Waist circumference

Increased waist circumference (greater than 40 inches or 102 cm in males and greater than 35 inches or 89 cm in females). 

Waist circumference greater than 40 inches (101.6 cm) in men (greater than 35 inches in Asian males), or 35 inches (88.9 cm) in women (greater than 31 inches in Asian females)... 

Men Waist circumference greater than 102 centimeters (40 inches)... 

Body mass index (BMI), waist circumference, comorbidities, and readiness to lose weight are used in the assessment of the overweight or obese patient. 

A 35-year-old woman with a history of hypertension presents to your clinic complaining of low energy and irritability. She reports not following any specific diet because they have all failed in the past. She does admit to eating out frequently. This patient does not exercise because her job and her kids are too demanding. Patient does smoke a half pack of cigarettes per day and consumes low-calorie, caffeinated and alcoholic drinks most days. Her BMI is 32 kg/m2, and her waist circumference is 38 in (97 cm). 

At each follow-up visit, compliance with a healthy lifestyle should be determined, as well as measurement of physical parameters, including weight, blood pressure, and heart rate. Waist circumference should be measured intermittently. A complete assessment also would include identification of adverse drug reactions or drug interactions if weight-loss medications have been initiated. 

Determine if history of BMI greater than 25 kg/m 2. If unavailable or BMI unknown, obtain weight, height, and waist circumference. Calculate the BMI. Assess the patient s willingness to lose weight. 

Prevention of weight gain is recommended in all patients with a BMI of 25 kg/m2 or greater. Weight loss is indicated for patients with a BMI of 25 to 29.9 kg/m2 or an elevated waist circumference with two or more risk factors or for any patient with a BMI of 30 kg/m2 or greater. 

Close monitoring should follow to assess weight, BMI, waist circumference, and presence of complications related to the treatment plan. If weight-loss goals are not attained, determine reasons for failure. 

In addition to supplementation or dietary intake of the xanthophylls, several other modulators that influence the MPOD response of subjects to supplementation with xanthophylls were reported (Mares et al. 2006). Larger waist circumference and the presence of diabetes predicted a decrease of MPOD. In contrast to earlier findings, iris color was not related to MPOD. No dependence of MPOD on age was revealed in this study but this may be because of its lower age limit of 53 years. 

The patient must have a waist circumference greater than 35 inches (89 cm) for women or 40 inches (102 cm) for men, and the risk factors stated above. 

Anthropometric measurements are gross measurements of body cell mass used to evaluate LBM and fat stores. The most common measurements are weight, height, limb size (e.g., skinfold thickness and midarm muscle, wrist, and waist circumferences), and bioelectrical impedance analysis (BIA). 

Measurements of skinfold thickness estimate subcutaneous fat, midarm muscle circumference estimates skeletal muscle mass, and waist circumference estimates abdominal fat content. 

Body mass index (BMI) and waist circumference (WC) are recognized, acceptable markers of excess body fat, which independently predict disease risk (Table 59-1). 

Classification of Overweight and Obesity by BMI, Waist Circumference, and Associated Disease Risk... 

FIGURE 59-1. Pharmacotherapy treatment algorithm. A select population of individuals, based on body mass index (BMI) and waist circumference (WC) together with concurrent risk factors, may benefit from medication therapy as an adjunct to a program of weight loss that includes diet, exercise, and behavioral modification. (CHD, coronary heart disease DM, diabetes mellitus, HTN, hypertension INC WC, >40 inches for males and >35 inches for females LCD, low-calorie diet.)... 

Weight should be monitored monthly for 3 months, then quarterly. Body mass index, waist circumference, blood pressure, fasting plasma glucose, and fasting lipid profile should be monitored at the end of 3 months, then annually. The use of patient self-assessments are encouraged. 

This relationship is age independent and the same for both sexes, but may not correspond to the same degree of fatness across different populations, partly due to differences in body proportions. Many would therefore advocate the use of waist circumference and waist hip ratio measurements in conjunction with BMI, as these measurements are more closely related to abdominal fat accumulation, which is implicated in the development of type-2 diabetes and heart disease. 

For adults, measurement of waist circumference is an easy and accurate indicator of upper body or abdominal adiposity. A waist circumference greater than 102 cm (40 inches) for men and greater than 88 cm (35 inches) for women is indicative of increased risk of cardiovascular disease. Comparable standards are not available for children and teens. 

Excess adiposity, particularly the abdominal obesity associated with increased waist circumference, is associated with insulin resistance, hypertension, and proinflammatory states. The prevalence of this complex of comorbidities associated with obesity, now referred to as the metabolic syndrome, is reaching epidemic proportions in the United States (Grundy et al., 2004 Roth et al., 2002). Indeed, increased abdominal adiposity is one of a cluster of factors that are used in the diagnosis of metabolic syndrome. Abdominal tissue in the trunk occurs in several compartments, including subcutaneous and intraperitoneal or visceral fat. Visceral fat in particular appears to contribute to perturbed fuel metabolism by at least two mechanisms. First, hormones and free fatty acids released from visceral fat are released into the portal circulation and impact directly on metabolism of the liver. Second, the visceral adipose depot produces a different spectrum of adipocytokines than that produced by subcutaneous fat (Kershaw and Flier, 2004). 

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