Having a big belly has consequences beyond trouble squeezing into your pants. It’s detrimental to your health, even if you have a healthy body mass index (BMI), a new international collaborative study has found. Men and women with large waist circumferences were more likely to die younger, and were more likely to die from illnesses such as heart disease, respiratory problems, and cancer after accounting for body mass index, smoking, alcohol use and physical activity.

Importantly, risk increased in a linear fashion such that for every 2 inches of greater circumference, mortality risk went up about 7 percent in men and about 9 percent in women. Thus, there was not one natural “cutpoint” for waist circumference that could be used in the clinic, as risk increased across the spectrum of circumferences.

Another key finding was that elevated mortality risk with increasing waist circumference was observed at all levels of BMI, even among people who had normal BMI levels. Because of the large size of this pooled study, researchers were able to clearly show the independent contribution of waist circumference after accounting for BMI, says James Cerhan, M.D., Ph.D., a Mayo Clinic epidemiologist and lead author of the study.

“The primary goal should be preventing both a high BMI and a large waist circumference,” Dr. Cerhan says. “For those patients who have a large waist, trimming down even a few inches – through exercise and diet – could have important health benefits.”

Source: Mayo Clinic. “Large waist linked to poor health, even among those in healthy body mass index ranges.” ScienceDaily. ScienceDaily, 12 March 2014.