Waist circumference and fitness -
If you're not sure how much to eat, use a calorie calculator to estimate your body's daily caloric needs. Then count calories to make sure you're getting the right amount to fuel your body and lose weight safely.
Additionally, consider increasing the nutrient density of your diet by incorporating more nutrient-packed foods into your meal planning, including fruits, vegetables, whole grains, nuts, seeds, lean proteins, and other unprocessed foods. Nearly a quarter of all Americans skip breakfast.
Although more research is needed to solidify the importance of breakfast, a meta-analysis including eight studies and about , participants suggests that skipping breakfast increases the risk for heart disease.
Skipping breakfast may also increase the risk for diabetes, becoming overweight, high blood pressure, and insulin resistance. Eliminating sugar-sweetened beverages—soda, especially—can also cut down your sugar and calorie intake. Quitting a sugared beverage habit can offer multiple benefits, including improved sleep, increased energy, and notably, weight loss.
This weight loss can then lead to a reduction in your waist measurement and disease risk. Once you've implemented a sustainable healthy eating plan, try increasing your activity level to burn more calories throughout the day and support a strong, healthy body.
Again, use a calorie estimator to find out how many calories you currently burn each day, then add small habit changes to burn a few more.
For example, you can take the stairs instead of the elevator at work or go for a walk every evening after dinner. Every step counts in your path to healthier living. The CDC recommends that you get minutes of moderate-intense aerobic activity or 75 minutes of vigorous aerobic activity with at least 2 days of the week doing muscle-strengthening training.
Alongside diet and exercise, some lifestyle changes can help in reducing waist circumference and improving overall health. If you consistently get too little sleep or poor sleep, it can be even more difficult to find the motivation to make healthier choices.
Improving your sleep and reducing fatigue can have a direct impact on your weight loss. The National Sleep Foundation recommends adults receive hours of sleep per night. Stress, like sleep, is also intricately linked to health. Research has shown that high stress can often lead to overeating , and the foods we choose while stressed tend to be high in calories and low in nutrients.
Finally, reducing alcohol consumption can also slash your calorie intake and help support weight loss. Eliminating or cutting down on these empty calories can aid in reducing your waist circumference measurement. There are many different ways to evaluate your health and your risk for disease—waist circumference is just one of them.
If you find that yours is higher than you'd like it to be, talk to your healthcare provider about your personal health risks and get suggestions for the best ways to improve your overall health.
Often, it's small, incremental changes to your lifestyle that ultimately make the biggest difference in your health and pave the path toward sustainable weight loss, so it's important to begin the conversation.
National Heart, Lung, and Blood Institute. Assessing Your Weight and Health Risk. Nalini M, Sharafkhah M, Poustchi H, et al.
Comparing anthropometric indicators of visceral and general adiposity as determinants of overall and cardiovascular mortality. Arch Iran Med. Center for Disease Control and Prevention. Assessing Your Weight.
Ponnalagu SD, Bi X, Henry CJ. Is waist circumference more strongly associated with metabolic risk factors than waist-to-height ratio in Asians? A biological perspective , The American Journal of Clinical Nutrition , Volume , Issue 6, June , Pages —, doi Takagi H, Hari Y, Nakashima K, Kuno T, Ando T.
Meta-analysis of relation of skipping breakfast with heart disease. The American Journal of Cardiology. How much physical activity do adults need? The Centers for Disease Control and Prevention. Classification of Overweight and Obesity by BMI, Waist Circumference, and Associated Disease Risks.
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Malia Frey, M. Learn about our editorial process. This may be the case even if other measures of being overweight, such as body mass index BMI are in normal range. The following chart shows how the WHO classify the risk of being affected by weight related health conditions according to WHR:.
As well as using WHR to indicate how likely someone is to develop certain health conditions; it may also be used to indicate obesity. According to WHO :. If a person has a high WHR and is carrying excess weight around their waist, they may be concerned about the related health risks.
To reduce these risks, it is a good idea to try to lose weight. The best way to lose weight is to consume fewer calories than are burned, usually by eating less and exercising more. Eating a healthful diet, reducing portion size, and exercising several times a week is a good place to start.
A study found that a diet high in fruit and dairy and low in white bread, processed meat, margarine, and soft drinks may help reduce abdominal fat. A doctor or nutritionist can provide further advice on how to lose weight. People may take inaccurate measurements or make a mistake when doing the calculation.
In addition, if someone has a high BMI or is less than 5 feet tall, their WHR may be less meaningful. It is important to note that a WHR is not designed to measure the health of children and should only be used for adults.
However, as a WHR can be measured inaccurately, it should not be relied on as a sole measure of obesity or health risk. Talking to the doctor about weight and any associated health risks is always the best way to get a more complete picture.
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Medical News Today. Health Conditions Health Products Discover Tools Connect. Why is the hip-waist ratio important? Medically reviewed by Daniel Bubnis, M. How to calculate waist-to-hip ratio What is a healthy ratio?
Impact on health How to improve the ratio Considerations Conclusion Waist-to-hip ratio, also known as waist-hip ratio, is the circumference of the waist divided by the circumference of the hips. How to calculate waist-to-hip ratio. Share on Pinterest Waist circumference should be measured just above the belly button.
What is a healthy ratio? Share on Pinterest The hips should be measured at the widest part of the hips.
Fitess Assistance and Food Systems Resources. Adult BMI Herbal remedies for immune support. A high Holistic reproductive health of body Holistic reproductive health can lead circumfedence weight-related diseases and an health issues. Being underweight is also a health risk. Body Mass Index BMI and waist circumference are screening tools to estimate weight status in relation to potential disease risk. However, BMI and waist circumference are not diagnostic tools for disease risks.Waist circumference and fitness -
In , the International Atherosclerosis Society IAS and International Chair on Cardiometabolic Risk ICCR Working Group on Visceral Obesity convened in Prague, Czech Republic, to discuss the importance of abdominal obesity as a risk factor for premature atherosclerosis and CVD in adults Supplementary Information.
The group agreed to work on the development of consensus documents which would reflect the position of the two organizations. In this Consensus Statement, we summarize the evidence that BMI alone is not sufficient to properly assess, evaluate or manage the cardiometabolic risk associated with increased adiposity and recommend that waist circumference be adopted as a routine measurement in clinical practice alongside BMI to classify obesity.
This Consensus Statement is designed to provide the consensus of the IAS and ICCR Working Group Supplementary Information on waist circumference as an anthropometric measure that improves patient management. The Consensus Statement was developed as follows.
The first face-to-face meeting occurred on 24 April to review the high-quality evidence available and known to the subject experts.
After discussion and deliberation amongst the experts regarding the context and quality of the evidence, an executive writing group R. and Y. was appointed and tasked with writing the first draft. High-quality published literature that became available after the initial face-to-face meeting through June was identified by all authors and reviewed by the executive writing group for inclusion in the manuscript.
The first author coordinated the final preparation and submission of the Consensus Statement after the group achieved consensus and approved its content. The importance of body fat distribution as a risk factor for several diseases for example, CVD, hypertension, stroke and T2DM and mortality has been recognized for several decades.
These classifications were later interpreted by Ahmed Kissebah and colleagues as upper versus lower body fat accumulation as reflected by a high or low waist—hip circumference ratio WHR , respectively The upper and lower body fat accumulation phenotypes were based on body morphology as assessed by external anthropometric measures such as skinfolds and circumferences.
The WHR increased in popularity when epidemiologists in the USA and Sweden showed that WHR, separately or in combination with BMI, was associated with increased risk of death, CVD and T2DM 19 , 20 , 21 , 22 , findings that were subsequently confirmed in many studies.
However, later evidence indicated that, compared with the WHR, waist circumference alone was more strongly associated with the absolute amount of intra-abdominal or visceral fat, the fat depot that conveys the strongest health risk 23 , Furthermore, when a ratio such as WHR is used to follow changes in regional adipose depots, the utility of the ratio is limited when both the numerator and denominator values change in response to treatment.
Consequently, the combination of WHR and BMI for assessing obesity risk were replaced by single threshold values for waist circumference alone Although the use of these specific waist circumference values to identify white adults with abdominal obesity remains a cornerstone of obesity guidelines worldwide, we present evidence to challenge the supportive rationale and provide evidence in support of alternative waist circumference values to be used in concert with BMI.
As an alternative to measurements of waist circumference, the WHR or waist—thigh circumference ratio, Margaret Ashwell and others proposed the waist—height ratio as a measure of abdominal obesity 26 , Compared with the previous measurements, the waist—height ratio shows similar and sometimes slightly stronger associations with the risk of CVD or T2DM 28 , An explanation for why adding height increases the prediction of disease risk might be because short stature is associated with increased risk of CVD In growing children and adolescents, the waist—height ratio could be more useful for the classification of abdominal obesity than waist circumference alone.
However, in fully grown adults, the waist—height ratio is less useful as height is generally fixed and the value can only be altered by changes in waist circumference. Moreover, height is only marginally associated with waist circumference For the assessment of the effectiveness of lifestyle changes in adults, waist circumference might be preferred as a simple tool.
Other alternatives to waist circumference have included the conicity index 32 and the abdominal obesity index 33 , but they are, at best, only slightly better predictors of disease risk than waist circumference alone.
Despite a strong association between waist circumference and BMI at the population level, emerging evidence suggests that, across populations, waist circumference might be increasing beyond what is expected according to BMI.
In other words, the phenotype of obesity might be changing over time to one that reflects an increase in abdominal adiposity For example, Ian Janssen and colleagues examined the changes in waist circumference for a given BMI over a year period in a Canadian sample Notably, for a given BMI, Canadians had a larger waist circumference in compared with Specifically, the researchers observed a waist circumference that was greater by 1.
Similarly, Sandra Albrecht and colleagues examined the secular changes in waist circumference in the USA — , England — , China — and Mexico — 36 and reported statistically significantly increased waist circumference values relative to BMI in all countries studied and in most subpopulations.
These observations are consistent with those of Tommy Visscher and colleagues, who performed an extensive review and concluded that the majority of the evidence suggests a trend in which the relative increases in waist circumference were larger than the relative increases in BMI This observation is seemingly independent of age, sex and ethnicity, as few groups failed to demonstrate the general trend of secular waist circumference increasing beyond that expected by BMI Fig.
The failure of BMI to detect such an increase in abdominal obesity confirms the limitations of BMI alone to identify the phenotype of obesity that conveys the greatest health risk. Changes in the prevalence of abdominal obesity measured using waist circumference and general obesity measured using BMI measured in different studies during the time period indicated on the x axis.
However, Xi et al. In addition, Barzin et al. Years given for example, — indicate the years in which data were collected. F, female; M, male. Data are from refs 37 , , , , , , , , , Although the prevalence of obesity measured by BMI might have plateaued in some countries, the prevalence of abdominal obesity as measured by waist circumference is generally increasing.
The lack of inclusion of waist circumference in global obesity surveillance might inadequately characterize the health risk associated with the global obesity prevalence, as it seems that the prevalence of abdominal obesity is increasing. Current obesity prevalence trends based on BMI alone should be interpreted with caution.
We recommend that serious consideration should be given to the inclusion of waist circumference in obesity surveillance studies. It is not surprising that waist circumference and BMI alone are positively associated with morbidity 15 and mortality 13 independent of age, sex and ethnicity, given the strong association between these anthropometric variables across cohorts.
However, it is also well established that, for any given BMI, the variation in waist circumference is considerable, and, in any given BMI category, adults with higher waist circumference values are at increased adverse health risk compared with those with a lower waist circumference 38 , 39 , This observation is well illustrated by James Cerhan and colleagues, who pooled data from 11 prospective cohort studies with , white adults from the USA, Australia and Sweden aged 20—83 years This finding is consistent with that of Ellen de Hollander and colleagues, who performed a meta-analysis involving over 58, predominantly white older adults from around the world and reported that the age-adjusted and smoking-adjusted mortality was substantially greater for those with an elevated waist circumference within normal weight, overweight and obese categories as defined by BMI The ability of waist circumference to add to the adverse health risk observed within a given BMI category provides the basis for the current classification system used to characterize obesity-related health risk 8 , Despite the observation that the association between waist circumference and adverse health risk varies across BMI categories 11 , current obesity-risk classification systems recommend using the same waist circumference threshold values for all BMI categories We propose that important information about BMI and waist circumference is lost when they are converted from continuous to broad categorical variables and that this loss of information affects the manner in which BMI and waist circumference predict morbidity and mortality.
Specifically, when BMI and waist circumference are considered as categorical variables in the same risk prediction model, they are both positively related to morbidity and mortality However, when BMI and waist circumference are considered as continuous variables in the same risk prediction model, risk prediction by waist circumference improves, whereas the association between BMI and adverse health risk is weakened 10 , Evidence in support of adjusting waist circumference for BMI comes from Janne Bigaard and colleagues who report that a strong association exists between waist circumference and all-cause mortality after adjustment for BMI Consistent with observations based on asymptomatic adults, Thais Coutinho and colleagues report similar observations for a cohort of 14, adults with CVD who were followed up for 2.
The cohort was divided into tertiles for both waist circumference and BMI. In comparison with the lowest waist circumference tertile, a significant association with risk of death was observed for the highest tertile for waist circumference after adjustment for age, sex, smoking, diabetes mellitus, hypertension and BMI HR 1.
By contrast, after adjustment for age, sex, smoking, diabetes mellitus, hypertension and waist circumference, increasing tertiles of BMI were inversely associated with risk of death HR 0.
The findings from this systematic review 44 are partially confirmed by Diewertje Sluik and colleagues, who examined the relationships between waist circumference, BMI and survival in 5, individuals with T2DM over 4.
In this prospective cohort study, the cohort was divided into quintiles for both BMI and waist circumference. After adjustment for T2DM duration, insulin treatment, prevalent myocardial infarction, stroke, cancer, smoking status, smoking duration, educational level, physical activity, alcohol consumption and BMI, the HR for risk of death associated with the highest tertile was 2.
By contrast, in comparison with the lowest quintile for BMI adjusted for the same variables, with waist circumference replacing BMI , the HR for risk of death for the highest BMI quintile was 0.
In summary, when associations between waist circumference and BMI with morbidity and mortality are considered in continuous models, for a given waist circumference, the higher the BMI the lower the adverse health risk. Why the association between waist circumference and adverse health risk is increased following adjustment for BMI is not established.
It is possible that the health protective effect of a larger BMI for a given waist circumference is explained by an increased accumulation of subcutaneous adipose tissue in the lower body This observation was confirmed by Sophie Eastwood and colleagues, who reported that in South Asian adults the protective effects of total subcutaneous adipose tissue for T2DM and HbA 1c levels emerge only after accounting for visceral adipose tissue VAT accumulation A causal mechanism has not been established that explains the attenuation in morbidity and mortality associated with increased lower body adiposity for a given level of abdominal obesity.
We suggest that the increased capacity to store excess energy consumption in the gluteal—femoral subcutaneous adipocytes might protect against excess lipid deposition in VAT and ectopic depots such as the liver, the heart and the skeletal muscle Fig. Thus, for a given waist circumference, a larger BMI might represent a phenotype with elevations in lower body subcutaneous adipose tissue.
Alternatively, adults with elevations in BMI for a given waist circumference could have decreased amounts of VAT. Excess lipid accumulation in VAT and ectopic depots is associated with increased cardiometabolic risk 47 , 48 , Moreover, VAT is an established marker of morbidity 50 , 51 and mortality 24 , These findings provide a plausible mechanism by which lower values for BMI or hip circumference for a given waist circumference would increase adverse health risk.
When this process becomes saturated or in situations where adipose tissue has a limited ability to expand, there is a spillover of the excess energy, which must be stored in visceral adipose tissue as well as in normally lean organs such as the skeletal muscle, the liver, the pancreas and the heart, a process described as ectopic fat deposition.
Visceral adiposity is associated with a hyperlipolytic state resistant to the effect of insulin along with an altered secretion of adipokines including inflammatory cytokines whereas a set of metabolic dysfunctions are specifically associated with increased skeletal muscle, liver, pancreas, and epicardial, pericardial and intra-myocardial fat.
FFA, free fatty acid. This notion is reinforced by Jennifer Kuk and colleagues who reported that BMI is an independent and positive correlate of VAT in adults before adjustment for waist circumference; however, BMI is negatively associated with VAT mass after adjustment for waist circumference This study also reported that, after adjustment for waist circumference, BMI was positively associated with lower body subcutaneous adipose tissue mass and skeletal muscle mass.
These observations support the putative mechanism described above and, consequently, that the negative association commonly observed between BMI and morbidity and mortality after adjustment for waist circumference might be explained by a decreased deposition of lower body subcutaneous adipose tissue and muscle mass, an increased accumulation of visceral adiposity, or both.
In summary, the combination of BMI and waist circumference can identify the highest-risk phenotype of obesity far better than either measure alone. Although guidelines for the management of obesity from several professional societies recognize the importance of measuring waist circumference, in the context of risk stratification for future cardiometabolic morbidity and mortality, these guidelines limit the recommendation to measure waist circumference to adults defined by BMI to have overweight or obesity.
On the basis of the observations described in this section, waist circumference could be just as important, if not more informative, in persons with lower BMI, where an elevated waist circumference is more likely to signify visceral adiposity and increased cardiometabolic risk.
This observation is particularly true for older adults In categorical analyses, waist circumference is associated with health outcomes within all BMI categories independent of sex and age. When BMI and waist circumference are considered as continuous variables in the same risk prediction model, waist circumference remains a positive predictor of risk of death, but BMI is unrelated or negatively related to this risk.
The improved ability of waist circumference to predict health outcomes over BMI might be at least partially explained by the ability of waist circumference to identify adults with increased VAT mass. For practitioners, the decision to include a novel measure in clinical practice is driven in large part by two important, yet very different questions.
The first centres on whether the measure or biomarker improves risk prediction in a specific population for a specific disease. For example, does the addition of a new risk factor improve the prognostic performance of an established risk prediction algorithm, such as the Pooled Cohort Equations PCE or Framingham Risk Score FRS in adults at risk of CVD?
The second question is concerned with whether improvement in the new risk marker would lead to a corresponding reduction in risk of, for example, cardiovascular events. In many situations, even if a biomarker does not add to risk prediction, it can still serve as an excellent target for risk reduction.
Here we consider the importance of waist circumference in clinical settings by addressing these two questions. The evaluation of the utility of any biomarker, such as waist circumference, for risk prediction requires a thorough understanding of the epidemiological context in which the risk assessment is evaluated.
In addition, several statistical benchmarks need to be met in order for the biomarker to improve risk prediction beyond traditional measures. These criteria are especially important for waist circumference, as established sex-specific and ethnicity-specific differences exist in waist circumference threshold levels 55 , In , the American Heart Association published a scientific statement on the required criteria for the evaluation of novel risk markers of CVD 57 , followed by recommendations for assessment of cardiovascular risk in asymptomatic adults in ref.
Novel biomarkers must at the very least have an independent statistical association with health risk, after accounting for established risk markers in the context of a multivariable epidemiological model.
This characteristic alone is insufficient, however, as many novel biomarkers meet this minimum standard yet do not meaningfully improve risk prediction beyond traditional markers. More stringent benchmarks have therefore been developed to assess biomarker utility, which include calibration , discrimination 58 and net reclassification improvement Therefore, to critically evaluate waist circumference as a novel biomarker for use in risk prediction algorithms, these stringent criteria need to be applied.
Numerous studies demonstrate a statistical association between waist circumference and mortality and morbidity in epidemiological cohorts. Notably, increased waist circumference above these thresholds was associated with increased relative risk of all-cause death, even among those with normal BMI In the USA, prospective follow-up over 9 years of 14, black, white and mixed ethnicity participants in the Atherosclerosis Risk in Communities study showed that waist circumference was associated with increased risk of coronary heart disease events; RR 1.
Despite the existence of a robust statistical association with all-cause death independent of BMI, there is no solid evidence that addition of waist circumference to standard cardiovascular risk models such as FRS 62 or PCE 63 improves risk prediction using more stringent statistical benchmarks.
For example, a study evaluating the utility of the PCE across WHO-defined classes of obesity 42 in five large epidemiological cohorts comprised of ~25, individuals assessed whether risk discrimination of the PCE would be improved by including the obesity-specific measures BMI and waist circumference The researchers found that although each measure was individually associated BMI: HR 1.
On the basis of these observations alone, one might conclude that the measure of waist circumference in clinical settings is not supported as risk prediction is not improved.
However, Nancy Cook and others have demonstrated how difficult it is for the addition of any biomarker to substantially improve prognostic performance 59 , 66 , 67 , Furthermore, any additive value of waist circumference to risk prediction algorithms could be overwhelmed by more proximate, downstream causative risk factors such as elevated blood pressure and abnormal plasma concentrations of glucose.
In other words, waist circumference might not improve prognostic performance as, independent of BMI, waist circumference is a principal driver of alterations in downstream cardiometabolic risk factors. A detailed discussion of the merits of different approaches for example, c-statistic, net reclassification index and discrimination index to determine the utility of novel biomarkers to improve risk prediction is beyond the scope of this article and the reader is encouraged to review recent critiques to gain insight on this important issue 66 , Whether the addition of waist circumference improves the prognostic performance of established risk algorithms is a clinically relevant question that remains to be answered; however, the effect of targeting waist circumference on morbidity and mortality is an entirely different issue of equal or greater clinical relevance.
Several examples exist in the literature where a risk marker might improve risk prediction but modifying the marker clinically does not impact risk reduction. For example, a low level of HDL cholesterol is a central risk factor associated with the risk of coronary artery disease in multiple risk prediction algorithms, yet raising plasma levels of HDL cholesterol pharmacologically has not improved CVD outcomes Conversely, a risk factor might not meaningfully improve statistical risk prediction but can be an important modifiable target for risk reduction.
Indeed, we argue that, at any BMI value, waist circumference is a major driver of the deterioration in cardiometabolic risk markers or factors and, consequently, that reducing waist circumference is a critical step towards reducing cardiometabolic disease risk.
As we described earlier, waist circumference is well established as an independent predictor of morbidity and mortality, and the full strength of waist circumference is realized after controlling for BMI.
We suggest that the association between waist circumference and hard clinical end points is explained in large measure by the association between changes in waist circumference and corresponding cardiometabolic risk factors.
For example, evidence from randomized controlled trials RCTs has consistently revealed that, independent of sex and age, lifestyle-induced reductions in waist circumference are associated with improvements in cardiometabolic risk factors with or without corresponding weight loss 71 , 72 , 73 , 74 , 75 , These observations remain consistent regardless of whether the reduction in waist circumference is induced by energy restriction that is, caloric restriction 73 , 75 , 77 or an increase in energy expenditure that is, exercise 71 , 73 , 74 , We have previously argued that the conduit between change in waist circumference and cardiometabolic risk is visceral adiposity, which is a strong marker of cardiometabolic risk Taken together, these observations highlight the critical role of waist circumference reduction through lifestyle behaviours in downstream reduction in morbidity and mortality Fig.
An illustration of the important role that decreases in waist circumference have for linking improvements in lifestyle behaviours with downstream reductions in the risk of morbidity and mortality.
The benefits associated with reductions in waist circumference might be observed with or without a change in BMI. In summary, whether waist circumference adds to the prognostic performance of cardiovascular risk models awaits definitive evidence. However, waist circumference is now clearly established as a key driver of altered levels of cardiometabolic risk factors and markers.
Consequently, reducing waist circumference is a critical step in cardiometabolic risk reduction, as it offers a pragmatic and simple target for managing patient risk. The combination of BMI and waist circumference identifies a high-risk obesity phenotype better than either measure alone.
We recommend that waist circumference should be measured in clinical practice as it is a key driver of risk; for example, many patients have altered CVD risk factors because they have abdominal obesity. Waist circumference is a critical factor that can be used to measure the reduction in CVD risk after the adoption of healthy behaviours.
Evidence from several reviews and meta-analyses confirm that, regardless of age and sex, a decrease in energy intake through diet or an increase in energy expenditure through exercise is associated with a substantial reduction in waist circumference 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , For studies wherein the negative energy balance is induced by diet alone, evidence from RCTs suggest that waist circumference is reduced independent of diet composition and duration of treatment Whether a dose—response relationship exists between a negative energy balance induced by diet and waist circumference is unclear.
Although it is intuitive to suggest that increased amounts of exercise would be positively associated with corresponding reductions in waist circumference, to date this notion is not supported by evidence from RCTs 71 , 74 , 89 , 90 , A doubling of the energy expenditure induced by exercise did not result in a difference in waist circumference reduction between the exercise groups.
A significant reduction was observed in waist circumference across all exercise groups compared with the no-exercise controls, with no difference between the different prescribed levels Few RCTs have examined the effects of exercise intensity on waist circumference 74 , 90 , 91 , However, no significant differences were observed in VAT reduction by single slice CT between high-intensity and low-intensity groups.
However, the researchers did not fix the level of exercise between the intensity groups, which might explain their observations. Their observations are consistent with those of Slentz and colleagues, whereby differences in exercise intensity did not affect waist circumference reductions.
These findings are consistent with a meta-analysis carried out in wherein no difference in waist circumference reduction was observed between high-intensity interval training and moderate-intensity exercise In summary, current evidence suggests that increasing the intensity of exercise interventions is not associated with a further decrease in waist circumference.
VAT mass is not routinely measured in clinical settings, so it is of interest whether reductions in waist circumference are associated with corresponding reductions in VAT. Of note, to our knowledge every study that has reported a reduction in waist circumference has also reported a corresponding reduction in VAT.
Thus, although it is reasonable to suggest that a reduction in waist circumference is associated with a reduction in VAT mass, a precise estimation of individual VAT reduction from waist circumference is not possible.
Nonetheless, the corresponding reduction of VAT with waist circumference in a dose-dependent manner highlights the importance of routine measurement of waist circumference in clinical practice.
Of particular interest to practitioners, several reviews have observed significant VAT reduction in response to exercise in the absence of weight loss 80 , Available evidence from RCTs suggests that exercise is associated with substantial reductions in waist circumference, independent of the quantity or intensity of exercise.
Exercise-induced or diet-induced reductions in waist circumference are observed with or without weight loss. We recommend that practitioners routinely measure waist circumference as it provides them with a simple anthropometric measure to determine the efficacy of lifestyle-based strategies designed to reduce abdominal obesity.
The emergence of waist circumference as a strong independent marker of morbidity and mortality is striking given that there is no consensus regarding the optimal protocol for measurement of waist circumference.
Moreover, the waist circumference protocols recommended by leading health authorities have no scientific rationale. In , a panel of experts performed a systematic review of studies to determine whether measurement protocol influenced the relationship between waist circumference, morbidity and mortality, and observed similar patterns of association between the outcomes and all waist circumference protocols across sample size, sex, age and ethnicity Upon careful review of the various protocols described within the literature, the panel recommended that the waist circumference protocol described by the WHO guidelines 98 the midpoint between the lower border of the rib cage and the iliac crest and the NIH guidelines 99 the superior border of the iliac crest are probably more reliable and feasible measures for both the practitioner and the general public.
This conclusion was made as both waist circumference measurement protocols use bony landmarks to identify the proper waist circumference measurement location. The expert panel recognized that differences might exist in absolute waist circumference measures due to the difference in protocols between the WHO and NIH methods.
However, few studies have compared measures at the sites recommended by the WHO and NIH. Jack Wang and colleagues reported no difference between the iliac crest and midpoint protocols for men and an absolute difference of 1.
Consequently, although adopting a standard approach to waist circumference measurement would add to the utility of waist circumference measures for obesity-related risk stratification, the prevalence estimates of abdominal obesity in predominantly white populations using the iliac crest or midpoint protocols do not seem to be materially different.
However, the waist circumference measurements assessed at the two sites had a similar ability to screen for the metabolic syndrome, as defined by National Cholesterol Education Program, in a cohort of 1, Japanese adults Several investigations have evaluated the relationship between self-measured and technician-measured waist circumference , , , , Instructions for self-measurement of waist circumference are often provided in point form through simple surveys Good agreement between self-measured and technician-measured waist circumference is observed, with strong correlation coefficients ranging between 0.
Moreover, high BMI and large baseline waist circumference are associated with a larger degree of under-reporting , Overall these observations are encouraging and suggest that self-measures of waist circumference can be obtained in a straightforward manner and are in good agreement with technician-measured values.
Currently, no consensus exists on the optimal protocol for measurement of waist circumference and little scientific rationale is provided for any of the waist circumference protocols recommended by leading health authorities.
The waist circumference measurement protocol has no substantial influence on the association between waist circumference, all-cause mortality and CVD-related mortality, CVD and T2DM.
Absolute differences in waist circumference obtained by the two most often used protocols, iliac crest NIH and midpoint between the last rib and iliac crest WHO , are generally small for adult men but are much larger for women.
The classification of abdominal obesity might differ depending on the waist circumference protocol. We recommend that waist circumference measurements are obtained at the level of the iliac crest or the midpoint between the last rib and iliac crest.
The protocol selected to measure waist circumference should be used consistently. Self-measures of waist circumference can be obtained in a straightforward manner and are in good agreement with technician-measured values.
Current guidelines for identifying obesity indicate that adverse health risk increases when moving from normal weight to obese BMI categories. Moreover, within each BMI category, individuals with high waist circumference values are at increased risk of adverse health outcomes compared with those with normal waist circumference values Thus, these waist circumference threshold values were designed to be used in place of BMI as an alternative way to identify obesity and consequently were not developed based on the relationship between waist circumference and adverse health risk.
In order to address this limitation, Christopher Ardern and colleagues developed and cross-validated waist circumference thresholds within BMI categories in relation to estimated risk of future CVD using FRS The results of their study revealed that the current recommendations that use a single waist circumference threshold across all BMI categories are insufficient to identify those at increased health risk.
In both sexes, the use of BMI category-specific waist circumference thresholds improved the identification of individuals at a high risk of future coronary events, leading the authors to propose BMI-specific waist circumference values Table 1. For both men and women, the Ardern waist circumference values substantially improved predictions of mortality compared with the traditional values.
These observations are promising and support, at least for white adults, the clinical utility of the BMI category-specific waist circumference thresholds given in Table 1. Of note, BMI-specific waist circumference thresholds have been developed in African American and white men and women Similar to previous research, the optimal waist circumference thresholds increased across BMI categories in both ethnic groups and were higher in men than in women.
However, no evidence of differences in waist circumference occurred between ethnicities within each sex Pischon and colleagues investigated the associations between BMI, waist circumference and risk of death among , adults from nine countries in the European Prospective Investigation into Cancer and Nutrition cohort Although the waist circumference values that optimized prediction of the risk of death for any given BMI value were not reported, the findings reinforce the notion that waist circumference thresholds increase across BMI categories and that the combination of waist circumference and BMI provide improved predictions of health risk than either anthropometric measure alone.
Ethnicity-specific values for waist circumference that have been optimized for the identification of adults with elevated CVD risk have been developed Table 2. With few exceptions, the values presented in Table 2 were derived using cross-sectional data and were not considered in association with BMI.
Prospective studies using representative populations are required to firmly establish ethnicity-specific and BMI category-specific waist circumference threshold values that distinguish adults at increased health risk.
As noted above, the ethnicity-specific waist circumference values in Table 2 were optimized for the identification of adults with elevated CVD risk. The rationale for using VAT as the outcome was that cardiometabolic risk was found to increase substantially at this VAT level for adult Japanese men and women We recommend that prospective studies using representative populations are carried out to address the need for BMI category-specific waist circumference thresholds across different ethnicities such as those proposed in Table 1 for white adults.
This recommendation does not, however, diminish the importance of measuring waist circumference to follow changes over time and, hence, the utility of strategies designed to reduce abdominal obesity and associated health risk. The main recommendation of this Consensus Statement is that waist circumference should be routinely measured in clinical practice, as it can provide additional information for guiding patient management.
Indeed, decades of research have produced unequivocal evidence that waist circumference provides both independent and additive information to BMI for morbidity and mortality prediction.
On the basis of these observations, not including waist circumference measurement in routine clinical practice fails to provide an optimal approach for stratifying patients according to risk.
The measurement of waist circumference in clinical settings is both important and feasible. Self-measurement of waist circumference is easily obtained and in good agreement with technician-measured waist circumference. Gaps in our knowledge still remain, and refinement of waist circumference threshold values for a given BMI category across different ages, by sex and by ethnicity will require further investigation.
To address this need, we recommend that prospective studies be carried out in the relevant populations. Despite these gaps in our knowledge, overwhelming evidence presented here suggests that the measurement of waist circumference improves patient management and that its omission from routine clinical practice for the majority of patients is no longer acceptable.
Accordingly, the inclusion of waist circumference measurement in routine practice affords practitioners with an important opportunity to improve the care and health of patients. Health professionals should be trained to properly perform this simple measurement and should consider it as an important vital sign to assess and identify, as an important treatment target in clinical practice.
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Content Map Terms. Measuring Your Waist. Active for Health For Persons with Chronic Conditions General Health Arthritis Cancer Cardiovascular Conditions Kidney Conditions Lung Conditions Mental Health Conditions Metabolic Conditions Helping You Make It Happen.
General Health Arthritis Cancer Cardiovascular Conditions Kidney Conditions Respiratory Conditions Mental Health Conditions Metabolic Conditions Helping You Make It Happen.
Infants, Children and Youth Child Who Is Overweight: Evaluating Nutrition and Activity Patterns Child Who Is Overweight: Medical Evaluation Eczema and Food Allergy in Babies and Young Children Feeding Your Baby: Sample Meals for Babies 6 to 12 Months of Age Finger Foods for Babies 6 - 12 Months Food Allergy Testing HealthLink BC Eating and Activity Program for Kids Healthy Eating for Children Healthy Eating Guidelines for Your Vegetarian Baby: months Healthy Eating Guidelines for Your Vegetarian Toddler: years Helping Your Child Who Is Overweight Interactive Tool: What Is Your Child's BMI?
Iron-Fortified Infant Cereal Recipes: Finger Foods For Babies and Toddlers Making Family Meals Enjoyable Mealtime and Your Toddler Parenting Babies months Recipes for Your Baby 6 - 9 Months Old Recipes for Your Baby 9 - 12 Months Old Reducing Risk of Food Allergy in Your Baby Snack Ideas for Preschoolers Specialized Formula Shortage Vitamins and Minerals for Toddlers Your Toddler: Nutritious Meals for Picky Eaters.
Activities for School Age Children Physical Activity Tips for Children Keeping Children and Teens Active Physical Activity for Youth Fitting in Physical Activity at College or University Preventing Injuries Physical Activity in Children: Get Children Involved.
Older Adults and Endurance Fitness Resistance Training Preventing Falls: Exercises for Strength and Balance Getting Older and Staying Physically Active Aging Well Videos Physical Activity Older Adults and Flexibility Preventing Falls. Black Cohosh for Menopause Symptoms. Health Benefits of Physical Activity Physical Activity Healthy Lifestyle Actions to Reduce and Manage Stress Mental and Emotional Benefits of Activity Muscular Strength and Endurance Physical Activity Definitions Healthy Muscles Weight-Bearing Excercises to Maintain Healthy Bones Fitness: Increasing Core Stability.
Getting Started: Adding More Physical Activity to Your Life Quick Tips: Fitting Physical Activity Into Your Day Quick Tips: Getting Active as a Family Fitness: Adding More Activity To Your Life Getting Started With Flexibility and Exercise Fitness Machines Fitness Clothing and Gear Be Active: Move to Feel Good The Three Kinds of Fitness Set SMART Goals.
What's Stopping You? Stages of Changing Behaviour Fitness: Getting Around Barriers to Exercise Overcoming Barriers to Being Physically Active for the Older Adult Physical Activity While Living with a Disability Kris's Story: Getting Active With No Excuses.
How to Choose Safe Equipment Exercising While Sitting Down Fitness DVDs and Videos Tips for Picking the Right Activities Quick Tips: Getting in Shape Without Spending Money Fitness: Walking for Wellness Walk Your Way To Health Tai Chi and Qi Gong Water Exercise Yoga Bob's Story: Biking for Health Exercise and Physical Activity Ideas Fitness: Choosing Activities That Are Right for You.
Fitness: Getting and Staying Active Fitness: Making It a Habit Quick Tips: Having Enough Energy to Stay Active Quick Tips: Staying Active at Home Quick Tips: Staying Active When You Travel Physical Activity in Winter Quick Tips: Staying Active in Cold Weather Quick Tips: Staying Active in Hot Weather.
Cooling Down How to Exercise Safely Injury Prevention Flexibility Precautions for Flexibility Activities Precautions for Strengthening Activities Warming Up Warming Up and Cooling Down Overtraining Returning to Play After a Head Injury During a Sporting Event Sports-Related Dehydration.
Diabetes and Hypoglycemia Eating Disorders Healthy Eating for Disease Prevention Eating Right When You Have More Than One Health Problem Being Active When You Have More Than One Health Problem Physical Activity and Disease Prevention Anemia Anemia of Chronic Disease ACD Folic Acid Deficiency Anemia Iron Deficiency Anemia Vitamin B12 Deficiency Anemia.
Eating Guidelines for Gout Exercise and Osteoarthritis Exercise for Rheumatoid Arthritis Healthy Habits to Prevent or Reduce Problems from Osteoporosis Osteoarthritis: Excercising with Arthritis Physiotherapy for Knee Arthritis Quick Tips: Exercising Safely with Arthritis. Excercises After Mastectomy Breast Cancer: Healthy Eating After a Diagnosis Eating Guidelines For After a Cancer Diagnosis Healthy Eating Guidelines for Cancer Survivors Cancer and Physical Activity Eating Well During Cancer Treatment Cancer Prevention Eating Guidelines.
Managing Constipation in Adults Healthy Eating Guidelines for People with Diverticular Disease Fibre and Your Health Lower Fibre Food Choices Eating Guidelines For Gallbladder Disease Healthy Eating Guidelines for Irritable Bowel Syndrome Lactose Intolerance Healthy Eating Guidelines for People with Peptic Ulcers Bowel Disease: Changing Your Diet Celiac Disease: Eating a Gluten-Free Diet GERD: Controlling Heartburn by Changing Your Habits Irritable Bowel Syndrome: Controlling Symptoms with Diet.
Severe Allergic Reaction to Food: Children and Teens Food Allergies. Cardiac Rehabilitation Coronary Artery Disease: Exercising for a Healthy Heart DASH Diet Sample Menu Healthy Eating Guidelines for People Taking Warfarin Anticoagulants Healthy Eating to Lower High Blood Pressure Exercising to Prevent a Stroke Healthy Diet Guidelines for a Healthy Heart Heart Arrhythmias and Exercise Heart Failure: Eating a Healthy Diet Heart Failure: Track Your Weight, Food and Sodium Heart-Healthy Eating Heart-Healthy Eating: Fish Heart-Healthy Lifestyle High Blood Pressure: Nutrition Tips High Cholesterol: How a Dietitian Can Help Modify Recipes for a Heart-Healthy Diet Plant-based Diet Guidelines Peripheral Arterial Disease and Exercise Physical Activity Helps Prevent a Heart Attack and Stroke High Blood Pressure: Using the DASH Diet Healthy Eating: Eating Heart-Healthy Foods Heart Health: Walking for a Healthy Heart Izzy's Story: Living with the DASH Diet.
Healthy Eating Guidelines for People with Early Chronic Kidney Disease CKD Stages 1 and 2 Healthy Eating Guidelines for Prevention of Recurrent Kidney Stones Healthy Eating for Chronic Hepatitis Kidney Disease: Changing Your Diet Kidney Stones: Preventing Kidney Stones Through Diet Non-Alcoholic Steatohepatitis NASH.
Healthy Eating Guidelines for People with Multiple Sclerosis. Spinal Cord Injury: Flexibility Exercises Multiple Sclerosis: Benefits of Exercise. About Healthy Eating Eating Habits Developing a Plan for Healthy Eating Drinking Enough Water Eating Healthy at Holiday Parties Eating Journal Emotional Eating Encourage Healthy Eating Away From Home Food Journaling: How to Keep Track of What You Eat Healthy Eating: Changing Your Eating Habits Healthy Eating: Getting Support When Changing Your Eating Habits Healthy Eating: Making Healthy Choices When You Eat Out Healthy Eating: Making Healthy Choices When You Shop Healthy Eating: Overcoming Barriers to Change Healthy Eating: Starting a Plan for Change Healthy Eating: Staying With Your Plan Healthy Eating to Decrease Stress Jaci's Story: Changing her Life With Small Steps Jeremy's Story: Focusing on Eating Habits Loralie's Story: It's Never Too Late Maggie Morries: Plan Ahead When You Eat Out.
Vegan Diet Plant Based Diet Guidelines Mediterranean Diet Quick Tips: Adding Fruits and Veggies To Your Diet What Makes Vegatables and Fruit So Special?
Sugary Drinks - How Much Sugar Are You Drinking? Energy and Sports Drinks. Food Sources of Sodium Healthy Eating Guidelines for Lower Sodium Salt Eating Videos: Sodium Savvy How to Find Sodium Salt Subsitute Recipe Healthy Eating: Eating Less Sodium.
Organic Foods Canadian Organic Logo and USDA Organic Seal Health Claims on Food Labels. Quick Tips: Healthy Eating on a Budget Eating on a Budget Meal Planning: Getting Started The Benefits of Eating Together For Children and Families Quick Tips: Making Fast, Healthy Meals Quick Tips: Making Healthy Snacks Lunches to Go.
Avoiding Mercury in Fish Food Safety: Cooking Food Safety: Following the Package Instructions Food Safety: Preparing Food Safety: Serving Food Safety: Storing Food Safety: Tips for Grocery Shopping Marine Toxins Summer Food Safety.
About Healthy Weights Genetic Influences on Weight Screening for Weight Problems Unplanned Weight Loss Quick Tips: Cutting Calories Physical Activity for Weight Loss Weight Loss by Limiting Calories Tips for Maintaining Weight Loss Choosing a Weight-Loss Program Boosting Your Metabolism Exercise Helps Maggie Stay at a Healthy Weight Healthy Eating: Recognizing Your Hunger Signals Hunger, Fullness, and Appetite Signals Weight Management Weight Management: Stop Negative Thoughts Maggie's Strategies for Eating Healthy Maggie: Making Room for Worth-It Foods Maggie's Story: Making Changes for Her Health Weight Management Centre.
Guidelines for Food and Beverage Sales in BC Schools Guidelines for Food and Beverage Sales: Making Bake Sales Delicious and Nutritious Guidelines for Food and Beverage Sales: Boosting the Sales of Nutritious Food in Schools Guidelines for Food and Beverage Sales: Food Fundraiser Ideas for Schools Guidelines for Food and Beverage Sales: Involving Everyone in Implementing the Guidelines Guidelines for Food and Beverage Sales: Selling Food and Beverages at School Sporting Events Guidelines for Food and Beverage Sales: Planning Healthy Cafeteria Menus.
Guidelines for Food and Beverage Sales: Stock Vending Machines and Stores with Healthy Food and Beverages. Measuring Your Waist Estimating Body Fat Percentage Factsheet Generator Fitness: Using a Pedometer or Step Counter.
Topic Contents Overview Related Information References Credits. Overview Waist circumference is the distance around your waist. For most people, the goal for a healthy waist is: footnote 1 Less than cm 40 in.
for men. Less than 88 cm 35 in. for women. Related Information Weight Management. References Citations Office of Nutrition Policy and Promotion, Health Canada Canadian Guidelines for Body Weight Classification in Adults.
Wqist Considering the eligibility circumfetence, Health-conscious drinking habits final sample of nine articles was finess. Discussion: Waaist exercise prevents increases ans BMI and WC Anthocyanins and mood regulation individuals abd IDD. Aerobic Waist circumference and fitness seems to be more effective in promoting WC and combined Waist circumference and fitness in BMI. Obesity is a major public cicrumference problem due to its growing prevalence, as it increases the risk of developing various diseases such as cardiovascular or metabolic diseases de Winter et al. Excessive adiposity results from an imbalance between energy intake and expenditure. Body mass index BMI and abdominal adiposity assessed using waist circumference WCbody composition and anthropometric variables, are essential markers to assess overweight and obesity and are associated to metabolic disease and QoL Klein et al. This measure are non-evasive methods widely used in individual with Intellectual and Developmental Disabilities IDD to measure nutritional status Temple et al. Your circukference waistline hits at the Waist circumference and fitness between Holistic reproductive health top of your amd bone and the bottom of your rib cage. Enhancing cognitive function waistline may be bigger circumfegence smaller depending on your Antidepressant alternatives, frame size, and lifestyle habits. Measuring the Holistic reproductive health of circumefrence waist may help clue you in to your health. According to the National Heart, Lung, and Blood Instituteyou can be at increased risk of developing type 2 diabetes, high blood pressure, and heart disease if you are a man with a waistline of more than 40 inches Read on to learn more about your waistline, and the connection between your waistline and your health. Your doctor may be your best reference for understanding what a healthy waist size is for you. For example, people who are particularly tall or short may have a different ideal waist size for health.
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