Waist and hip circumferences have independent and opposite effects on cardiovascular disease risk factors: the Quebec Family Study

Am J Clin Nutr. 2001 Sep;74(3):315-21. doi: 10.1093/ajcn/74.3.315.


Background: A high waist-to-hip ratio is associated with unfavorable cardiovascular disease risk factors. This could be due to either a relatively large waist or a small hip girth.

Objective: We sought to define the separate contributions of waist girth, hip girth, and body mass index (BMI) to measures of body composition, fat distribution, and cardiovascular disease risk factors.

Design: Three-hundred thirteen men and 382 women living in the greater Quebec City area were involved in this cross-sectional study. Percentage body fat, anthropometric measurements, and abdominal fat distribution were obtained and BMI (in kg/m2) and waist-to-hip ratio were calculated. Serum blood lipids were determined from blood samples collected after subjects had fasted overnight

Results: A large waist circumference in men and women (adjusted for age, BMI, and hip circumference) was associated significantly with low HDL-cholesterol concentrations (P < 0.05) and high fasting triacylglycerol, insulin, and glucose concentrations (P < 0.01). In women alone, a large waist circumference was also associated with high LDL-cholesterol concentrations and blood pressure. A narrow hip circumference (adjusted for age, BMI, and waist circumference) was associated with low HDL-cholesterol and high glucose concentrations in men (P < 0.05) and high triacylglycerol and insulin concentrations in men and women (P < 0.05). Waist and hip girths showed different relations to body fat, fat-free mass, and visceral fat accumulation.

Conclusions: Waist and hip circumferences measure different aspects of body composition and fat distribution and have independent and often opposite effects on cardiovascular disease risk factors. A narrow waist and large hips may both protect against cardiovascular disease. These specific effects of each girth measure are poorly captured in the waist-to-hip ratio.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue / anatomy & histology*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anthropometry
  • Blood Glucose
  • Blood Pressure / physiology
  • Body Composition
  • Body Constitution / physiology*
  • Body Mass Index
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology*
  • Cholesterol / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Insulin / blood
  • Lipids / blood*
  • Male
  • Middle Aged
  • Quebec
  • Regression Analysis
  • Risk Factors


  • Blood Glucose
  • Insulin
  • Lipids
  • Cholesterol