Trends in waist-to-hip ratio and its determinants in adults in Finland from 1987 to 1997

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Abstract
Background: Although abdominal obesity has been shown to be an important risk factor for cardiovascular disease and a variety of other diseases, secular changes in fat distribution in populations have rarely been documented. Objective: Our objective was to assess trends in waist-to-hip ratio (WHR) in the Finnish population during a 10-y period. In addition, we investigated the associations of WHR with body mass index (BMI), age, education, and lifestyle factors. Design: Three independent cross-sectional surveys were carried out at 5-y intervals between 1987 and 1997. Altogether, 15096 randomly selected men and women aged 25–64 y participated in these surveys. Results: The WHR increased in both men and women during the 10-y period (P < 0.0001). In men, the strongest upward trend took place in the first 5-y period and then seemed to plateau; in women, the WHR continued to increase into the 1990s. In both sexes, the most prominent increase was observed in subjects aged ≥45 y. The WHR increased in all education-level groups, the lowest WHR being among those with the highest education. Age (18% in men, 12% in women) and BMI (33% in men, 25% in women) accounted for most of the variation in WHR, whereas only 3% was explained by education and lifestyle factors. Conclusions: Abdominal obesity is a growing problem in Finland, especially in persons aged ≥45 y. These adverse changes in body shape continued to take place, particularly in women, in the 1990s.