Weight gain that settles in the abdominal area--fat that some people call a "spare tire"--is usually thought of as a problem common to middle-aged men. But an article in a recent issue of Archives of Internal Medicine points out that abdominal weight gain is also a problem for many women as they approach menopause, and this type of obesity poses a particularly potent health risk.

Researchers from the University of Minnesota assessed the Body Mass Index (BMI), waist circumference, and waist-hip ratio (all measurements of body fatness) of more than 30,000 women ages 55 to 69. They then kept track of the women over a 12-year period, noting how many of them died or developed heart disease, cancer, diabetes, or high blood pressure during that time. Compared with BMI and waist circumference, waist-hip ratio (which is specifically a measurement of abdominal obesity) was most closely tied to mortality. In other words, overweight women who carried their excess weight around their middle were more likely than generally overweight women to have died during the course of the study. Waist-hip ratio was also a strong predictor of the likelihood of developing heart disease over this time span.

This study supports scientists' view that it is not just total fatness, but where the fat sits on the body that makes being overweight such a health hazard. The "gynoid" type of fat distribution common to many women is often described as "pear" shaped, where fat deposits are located mainly in the buttocks, hips, and thighs. Those with the "android" type of fat distribution carry most of their excess fat around their middle. This so-called "apple" shaped distribution of body fat is more common in men but is also seen in some women as they approach menopause. Scientists think that the type of fat that accumulates around the middle is metabolized differently from fat located in other parts of the body, and this difference contributes to high blood pressure and increased blood levels of cholesterol and triglycerides--all of which can increase the risk of heart disease.

Individuals can determine their waist-hip ratio by dividing their waist measurement by their hip measurement. A waist-hip ratio greater than 1.0 in men and 0.8 in women indicates an "apple" distribution of body fatness. While an expanding waistline is generally seen as a problem for men as they get older, the results of this study point out that excess abdominal weight is a health problem that neither men nor women can afford to ignore.