Evaluating CMR

Clinical Tools

Waist Circumference

Association Between Changes in Waist Circumference and Intra-abdominal Fat

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Waist circumference is also commonly used to assess changes in abdominal obesity, and is a stronger predictor of changes in intra-abdominal fat than waist-to-hip ratio (23, 32, 33). Changes in waist circumference are associated with changes in intra-abdominal fat in response to diet and/or exercise-induced weight loss (Figure 5) (23, 32-34). Although the exact amount of intra-abdominal fat loss for a given reduction in waist circumference varies considerably (33), reductions in waist circumference are likely to reduce intra-abdominal fat. Exercise can often reduce intra-abdominal fat and waist circumference, even if it does not reduce body weight significantly (35-40). Accordingly, waist circumference should be measured as part of interventions aimed at reducing intra-abdominal fat and related health risk.

Waist circumference is a strong predictor of health risk beyond that explained by BMI alone. This may be partly due to the strong ties between waist circumference and intra-abdominal fat. Indeed, waist circumference is the strongest anthropometric predictor of intra-abdominal fat and changes to it. Because abdominal obesity has such a harmful impact on one’s health, it is important to routinely measure waist circumference in the clinical assessment of cardiometabolic risk.


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