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Physical inactivity, abdominal obesity and risk of coronary heart disease in apparently healthy men and women

International Journal of Obesity volume 34, pages 340–347 (2010)Cite this article

Abstract

Objective:

To test the hypothesis that for any given body mass index (BMI) category, active individuals would have a smaller waist circumference than inactive individuals. Our second objective was to examine the respective contribution of waist circumference and physical inactivity on coronary heart disease (CHD) risk.

Design:

Prospective, population-based study with an 11.4-year follow-up.

Subjects:

A total of 21 729 men and women aged 45–79 years, residing in Norfolk, UK.

Methods:

During follow-up, 2191 CHD events were recorded. Physical activity was evaluated using a validated lifestyle questionnaire that takes into account both leisure-time and work-related physical activity. Waist circumference was measured and BMI was calculated for each participant.

Results:

For both men and women, we observed that within each BMI category (<25.0, 25–30 and ⩾30.0 kg m−2), active participants had a lower waist circumference than inactive participants (P<0.001). In contrast, within each waist circumference tertile, BMI did not change across physical activity categories (except for women with an elevated waist circumference). Compared with active men with a low waist circumference, inactive men with an elevated waist circumference had a hazard ratio (HR) for future CHD of 1.74 (95% confidence interval (CI), 1.34–2.27) after adjusting for age, smoking, alcohol intake and parental history of CHD. In the same model and after further adjusting for hormone replacement therapy use, compared with active women with a low waist circumference, inactive women with an elevated waist circumference had an HR for future CHD of 4.00 (95% CI, 2.04–7.86).

Conclusion:

In any BMI category, inactive participants were characterized by an increased waist circumference, a marker of abdominal adiposity, compared with active individuals. Physical inactivity and abdominal obesity were both independently associated with an increased risk of future CHD.

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Acknowledgements

We thank the participants, general practitioners and staff in EPIC-Norfolk. EPIC-Norfolk was supported by program grants from the Medical Research Council UK and Cancer Research UK and with additional support from the European Union, Stroke Association, British Heart Foundation, and Research into Ageing. None of the study sponsors have had any role in study design, collection analysis and interpretation of data, writing of the report or decision to submit the paper for publication. Jean-Pierre Després is Scientific Director of the International Chair on Cardiometabolic Risk, which is supported by an unrestricted grant awarded to Université Laval by Sanofi Aventis.

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Authors and Affiliations

  1. Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada

    B J Arsenault, I Lemieux & J-P Després

  2. Department of Anatomy and Physiology, Faculty of Medicine, Université Laval, Québec, Canada

    B J Arsenault

  3. Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands

    J S Rana, J J P Kastelein & S M Boekholdt

  4. Cedars-Sinai Medical Center, Heart Institute, David Geffen School of Medicine at University of California Los Angeles, CA, USA

    J S Rana

  5. Division of Kinesiology, Department of Social and Preventive Medicine, Université Laval, Québec, Canada

    J-P Després

  6. Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands

    S M Boekholdt

  7. Medical Research Council Epidemiology Unit, Cambridge, UK

    N J Wareham

  8. Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK

    K-T Khaw

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  1. B J Arsenault
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Correspondence to K-T Khaw.

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Arsenault, B., Rana, J., Lemieux, I. et al. Physical inactivity, abdominal obesity and risk of coronary heart disease in apparently healthy men and women. Int J Obes 34, 340–347 (2010). https://doi.org/10.1038/ijo.2009.229

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