Waist-to-Height Ratio Outperforms Classic Anthropometric Indices in Predicting Successful Aging in Older Adults; an Analysis of the ATTICA and MEDIS Epidemiological Studies

ABSTRACT

Background/Study context: The aim of the present work was to investigate the association of Waist-to-Height Ratio (WHtR) with Successful Aging (SA) status and compare it to classic anthropometric indices, among middle-aged and older individuals.

Methods: Among various socio-demographic, clinical and lifestyle characteristics, height, weight, waist circumference (WC), Waist-to-Hip Ratio (WHR) and WHtR of the Greek participants, over 50 years old, enrolled in the ATTICA (n = 1,128) and the MEDIS (n = 2,221) in relation to SA; SA was evaluated using the validated Successful Aging Index (SAI, range 0–10) comprising of health-related, social, lifestyle, and clinical parameters.

Results: WHtR was inversely associated with SAI with every 0.1-unit increase, lowering SAI by almost 0.5 units (b-coefficient±SE: −4.71 ± 0.26; 95%CI: −5.21, −4.20). Also, WHtR was more strongly associated with SAI (b = −0.352), surpassing the effect of age and sex (b = −0.347 and 0.11, respectively). With respect to the other anthropometric indices (weight, height, WC, WHR), WHtR exhibited the highest explanatory ability (Adjusted R² = 0.345); the higher the adjusted R² the higher explanatory ability.

Conclusions: WHtR was revealed as the best determinant of successful aging, with respect to other anthropometric indices (weight, height, WC, WHR). The present findings are of significant public health importance for better understanding the role of body mass distribution on the aging process.

Acknowledgments

Authors are particularly grateful to the men and women from all areas that participated in the ATTICA and MEDIS studies, as well as to both studies investigators.

Author Contributions

EK conceived the research question, EK and AF carried out the analysis and completed the draft of the manuscript, DP designed the supervised the study and the interpretation of data analyses, CP, ALM, and EP contributed to the design of study and interpretation of data. CC, AF, ST, and KG contributed to the interpretation of data analyses. All authors contributed to the critical revision of the manuscript and approved its final version.

Conflict of interest

The authors have no conflicts of interest to declare.

Additional information

Funding

The ATTICA study is supported by research grants from the Hellenic Cardiology Society (HCS2002) and the Hellenic Atherosclerosis Society (HAS2003). The MEDIS study was funded by Research grants from the Hellenic Heart Foundation, the Graduate Program of the Department of Nutrition & Dietetics, Harokopio University and the Rutgers University, NJ, USA (GA #5884). Stefanos Tyrovolas was supported by the Foundation for Education and European Culture (IPEP), the Sara Borrell postdoctoral program (reference no. CD15/00019 from the Instituto de Salud Carlos III (ISCIII - Spain) and the Fondos Europeo de Desarrollo Regional (FEDER). Demosthenes Panagiotakos, Stefanos Tyrovolas, Efi Koloverou and Alexandra Foscolou have been funded from ATHLOS project to study trajectories of healthy aging (European Union’s Horizon 2020 research and innovation program, grant agreement No 635316).