For those in the top fifth of the midriff bulge range the chances of dying are doubled, according to the research.
Among individuals with the same relative body mass, each five centimetre increase in waist circumference was shown to increase mortality risk by 17% in men and 13% in women.
Comparative hip and waist size also appeared to have a significant bearing on lifespan.
The study involved more than 350,000 people from nine European countries.
Experts are increasingly coming to the conclusion that fat deposited between the hips and navel is a better health indicator than Body Mass Index (BMI).
However the study found that even people with “normal” BMIs who are not defined as overweight are at a higher risk of dying if they have thick waistlines.
Participants, who were aged 25 to 70, were monitored for an average of 9.7 years. During this time, a total of 14,723 died.
For people with the same BMI, the risk of death increased in a “linear” fashion as waist circumference rose.
Men with waists measuring more than 47.2 inches were twice as likely to die during the study period as those with waists of less than 31.5 inches.
The same was true for women with waistlines of more than 39.4 inches compared with those measuring less than 25.6 inches.
The research, reported in the New England Journal of Medicine, forms part of a major long-term study called the European Prospective Investigation into Cancer and Nutrition (Epic).
Professor Elio Riboli, of Imperial College London, said: “Although smaller studies have suggested a link between mortality and waist size, we were surprised to see the waist size having such a powerful effect on people’s health and premature death.
“Our study shows that accumulating excess fat around your middle can put your health at risk even if your weight is normal based on body mass index scores. There aren’t many simple individual characteristics that can increase a person’s risk of premature death to this extent, independently from smoking and drinking.
“If you have a large waist, you probably need to increase the amount of exercise you do every day, avoid excessive alcohol consumption and improve your diet,” added Prof Riboli.
“This could make a huge difference in reducing your risk of an early death.”
Fat stored around the waistline is known to secrete messenger molecules, hormones and metabolically active compounds that may contribute to serious chronic conditions such as heart disease and cancer.
While underlining the importance of waistline fat, the study also found that higher BMI had a significant influence on mortality. BMIs of 25.3 in men and 24.3 in women were associated with the lowest risk of death.
People with high BMIs died more often from heart and artery diseases or cancer. Those with low BMIs tended to die more frequently from lung diseases.
And an American study has found obese children have the arteries of 45-year-old adults.
Researchers in the US used ultrasound to measure the thickness of arteries in the necks of 70 boys and girls with an average age of 13.
They discovered that many had “furred-up” arteries looking like those of people 30 years older.
All the children had heart disease risk factors such as abnormal levels of cholesterol and triglyceride blood fats, or raised blood pressure.