Abdominal Adiposity Has Adverse Effects, Regardless of BMI

In general, evidence implicates body-fat distribution as a risk factor for morbidity and mortality. To evaluate the link between abdominal adiposity and premature death in lean populations, trained interviewers measured baseline weight, height, and waist and hip circumferences (according to a standard protocol) for more than 72,000 nonsmoking participants in the Shanghai Women's Health Study, a population-based, prospective cohort study (age range, 40–70). Mortality data were verified via registries and death certificates. Mean age at enrollment was 52. Mean BMI was normal (24 kg/m²); 35.2% were overweight or obese (BMI ≥25), and 5% were obese (BMI ≥30). Mean waist-hip ratio (WHR) was 0.81.

During a mean follow-up of 5.7 years, 1456 women di…