Abdominal Obesity in Women
- For any given weight or body mass index (BMI), women haven significantly less fat deposits in waist (belly fat) and more fat in their hip, buttocks, and thighs.1 (Figure 053)
- At any given level of abdominal (visceral) obesity measured as waist circumference (WC) or waist to hip ratio (WHR), coronary artery disease (CAD) rates are identical in men and women.1
- The lower risk of heart disease in women is primarily due to their smaller waist size, not their gender per se.1 It is plausible that sex differences in central obesity are the key to the gender gap in CAD.1
- The cut point for abdominal obesity for Europids is 88cm for women as opposed to102cm for men. The waist circumference for Asian Indian women is 80cm as opposed to 90cm for Asian Indian men.2
- Among normal weight people, a 10cm increase in WC confers a 25% increase in the mortality in women compared to 16% in men.3
- The risk of death doubles when the WC increases from <75 to >110 cm in women and is similar in magnitude to the increase in WC from <90 to >120 in men.3
- Visceral adiposity is an important marker of cardiovascular risk in girls.4 Obese girls have 2 to 3-fold greater visceral fat depots than non obese girls.
- Visceral fat is highly correlated with basal insulin, high triglycerides, and low HDL levels whereas femoral adipose tissue is inversely related to these measures in obese girls. 4
- South Asian women with similar BMI have significantly higher abdominal obesity than Europid women.5 This explains the high rate of gestational diabetes among Asian Indian women.
1. Barrett-Connor E. Sex differences in coronary heart disease. Why are women so superior? The 1995 Ancel Keys Lecture. Circulation. 1997;95(1):252-264.
2. Enas EA, Singh V, Gupta R, Patel R, et al. Recommendations of the Second Indo-US Health Summit for the prevention and control of cardiovascular disease among Asian Indians. Indian heart journal. 2009;61:265-74.
3. Jacobs EJ, Newton CC, Wang Y, et al. Waist circumference and all-cause mortality in a large US cohort. Arch Intern Med. Aug 9 2010;170(15):1293-1301.
4. Caprio S, Hyman LD, McCarthy S, Lange R, Bronson M, Tamborlane WV. Fat distribution and cardiovascular risk factors in obese adolescent girls: importance of the intraabdominal fat depot. Am J Clin Nutr. Jul 1996;64(1):12-17.
5. Lean ME, Han TS, Bush H, Anderson AS, Bradby H, Williams R. Ethnic differences in anthropometric and lifestyle measures related to coronary heart disease risk between South Asian, Italian and general- population British women living in the west of Scotland. Int J Obes Relat Metab Disord. 2001;25(12):1800-1805.