Ratio” which is found by dividing the circumference of the waist by the circumference of the hips (measured at the widest part). For example, someone with 40″ hips and a 32″ waist would have a Waist-to-Hip Ratio of .8 (32 divided by 40).

Women whose waist-to-hip ratios in the .7 range and men within the .9 range seem to be less susceptible to all sorts of major diseases from diabetes to heart disease to cancer. And if obesity is redefined using Waist-to-Hip measurement instead of the more common BMI (Body Mass Index), the proportion of people categorized as “at risk” for a heart attack triples!

Most health professionals now recognize that a waist size of 35″ or greater for women and 40″ or greater for men is a very good indicator of insulin resistance. This is one reason that “apple shapes” (who store their fat primarily around the middle) are far more at risk for health problems than “pear shapes” (who store it around the butt and thighs).

Fortunately, there’s a solution: The Atkins Advantage plan is a wonderfully effective way to both reduce waist size and to combat insulin resistance! A lower carb diet with adequate protein and good fat has proven itself time and again as one of the best strategies for losing weight and belly fat – not to mention improving overall health and well-being!

I’ve written before about the importance of waist size and of the waist-to-hip ratio. Nutritionists and smart doctors have long known that 35″ for women and 40″ for men represent a danger point for insulin resistance (which is the cornerstone of Metabolic Syndrome, also known as pre-diabetes). Metabolic Syndrome significantly increases the risk for heart disease.

If your waist is over 35″ (women) or 40″ (men), it’s time to start doing something. I’ve found that a low-carb diet is one of the most effective ways to combat belly fat and reduce the size of your waist.


1). Levitan, et al “Adiposity and Incidence of Heart Failure Hospitalization and Mortality: A Population-based Prospective Study”, Circulation: Heart Failure, Published online before print, April 7, 2009

2). Winter, et al “Contribution of Obesity and Abdominal Fat Mass to Risk of Stroke and Transient Ischemic Attacks”, Stroke, 2008; 39: 3145

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