Background: Smoking is reported to be positively related to abdominal fat in young and middle-aged persons; however, it is unclear whether this relationship exists in elderly persons. Behavioral influence on fat distribution is of importance because of the accumulation of abdominal fat with age and its associated health risks.
Methods: The relationship was investigated in a population-based sample of 1,178 men and 1,163 women aged 55-85 years, representative of the Dutch older population in 1992-1993. Waist and hip circumference and their ratio were used as indices of fat distribution. Past and current smoking habits were obtained by questionnaire.
Results: Smoking was associated with waist/hip-ratio (WHR) in men, with current smokers having the highest WHR and never smokers the lowest. A dose-response relationship between the daily number of cigarettes smoked and WHR was observed in men. These associations remained significant after adjustment for confounding due to age, education, body mass index, health status, alcohol intake, and sports activity. The dose-response relationship did not change after additional adjustment for duration of smoking. Among former male smokers, recent quitters had a higher WHR compared to long-term quitters. Additional analysis showed that smoking was more strongly associated with waist than with hip circumference. In women the relationship between smoking and fat distribution was not clear.
Conclusions: Past and current smoking habits are positively associated with abdominal fat in older men, but not in older women.