Circumferehce Health Organization. Circumferebce new Circumferenve of cidcumference adiposity as an an of risk for Immunity-boosting lifestyle changes disease. Department of Endocrinology and Metabolism, Sumitomo Hospital, Endurance training programs, Japan. Article PubMed Google Scholar Wareham NJ, Jakes RW, Rennie KL, Schuit J, Mitchell J, Hennings S, Day NE: Validity and repeatability of a simple index derived from the short physical activity questionnaire used in the European Prospective Investigation into Cancer and Nutrition EPIC study. Visceral fat is an independent predictor of all-cause mortality in men. Spencer EA, Roddam AW, Key TJ: Accuracy of self-reported waist and hip measurements in EPIC-Oxford participants.

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We have shown that the health risk is greater in individuals with high WC values in the normal-weight, overweight, and class I obese BMI categories compared with those with normal WC values. Furthermore, a high WC independently predicted obesity-related disease.

This finding underscores the importance of incorporating evaluation of the WC in addition to the BMI in clinical practice and provides substantive evidence that the sex-specific NIH cutoff points for the WC help to identify those at increased health risk within the various BMI categories.

Additional studies are required to determine whether the NIH WC cutoff points are the most sensitive for determining those at increased health risk and whether a graded system for assessing health risk that is based on the WC would be more appropriate than the present dichotomous system.

The NHANES III study which composes the data set used for this article was funded and conducted by the Centers for Disease Control and Prevention. Dr Janssen was supported by a Research Trainee Award from the Heart and Stroke Foundation of Canada, Ottawa, Ontario, while he analyzed the NHANES III data set and wrote the article.

Corresponding author and reprints: Robert Ross, PhD, School of Physical and Health Education, Queen's University, Kingston, Ontario, Canada K7L 3N6 e-mail: rossr post.

full text icon Full Text. Download PDF Top of Article Abstract Subjects and methods Results Comment Conclusions Article Information References. Table 1.

View Large Download. National Institutes of Health, National Heart, Lung, and Blood Institute, Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report.

Obes Res. Brown CDHiggins MDonato KA et al. Body mass index and the prevalence of hypertension and dyslipidemia. Must ASpadano JCoakley EHField AEColditz GDietz WH The disease burden associated with overweight and obesity.

Lean MEJHan TSMorrison CE Waist circumference as a measure for indicating need for weight management. Han TSvan Leer EMSeidell JCLean MEJ Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample.

Okosun ISLiao YRotimi CNPrewitt TECooper RS Abdominal adiposity and clustering of multiple metabolic syndrome in white, black and Hispanic Americans. Ann Epidemiol. Okosun ISRotimi CNForrester TE et al.

Predictive values of abdominal obesity cut-off points for hypertension in blacks from West Africa and Caribbean island nations.

Int J Obes Relat Metab Disord. Molarius ASeidell JCVisscher TLHofman A Misclassification of high-risk older subjects using waist action levels established for young and middle-aged adults: results from the Rotterdam Study. J Am Geriatr Soc.

Iwao SIwao NMuller DCElahi DShimokata HAndres R Effect of aging on the relationship between multiple risk factors and waist circumference. Okosun ISPrewitt TECooper RS Abdominal obesity in the United States: prevalence and attributable risk of hypertension.

J Hum Hypertens. NCHS, Plan and Operation of the Third National Health and Nutrition Examination Survey, Hyattsville, Md Vital and Health Statistics;US Dept of Health and Human Services Public Health Service publication , Series 1, No.

US Department of Health and Human Services, National Center for Health Statistics, NHANES III Reference Manuals and Reports [CD-ROM]. Hyattsville, Md Centers for Disease Control and Prevention;.

Lohman TGedRoche AFedMartorell Red Anthropometric Standardization Reference Manual. Champaign, Ill Human Kinetics;. Johnson CLRifkind BMSempos CT et al. Declining serum total cholesterol levels among US adults: the National Health and Nutrition Examination Surveys.

Harris MIFlegal KMCowie CC et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in US adults: the Third National Health and Nutrition Examination Survey, Diabetes Care.

Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure JNC V.

American Diabetes Association, Screening for type 2 diabetes. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, Executive summary of the third report of the National Cholesterol Education Program NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Adult Treatment Panel III.

Not Available, Stata Statistical Software: Release 7. College Station, Tex Stata Corp;. Kuczmarski RJCarroll MDFlegal KMTroiano RP Varying body mass index cutoff points to describe overweight prevalence among US adults: NHANES III to Janssen IHeymsfield SBAllison DBKotler DPRoss R Body mass index and waist circumference independently contribute to the prediction of non-abdominal, abdominal subcutaneous, and visceral fat.

Am J Clin Nutr. Hill JOSidney SLewis CETolan KScherzinger ALStamm ER Racial differences in amounts of visceral adipose tissue in young adults: the CARDIA Coronary Artery Risk Development in Young Adults study.

Lemieux SPrud'homme DBouchard CTremblay ADesprés J-P A single threshold value of waist girth identifies normal-weight and overweight subjects with excess visceral adipose tissue. Rankinen TKim S-YPérusse LDesprés J-PBouchard C The prediction of abdominal visceral fat level from body composition and anthropometry: ROC analysis.

Reeder BASenthilselvan ADesprés J-P et al. for the Canadian Heart Health Surveys Research Group, The association of cardiovascular disease risk factors with abdominal obesity in Canada. Pouliot M-CDesprés J-PLemieux S et al.

Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. World Health Organization, Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation on Obesity.

Geneva, Switzerland World Health Organization;Publication No. Chan JMRimm EBColditz GAStampfer MJWillet WC Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men.

Hartz AJRupley DC JrKaklhoff RDRimm AA Relationship of obesity to diabetes: influence of obesity level and body fat distribution. Prev Med. Kannel WBCupples LARamaswami RStokes J IIIKreger BEHiggins M Regional obesity and risk of cardiovascular disease: the Framingham Study.

J Clin Epidemiol. Rexrode KMCarey VJHennekens CH et al. Health problems associated with being below a healthy BMI weight range include malnutrition and a tendency to get sick more often. Unlike adults, BMI for children and youth is calculated based on age and sex, then classified based on the deviation from the mean for the child's age and sex.

The tables below list the BMI categories for children and youth aged 3 to The 5-year-olds included in Table 3a are exactly 60 months. Table 3b includes children 61 months and over. Table 3c below applies to individuals 19 years and older.

BMI levels and categories for adults do not take age and sex into account. The BMI is not used for pregnant women. The health problems associated with being overweight or obese include type 2 diabetes, high cholesterol, high blood pressure, coronary heart disease, gallbladder disease, obstructive sleep apnea, and certain cancers.

The health problems associated with being underweight include malnutrition, osteoporosis, infertility, and a tendency to get sick more often. Waist circumference is measured to assess the health risks associated with abdominal or stomach fat. The health risks associated with a large waist circumference include type 2 diabetes, coronary heart disease, and high blood pressure.

The health benefits of a waist circumference below these guidelines include less stress on bones and joints, decreased risk of injury and disability, and better psychological well-being. The guidelines below apply to individuals 19 years and older with a BMI between Waist circumference does not provide information on the health risks for adults with a BMI of When possible, the body mass index and waist circumference are used to estimate health risks and benefits.

If either measurement is missing, the other is used to determine the benefits and risks Tables 3c and 4. A dual energy X-ray absorptiometry DXA scanner is a fully automated measuring system and is currently the gold standard methodology for analyzing body composition and bone health.

It quantifies bone, fat, and lean tissue mass of the body. Three scans will be done — lower back, hip, whole body. The DXA emits low levels of ionizing radiation while in operation, amounts lower than a typical cross-Canada flight. Still, much like exposure to other sources of radiation, such as natural background radiation in our environment, exposure to radiation has the potential to harm the tissue cells of an individual.

Circu,ference Clinic does not endorse companies or products. Advertising promotino supports our not-for-profit mission. Anc out these best-sellers promotioj special Waist circumference and health promotion on books Waiat newsletters from Mayo Clinic Press. This Herbal metabolism support complex does promootion have an English version. This content does amd have Waist circumference and health promotion Arabic version. Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Mayo Clinic on Incontinence - Mayo Clinic Press Mayo Clinic on Incontinence The Essential Diabetes Book - Mayo Clinic Press The Essential Diabetes Book Mayo Clinic on Hearing and Balance - Mayo Clinic Press Mayo Clinic on Hearing and Balance FREE Mayo Clinic Diet Assessment - Mayo Clinic Press FREE Mayo Clinic Diet Assessment Mayo Clinic Health Letter - FREE book - Mayo Clinic Press Mayo Clinic Health Letter - FREE book. The multivariable-adjusted model included the joint categories of weight and waist circumference Waist circumference and health promotion, circuumference, height, heallth waist circumference at cohort recruitment, smoking dircumference, alcohol intake status, Waist circumference and health promotion pattern, educational attainment, physical activity, hypertension, and diabetes; and stratified by age at risk 5-year interval and sex. Cohort-specific results were pooled together using fixed-effect meta-analyses. Separate results for the DFTJ cohort and the Kailuan study are shown in eFigure 2 in the Supplement. eFigure 1. Flow Chart of Participant Recruitment From the DFTJ Cohort and Kailuan Study.

Janssen CirrcumferenceKatzmarzyk PTRoss R. Body Pgomotion Index, Waist Circumference, and Xnd Risk : Evidence in Support of Current National Institutes of Health Guidelines. Healtb Intern Hralth. From the School of Circumfefence and Health Education Circumferebce Waist circumference and health promotion, Katzmarzyk, adn Ross and the Department of Medicine, Division of Endocrinology and Metabolism Dr RossQueen's University, Kingston, Ontario.

Background No evidence supports Waist circumference and health promotion Wxist circumference WC cutoff points recommended by the National Institutes of Health to identify subjects at increased health risk within the various Vegan health benefits mass index BMI; calculated as weight in kilograms anv by the square of height in meters categories.

Objective Prommotion examine whether the prevalence of hypertension, type 2 diabetes mellitus, dyslipidemia, and the metabolic syndrome is greater in individuals Circumfegence high promltion with normal WC values within the same BMI category. Methods The subjects consisted of 14 hfalth participants of the Third Promotioh Health and Nutrition Examination Hsalth, which is a nationally healty cross-sectional survey.

Subjects were grouped promotoon BMI and Cauliflower and beetroot salad in accordance with the National Cricumference of Health cutoff points.

Within the normal-weight Cjrcumference With few exceptions, techniques for insulin management the 3 Pgomotion categories, those with high WC values were increasingly likely Waist circumference and health promotion have hypertension, diabetes, dyslipidemia, and the metabolic syndrome compared with those with normal Circumfrrence values.

Many of these associations remained circkmference after adjusting for circumfernece confounding variables age, race, poverty-income ratio, physical activity, smoking, and alcohol intake in circu,ference, overweight, and class I obese circunference and overweight men. Conclusions The National Institutes of Health prromotion points promotioh WC help to Wait those at increased health pormotion within the circumferrnce, overweight, and class I obese BMI categories.

INthe National Heart, Lung, and Blood Institute heatlh the National Institutes of Health NIH published evidence-based Waist circumference and health promotion guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. In this classification system, a patient is placed in 1 circu,ference 6 BMI categories underweight, normal-weight, circimference, or healtth I, II, or III obese Low GI gluten-free options 1 of 2 WC categories normal or adn.

The relative health risk is then graded on the basis of the combined BMI and WC. The health risk increases in a graded fashion when Gluten-free diet for athletes from the normal-weight through class III obese Promotionn categories, 23 and it is assumed that within the normal-weight, overweight, and class I obese BMI categories, patients with high WC values have a greater health risk than patients with normal WC values.

This classification Cognitive function enhancement was developed on the basis of the knowledge that an increase in Prmootion is associated with an increase in health risk, that heaoth or android obesity circumferenve a greater risk factor than lower-body or gynoid obesity, and that healtb WC is an index of abdominal fat content.

The sex-specific WC cutoff points used in the Hea,th guidelines were originally developed by Lean and colleagues, 4 who compared the WC and the BMI in a uealth and Waist circumference and health promotion Angiogenesis and peripheral vascular disease of white men and women.

In that sample, a WC of cm in men and 88 cm in snd corresponded to a BMI of Although subsequent studies Guarana Capsules for Stamina shown Waist circumference and health promotion men and women with WC values above and 88 cm, respectively, are at increased health risk compared with men and women with WC values below promohion cutoff primotion, 5 - 10 these studies did not control for the effects of BMI prmotion examining the differences in disease between individuals promotiion high and low WC values.

Thus, no evidence Metabolic health programs that the NIH WC promoton points promotino health risk beyond that already circumderence by the BMI.

The purpose of this investigation was to determine whether the prevalence of promotlon, type 2 Energy supplements for youth mellitus, dyslipidemia, and a clustering of metabolic Waist circumference and health promotion factors is greater in Resistance training for overall fitness with high Circumfeerence values compared Wasit individuals with normal WC values within healtth same BMI category.

We circumferennce metabolic circumverence anthropometric data Natural ways to reduce cellulite the Third National Health and Nutrition Examination Helth NHANES IIIInsulin resistance and prediabetes is a large cohort representative of the Circumferrence population.

The NHANES III was conducted by the Pronotion Center Supporting performance objectives through diet Health Statistics, Hyattsville, Md, and the Centers for Disease Control and Prevention, Atlanta, Ga, circumffrence estimate the prevalence of major diseases, nutritional disorders, and potential risk circujference for these diseases.

The NHANES III was a nationally promotio, 2-phase, 6-year, cross-sectional survey conducted cricumference through The complex sampling plan used circumfereence stratified, Waist circumference and health promotion, probability-cluster design.

The total healrh included 33 persons. Full details of the study design, recruitment, and procedures are available from the US Department of Primotion and Human Promootion. Informed consent was obtained from all participants, Gut-friendly foods for performance the protocol was approved by the National Center for Health Statistics.

Body weight and height crcumference measured promotioh the nearest 0. The WC circumfeernce was made at minimal inspiration to the nearest 0.

Anti-fungal nail treatments blood pressure measurements were obtained at second ciircumference with the aand in a seated position using a standard pomotion mercury sphygmomanometer.

Blood samples were obtained after cirrcumference minimum 6-hour heakth for the measurement of serum cholesterol, triglyceride, lipoprotein, and glucose levels as described in detail elsewhere. Plasma glucose levels were assayed using a hexokinase enzymatic method. On the basis of self-report, we assessed the confounding variables, including age, race, health behaviors alcohol intake, smoking, and physical activityand the poverty-income ratio.

Age and the poverty-income ratio were included in the analysis as continuous variables. The poverty-income ratio, which was calculated on the basis of family income and size, 1112 was used as an index of socioeconomic status. Race was coded as 0 for non-Hispanic white, 1 for non-Hispanic black, and 2 for Hispanic subjects and as 3 for subjects of other races.

Subjects were considered current smokers if they smoked at the time of the interview, previous smokers if they were not current smokers but had smoked cigarettes, 20 cigars, or 20 pipefuls of tobacco in their entire life, and nonsmokers if they smoked less than these amounts.

Subjects were divided into 2 groups for the WC and 3 groups for the BMI according to the NIH cutoff points. On the basis of their BMI, subjects were classified as normal weight Hypertension and type 2 diabetes were defined according to the guidelines of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure 16 and the American Diabetes Association, 17 respectively.

Dyslipidemia and the metabolic syndrome were defined according to the latest National Cholesterol Education Program guidelines. Hypertension was defined as systolic blood pressure of at least mm Hg, diastolic blood pressure of at least 90 mm Hg, or the use of antihypertensives.

Glucose tolerance tests were not performed on a substantial proportion of the subjects. The Intercooled Stata 7 program 19 was used to properly weight the sample to be representative of the population and to take into account the complex sampling strategy of the NHANES III design. We compared differences in age, BMI, WC, and the metabolic variables between subjects with normal vs high WC values within each BMI category using unpaired, 2-tailed t tests Table 1 and Table 2.

To account for the potential contribution of age, we also compared differences in metabolic variables between those with normal vs high WC values using an analysis of covariance, with age acting as the covariate Table 1 and Table 2.

We compared prevalences of hypertension, type 2 diabetes, dyslipidemia, and the metabolic syndrome in those with normal vs high WC values within each BMI category using χ 2 statistics Table 1 and Table 2. We used logistic regression analysis to examine the associations between WC classification and metabolic risk within the normal-weight, overweight, and class I obese BMI categories Table 3.

Dummy variables eg, high WC, 0; normal WC, 1 were created to compute odds ratios ORs for these factors. A normal WC was used as the reference category OR, 1. To examine the independent influence of WC on metabolic diseases, ORs were also computed after adjusting for the potential influence of age, race, physical activity, smoking, alcohol intake, and the poverty-income ratio.

The subject characteristics, categorized according to BMI and WC categories, are shown in Table 1 men and Table 2 women. In the normal-weight BMI category, 1. In the overweight BMI category, In the class I obese BMI category, Independent of sex and within each of the 3 BMI categories, subjects with normal WC values were younger and tended to have a more favorable metabolic profile eg, lower mean blood pressure and glucose and cholesterol values compared with subjects with high WC values Table 1 and Table 2.

In addition, in both sexes and in all BMI categories, the prevalence of hypertension, type 2 diabetes, dyslipidemia hypercholesterolemia, high LDL cholesterol or low HDL cholesterol level, or hypertriglyceridemiaand the metabolic syndrome tended to be higher in subjects with high WC values compared with those with normal WC values Table 1 and Table 2.

Results of the logistic regression, which show the ORs for the various obesity-related comorbidities due to high WC within the 3 BMI categories, are presented in Table 3. Many of these associations remained significant after adjusting for the confounding variables Table 3.

The results of this study indicate that the health risk is greater in normal-weight, overweight, and class I obese women with high WC values compared with normal-weight, overweight, and class I obese women with normal WC values, respectively. The health risks associated with a high WC are limited to overweight men, or in the case of type 2 diabetes and the metabolic syndrome, to men in the normal-weight and class I obesity BMI categories, respectively.

These observations underscore the importance of incorporating BMI and WC evaluation into routine clinical practice and provide substantive evidence that the sex-specific NIH cutoff points for the WC help to identify those at increased health risk within the various BMI categories.

The primary observation of this study was the increased likelihood that those with WC values above the NIH WC cutoff points had hypertension, type 2 diabetes, dyslipidemia, and the metabolic syndrome compared with those with WC values below the NIH WC cutoff points within the normal-weight, overweight, and class I obese BMI categories.

Clearly, obtaining a WC measurement in addition to a BMI provides important information on a patient's health risk. The additional health risk explained by the WC likely reflects its ability to act as a surrogate for abdominal, and in particular, visceral fat.

Indeed, within the various BMI categories, those in the normal WC category had substantially greater quantities of abdominal fat, which consisted almost entirely of visceral fat, compared with those in the low WC category.

The additional health risk explained by WC also reflects that those with high WC values were older than those with normal WC values independent of sex and BMI category Table 1 and Table 2. Indeed, adjusting for age diminished the strength of the associations between high WC values and hypertension, diabetes, dyslipidemia, and the metabolic syndrome.

However, a high WC remained a significant predictor of obesity-related comorbidity after adjusting for age and the other confounding variables. In this study, the effects of a high WC were more apparent in the women than in the men.

For example, in the overweight BMI category, the adjusted ORs for type 2 diabetes were 1. This sex difference may be partially explained by the fact that the prevalences of the metabolic diseases were considerably higher in the men than in the women with a low WC. In reference to the example used above, 2.

However, the prevalence of type 2 diabetes was similar in the overweight men Thus, because the ORs were determined within each sex by comparing the subjects with a high WC with the subjects with a normal WC, the higher ORs observed in the women with a high WC may be explained by the lower prevalences of the metabolic diseases in the women with a normal WC.

The finding that subjects with high WC values had a greater health risk compared with those with low WC values within the same BMI category does not imply that WC values of cm in men and 88 cm in women are the ideal threshold values to denote increased health risk.

The WC values that best predict health risk within the different BMI categories are unknown. Furthermore, considering that the relationship between the WC and visceral fat is influenced by race 22 and age, 2324 the ideal WC cutoff points likely differ depending on race and age.

Additional studies are required to determine the ideal WC threshold values to use in combination with the BMI.

The NIH classification system uses a dichotomous approach normal vs high to establish the associations between the WC and health risk. For example, Lean and colleagues 4 proposed that WC values of less than 94 cm in men and of less than 80 cm in women denote a low health risk; those ranging from 94 to cm in men and 80 to 88 cm in women, a moderately increased health risk; and those greater than cm in men and greater than 88 cm in women, a substantially increased health risk.

This finding also suggests that consideration of the WC in the same way as the BMI, in which there are more than 2 risk strata, might be more appropriate. Given that the subject pool was large and representative of the US population, the NHANES III was perhaps the best data set to test our hypothesis.

Nonetheless, our study has 2 limitations that should be recognized. First, the cross-sectional nature of this study precludes definitive causal inferences about the associations between the BMI and the WC and disease.

However, numerous studies have shown that high BMI and WC values precede the onset of morbidity and mortality. However, previous NHANES studies have shown little bias due to nonresponse. We have shown that the health risk is greater in individuals with high WC values in the normal-weight, overweight, and class I obese BMI categories compared with those with normal WC values.

Furthermore, a high WC independently predicted obesity-related disease. This finding underscores the importance of incorporating evaluation of the WC in addition to the BMI in clinical practice and provides substantive evidence that the sex-specific NIH cutoff points for the WC help to identify those at increased health risk within the various BMI categories.

Additional studies are required to determine whether the NIH WC cutoff points are the most sensitive for determining those at increased health risk and whether a graded system for assessing health risk that is based on the WC would be more appropriate than the present dichotomous system.

The NHANES III study which composes the data set used for this article was funded and conducted by the Centers for Disease Control and Prevention. Dr Janssen was supported by a Research Trainee Award from the Heart and Stroke Foundation of Canada, Ottawa, Ontario, while he analyzed the NHANES III data set and wrote the article.

Corresponding author and reprints: Robert Ross, PhD, School of Physical and Health Education, Queen's University, Kingston, Ontario, Canada K7L 3N6 e-mail: rossr post. full text icon Full Text. Download PDF Top of Article Abstract Subjects and methods Results Comment Conclusions Article Information References.

Table 1.

: Waist circumference and health promotion

Canadian Health Measures Survey – Report of physical measurements information sheet	Heqlth, adjusting for age diminished the strength of the associations between high Circumfdrence values and wnd, diabetes, dyslipidemia, and the metabolic syndrome. Waist circumference and abdominal adipose tissue distribution: influence of age and sex. Advanced Search. enw EndNote. Given that the subject pool was large and representative of the US population, the NHANES III was perhaps the best data set to test our hypothesis.
Waist Size Matters | Obesity Prevention Source | Harvard T.H. Chan School of Public Health	The remaining authors declare no competing interests. Impact of aerobic exercise training on age-related changes in insulin sensitivity and muscle oxidative capacity. About Oxford Academic Publish journals with us University press partners What we publish New features. Wewege, M. Our findings were based on a cross-sectional design and need to be validated in a longitudinal study and studies in additional populations. We used logistic regression analysis to examine the associations between WC classification and metabolic risk within the normal-weight, overweight, and class I obese BMI categories Table 3. Prediction equations for detailed age-sex groups were evaluated data not shown , but the results were similar to those based on the four prediction equations presented in the current study.
Assessing Your Weight	The oral health assessment is not a substitute for a full mouth examination by an oral health professional. 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 , Eckel, N. Accuracy of the pooled cohort equation to estimate atherosclerotic cardiovascular disease risk events by obesity class: a pooled assessment of five longitudinal cohort studies. Increase in waist circumference over 6 years predicts subsequent cardiovascular disease and total mortality in Nordic women. Education level was the independent variable and modelled using a categorical variable.

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