Evaluating CMR

Clinical Tools

Waist Circumference

Waist Circumference and Health Risk

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Jean Vague was the first to recognize the harmful health consequences of excess abdominal fat over 50 years ago (1). Since this initial observation, a great deal of research has strengthened abdominal obesity’s independent association with diabetes, hypertension, cardiovascular disease, some cancers, and mortality risk (2-5). It is now acknowledged that waist circumference increases health risk beyond that explained by body mass index (BMI) alone (6-9)


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1. Vague J. La differenciation sexuelle, facteur determinant des formes de l'obesite. La Presse Medicale 1947; 30: 339-40.
2. Folsom AR, Kushi LH, Anderson KE, et al. Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women's Health Study. Arch Intern Med 2000; 160: 2117-28.
3. Rexrode KM, Carey VJ, Hennekens CH, et al. Abdominal adiposity and coronary heart disease in women. JAMA 1998; 280: 1843-8.
4. Woo J, Ho SC, Yu AL, et al. Is waist circumference a useful measure in predicting health outcomes in the elderly? Int J Obes Relat Metab Disord 2002; 26: 1349-55.
5. Bigaard J, Frederiksen K, Tjonneland A, et al. Waist and hip circumferences and all-cause mortality: usefulness of the waist-to-hip ratio? Int J Obes Relat Metab Disord 2004; 28: 741-7.
6. Janssen I, Katzmarzyk PT and Ross R. Body mass index, waist circumference, and health risk: evidence in support of current National Institutes of Health guidelines. Arch Intern Med 2002; 162: 2074-9.
7. Karter AJ, D'Agostino RB, Jr., Mayer-Davis EJ, et al. Abdominal obesity predicts declining insulin sensitivity in non-obese normoglycaemics: the Insulin Resistance Atherosclerosis Study (IRAS). Diabetes Obes Metab 2005; 7: 230-8.
8. Janssen I, Katzmarzyk PT and Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr 2004; 79: 379-84.
9. Ardern CI, Katzmarzyk PT, Janssen I, et al. Discrimination of health risk by combined body mass index and waist circumference. Obes Res 2003; 11: 135-42.