Menopause: The Journal of The North American Menopause Society Vol. 20, No. 2, pp. 202/208 DOI: 10.1097/gme.0b013e318261f242 * 2012 by The North American Menopause Society Relationship of body mass index and body fat distribution with postural balance and risk of falls in Spanish postmenopausal women Fidel Hita-Contreras, MD, 1,2 Antonio Martı ´nez-Amat, PhD, 1,2 Rafael Lomas-Vega, PhD, 1 Pablo A ´ lvarez, PhD, 2 Nicola ´s Mendoza, MD, 3 Natalia Romero-Franco, MHS, 1 and Antonia Ara ´nega, MD 2,4,5 Abstract Objective: Menopause status has been associated with weight gain and increased central adiposity. Obesity and postural instability are related to an increased risk of falls. The purpose of our study was to analyze the association of body weight and body fat distribution with postural balance and their correlation with falls in postmenopausal women. Methods: A cross-sectional, observational study was conducted on 100 postmenopausal women aged 50 to 65 years with at least 12 months of amenorrhea. The participants were divided into obese, overweight, and normal-weight groups according to their body mass index (BMI) and into android, uniform, and gynoid body fat distribution types according to waist-to-hip ratio. Postural stability was assessed with force platforms. W 2 and Kruskal-Wallis tests were used for statistical analysis. Results: A total of 18 participants reported falls in the previous 12 months. The obese group had significantly higher values for the root-mean-square amplitude of the center of pressure in the posteroanterior direction under both eyes-open and eyes-closed conditions (P = 0.005 and P = 0.007, respectively), as well as for the velocity of center-of-pressure displacements (P = 0.032). In the android group, most stabilometric parameters under the condition Beyes open and standing on a foam surface[ were significantly higher, whereas greater values were observed in the uniform-type group with eyes closed. A BMI of 25 kg/m 2 or higher (odds ratio, 3.58; 95% CI, 1.07-11.9; P = 0.038) and android body fat distribution (odds ratio, 5.35; 95% CI, 1.75-16.39; P = 0.003) were correlated with the risk of falling. Conclusions: Postural instability is associated with obesity and uniform and android body fat distribution types (waist-to-hip ratio 9 0.76) in Spanish postmenopausal women aged 50 to 65 years. Our results also suggest that a BMI of 25 kg/m 2 or higher and android body fat distribution can be considered as independent risk factors for falls. Key Words: Postural balance Y Postmenopause Y Obesity Y Body mass index Y Waist-to-hip ratio Y Falls. O besity is a long-term relapsing condition that is associated with significant morbidity and prema- ture mortality. There has been a substantial increase in the prevalence of obesity globally (even in developing countries) in the last 20 years, 1 and one of the most impor- tant concerns regarding obesity is its association with an increased risk of falls and subsequent injury. 2 Body mass index (BMI) and waist-to-hip ratio (WHR) have been widely used as anthropometric measurements of adiposity. 3 BMI is the method most commonly used to quantify weight across a range of body sizes in adults. 4 Although this measure is correlated with total body fat, it does not distinguish fat from muscle or between different body fat distributions, whereas WHR has been strongly correlated with abdominal fat measured through the use of imaging techniques, 5 and a single boundary value is appli- cable to different ethnic, age, and sex groups. 6 The transition from premenopause status to postmen- opause status has been associated with changes in body composition, 7,8 and many women experience weight gain, increases in central adiposity, and other changes in body composition around menopause. 9<11 Donato et al 12 described postmenopausal women as having a significantly greater WHR than premenopausal women, independent of BMI and other confounding factors. Estrogen deficiency at men- opause has been associated with an increase in visceral fat 13 and is responsible for the change from a gynoid fat pattern to an android fat pattern (ie, fat accumulates on the upper Received April 6, 2012; revised and accepted May 29, 2012. From the 1 Department of Health Sciences, Faculty of Health Sciences, University of Jae ´n, Jae ´n, Spain; 2 Institute of Biopathology and Regen- erative Medicine, Department of Human Anatomy and Embryology and 3 Department of Obstetrics and Gynecology, Faculty of Medicine, Uni- versity of Granada, Granada, Spain; 4 Department of Didactics of Musi- cal, Plastic, and Corporal, University of Jae ´n, Jae ´n, Spain; and 5 Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, Spain. Funding/support: None. Financial disclosure/conflicts of interest: None reported. Address correspondence to: Fidel Hita-Contreras, MD, Department of Health Sciences, Faculty of Health Sciences, University of Jae ´n, E-23071 Jae ´n, Spain. E-mail: fhita@ujaen.es 202 Menopause, Vol. 20, No. 2, 2013 Copyright © 2013 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.