Distribution of fat is at least as important as the total amount of fat in the body. Marked adverse metabolic consequences are seen with central (android or apple-type), but rarely with gluteo-femoral (gynoid or pear-type) obesity. The usual measure of central obesity is the waste hip ratio (WHR). Since the excess fat is usually concentrated in the hip in women and the waist in men, the optimum value for the WHR is lower in women (<0.85) than in men (<0.95).
Recently, waist circumference has been found to be an even better marker of central obesity than WHR. Optimum waist circumference is <80 cm in women and <90 cm in men. At any given level of WHR or waist circumference, coronary artery disease (CAD) rates are identical in men and women.
It is plausible that sex differences in central obesity are the key to the gender gap in CAD.