A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys

Cj, Dobbelsteyn; Mr, Joffres; Dr, MacLean; Flowerdew, Gordon

doi:10.1038/sj.ijo.0801582

Cited by 402 publications

(335 citation statements)

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“…In women, younger adults and those with more prevalent risk factors such as dyslipidemia, lower cutoff points are more appropriate, whereas in older age groups and those with less-prevalent risk factors such as multiple risk factors (as a surrogate for incident CVD), higher values are more suitable. 13,33 In this study, overall predictive discrimination (as judged by AUC) for incident CVD was better for WHR, WHtR and WC than BMI in both genders aged o60 years; however, there was no difference in the predictive power of anthropometric variables in either genders aged 460 years, a finding that is similar to other studies. 34,35 Harris et al 35 highlighted that in older men and women, WC and BMI were more closely related to total body fat than visceral fat; hence, central obesity variables, which include subcutaneous fat, in older population may not be related to CVD events as the same degree as in the middle-aged population.…”

Section: Obesity Variables To Predict Cardiovascular Events F Hadaeghsupporting

confidence: 87%

Appropriate cutoff values of anthropometric variables to predict cardiovascular outcomes: 7.6 years follow-up in an Iranian population

et al. 2009

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Objective: To determine cutoff points of anthropometric variables for predicting incident cardiovascular disease (CVD) in Iranian adults. Design: It is a population-based longitudinal study. Subjects: A total of 1614 men and 2006 women, aged X40 years, free of CVD at baseline were included in the study. Measurements: Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and cardiovascular risks were assessed. Incident CVD was ascertained over a median of 7.6 years follow-up. The adjusted hazard ratios (HRs) for CVD were calculated for 1 s.d. change in all obesity variables using Cox proportional hazards regression analysis. Receiver operator characteristic (ROC) curve analysis was used as the method of defining the points of the maximum sum of sensitivity and specificity (MAXss) of each variable as a predictor of CVD. Results: We found 333 CVD events during follow-up. The risk-factor-adjusted HRs were significant for all anthropometric variables in males and WHR in females and were 1.19, 1.24, 1.21 and 1.24 for BMI, WC, WHR and WHtR in males and 1.27 for WHR in females, respectively (all Po0.05). ROC analysis showed the highest area under curve (AUC) for WHR, WHtR and WC, followed by BMI in males and both genders agedp60 years. In females, WHR and WHtR had the highest AUC, followed by WC and BMI. Among those 460 years old, all the anthropometric variables showed same CVD predicting power. The cutoff values (MAXss) for CVD prediction in males and females were BMIs 26.95 and 29.19 kg m À2 ,WCs 94.5 and 94.5 cm, WHRs 0.95 and 0.90, and WHtR 0.55 and 0.62, respectively. Conclusion: There was no difference between central obesity variables in predicting CVD in males, whereas in females WHR and WHtR were more appropriate. The cutoff values of anthropometric variables were higher in the Iranian than in other Asian populations.

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Section: Obesity Variables To Predict Cardiovascular Events F Hadaeghsupporting

confidence: 87%

Appropriate cutoff values of anthropometric variables to predict cardiovascular outcomes: 7.6 years follow-up in an Iranian population

et al. 2009

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“…Subjects were instructed to continue their regular diet and exercise patterns. They also received instructions on how to properly complete the daily dietary intake record; and they were asked to complete these records on 2 occasions for periods of 3 days (days 1-3 and days [40][41][42]. The records were analyzed by Food Processor (Salem, Oregon).…”

Section: Study Protocolmentioning

confidence: 99%

“…In addition to the assessment of the potential for this product to aid in body weight loss of obese subjects, the influence of this nutraceutical on upper abdominal, waist, and hip circumference; heart rate; and blood pressure was investigated. Waist circumference and body fat percentage were of particular interest because some reports [34][35][36][37][38][39][40][41][42][43] indicate that they are better predictors of cardiovascular disease than either body mass index (BMI) or waist-to-hip ratio.…”

Section: Introductionmentioning

confidence: 99%

Effects of a Stimulant-Free Dietary Supplement on Body Weight and Fat Loss in Obese Adults: A Six-Week Exploratory Study

Woodgate¹,

Conquer²

2003

Current Therapeutic Research

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Background: Obesity is a well-established risk factor for cardiovascular disease, diabetes, hyperlipidemia, hypertension, osteoarthritis, and stroke. Stimulants, such as ephedrine and caffeine and their herbal counterparts, have proved effective in facilitating body weight loss, but their use is controversial due to their undesired effects. Other nutraceuticals have shown moderate success in reducing body weight, whereas several other compounds have demonstrated little or no effect. Therefore, a tolerable and effective nutraceutical that can increase energy expenditure and/or decrease caloric intake is desirable for body weight reduction.Objective: The primary purpose of this study was to assess the tolerability and effectiveness of a novel, stimulant-free, dietary supplement containing glucomannan, chitosan, fenugreek, Gymnema sylvestre, and vitamin C on body weight and fat loss and change in body composition in obese adults.Methods: In this single-center, prospective, randomized, double-blind, placebocontrolled study conducted at the University of Guelph (Guelph, Ontario, Canada), obese adults (aged 20-50 years; body mass index [BMI], ≥30 kg/m 2 ) were randomized to the treatment or placebo group. The treatment group received 6 capsules of a dietary supplement containing a proprietary blend of glucomannan, chitosan, fenugreek, G sylvestre, and vitamin C daily for 6 weeks, and the placebo group received 6 capsules of rice flour daily for 6 weeks. Body weight; percentage of body fat; absolute fat mass; lean body mass; BMI; upper abdominal, waist, and hip circumference; and anthropometric measurements were recorded at baseline and at study end. Patients completed daily dietary intake records on days 1 to 3 and days 40 to 42. They also completed weekly activity logs throughout the study.Results D.E. Woodgate and J.A. Conquerto the treatment group (8 women, 4 men) or the placebo group (9 women, 3 men). Two subjects (8.3%; 1 patient [8.3%] from each group) dropped out for personal reasons unrelated to the study. No significant changes in the consumption of total calories; the percentage of calories ingested as carbohydrates, fat, or protein; or activity levels were found in either group throughout the study. Compared with the placebo group, the treatment group lost significantly more body weight (Ϫ2.3 kg vs 0.0 kg; P Ͻ 0.01), percentage of body fat (Ϫ1.1% vs 0.2%; P Ͻ 0.05), and absolute fat mass (Ϫ2.0 kg vs 0.2 kg; P Ͻ 0.001).The treatment group also experienced a significantly greater reduction in upper abdominal circumference (Ϫ4.5 cm vs Ϫ0.7 cm), waist circumference (Ϫ4.1 cm vs 0.1 cm), and hip circumference (Ϫ2.9 cm vs 0.6 cm) compared with the placebo group (P Ͻ 0.05 for all). No significant changes in heart rate or blood pressure were found in either group. Both the treatment and the placebo were well tolerated. Conclusion:Within the context of this study, the novel combination of glucomannan, chitosan, fenugreek, G sylvestre, and vitamin C results in significant body weight and fat loss in obese adu...

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“…It has been suggested that 'optimal' WC thresholds for predicting future coronary risk may differ from the single thresholds. An ROC analysis of the CHHS (Dobbelsteyn et al, 2001) demonstrated that thresholds of 80 cm (F)/90 cm (M) provided the best balance between sensitivity and specificity in predicting the presence of Z2 CVD risk factors. Recently, it was shown that specific WC thresholds within BMI categories could improve the identification of individuals at high risk of future coronary events over a single WC cutoff (Ardern et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Application of obesity treatment algorithms to Canadian adults

Mason

Katzmarzyk

2005

Eur J Clin Nutr

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Objective: The purpose of this study was to apply obesity treatment algorithms to a representative sample of Canadians to determine their potential impact on the population. Design: The Canadian Heart Health Surveys (1986)(1987)(1988)(1989)(1990)(1991)(1992) were used to describe the prevalence of adults (18-64 y) that would be eligible for weight loss treatment according to the US NIH algorithm, which uses body mass index (BMI), waist circumference (WC), and the presence of two or more cardiovascular disease (CVD) risk factors. Similar algorithms based on CVD risk factors and a single measure of either BMI or WC alone were also evaluated. Results: Using the NIH algorithm, 24% of Canadians (28% men, 19% women) would be identified for weight loss treatment. Virtually, all subjects received the same treatment recommendations when using BMI and CVD risk factors only, while 22% (23% men, 21% women) would meet the criteria for treatment using WC and CVD risk factors only.Conclusions: Approximately one in four Canadians would be eligible for weight loss treatment using the NIH obesity treatment algorithm. However, the algorithm may be improved through the incorporation of more sensitive WC thresholds. IntroductionExcess body weight is an increasingly significant health issue. There is clear evidence that the prevalence of obesity is rising in Canada (Katzmarzyk, 2002;Torrance et al, 2002) and that excess adiposity places individuals at greater risk of premature mortality and of developing several health problems including type II diabetes, cardiovascular disease (CVD), osteoarthritis, respiratory impairment and numerous types of cancer (McTigue et al, 2003).In 1998, the U.S. National Institutes of Health (NIH) proposed a treatment algorithm using body mass index (BMI), waist circumference (WC) and CVD risk factors to help health practitioners identify patients that would benefit from weight loss treatment (U.S. National Institutes of Health, 1998). However, there remains some debate about the clinical utility of the measures used in this algorithm (Kiernan & Winkleby, 2000). Thus, the purpose of this study was to assess the impact of applying the NIH algorithm and three alternative algorithms, based on single measures of BMI or WC to the Canadian population. MethodsA secondary analysis was performed on data from the Canadian Heart Health Surveys (CHHS) (n ¼ 23,129; 18-64 y), a series of surveys on CVD risk factors and risk factor knowledge conducted in each province between 1986 and 1992. A detailed description of the sampling methods is available elsewhere (MacLean et al, 1992). Identified through provincial health insurance registries, participants were selected using stratified probability methods to ensure the geographical, sex and age representativeness of the sample. The present analysis was limited to 7501 participants with complete measures of all variables from the provinces of Alberta, Saskatchewan, Manitoba, Ontario, and Quebec where WC measures were collected. In 1991, these provinces accounted for 79% of...

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A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys

Cited by 402 publications

References 24 publications

Appropriate cutoff values of anthropometric variables to predict cardiovascular outcomes: 7.6 years follow-up in an Iranian population

Appropriate cutoff values of anthropometric variables to predict cardiovascular outcomes: 7.6 years follow-up in an Iranian population

Effects of a Stimulant-Free Dietary Supplement on Body Weight and Fat Loss in Obese Adults: A Six-Week Exploratory Study

Application of obesity treatment algorithms to Canadian adults

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