Anthropometric and psychosocial determinants of visceral obesity in healthy postmenopausal women.

OBJECTIVE

To identify the best predictor among waist circumference, waist to hip ratio (WHR), weight and body mass index (BMI) of visceral obesity across 8.5-10.8 y. We also examined whether changes in waist across the study period co-occur with changes in psychosocial distress or quality of life, and tested whether action levels of waist (level 1 < 80 cm, level 1-2: 80-87.9 cm, level 2 > or = 88 cm) differentiate between women with varying levels of psychosocial distress and quality of life.

SUBJECTS AND MEASUREMENTS

Visceral adipose tissue (VAT) was determined by computerized-tomography at the L4-L5 disc space, and waist circumference, WHR, weight and BMI by anthropometric techniques in a population-based sample of postmenopausal Healthy Women Study participants. Psychosocial distress and quality of life were assessed by standardized tests of personality and behavior. The n varied from 120-345, depending on the research question.

RESULTS

Waist circumference was superior over the other anthropometric measures in predicting VAT accounting for 40.1-63.5% of the variance in VAT over the study period (P < 0.001). Associations between symptoms of depression, anxiety or distress, low levels of social support or impaired quality of life with waist circumference were cross-sectional (P < 0.04), with lower levels of distress and less impaired daily functioning being characteristic to women at the action level 1 relative to levels 1-2 or 2. Increasing anger over time was associated longitudinally with increasing waist circumference (P < 0.03).

CONCLUSIONS

Identification of healthy women with large waist circumferences is important for prevention and intervention of poor quality of life and chronic disease.