SEPARATE ASSOCIATIONS OF WAIST AND HIP CIRCUMFERENCE WITH LIFE-STYLE FACTORS

Objective To study the associations of lifestyle factors with waist ci rcumference 'Action Levels', hip circumference and body mass index. De sign Cross-sectional study in a random sample of 5887 men and 7018 wom en aged 20-59 years, selected from the civil registries of Amsterdam, Maastricht and Doetinchem, The Netherlands. Results Results were compa red to those in low health risk reference groups: non-smokers, occasio nal drinkers, highest educated, physically active, employed subjects, women who had no live births, or 20-29-year-olds. In multivariate logi stic regression analysis, odds ratios (95% confidence interval) for ha ving a waist above 'Action Level 2' (greater than or equal to 102 cm i n men, greater than or equal to 88 cm in women) were significantly low er in smokers, and higher in heavy drinkers, inactive subjects, unempl oyed people, those educated below secondary level, women who had great er than or equal to 3 live births, and older age. Mean waist-to-hip ra tio adjusted for body mass index and age were higher in these groups. Residual analysis showed that the likelihood of having larger waist th an 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 femal e 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 exp ected from body mass index was 1.2 times (1.1-1.4) in male and 1.2 tim es (1.0-1.3) in female smokers, 1.2 times (1.1-1.3) in men and 1.1 tim es (1.0-1.2) in women who were inactive. Conclusions Each lifestyle fa ctor influences the size of waist and the hips differently, and unders tanding 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.