Minimal versus Umbilical Waist Circumference Measures as Indicators of Cardiovascular Disease Risk

Willis, Leslie H.; Slentz, Cris A.; Houmard, Joseph A.; Johnson, Johanna L.; Duscha, Brian D.; Aiken, Lori B.; Kraus, William E.

doi:10.1038/oby.2007.612

Cited by 58 publications

(68 citation statements)

References 28 publications

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“…The anatomic position of IMAT, within the myofascial compartment and with direct vascular connection to more metabolically active tissues, is analogous to that of VAT in the abdomen, with its direct vascular link to the liver. Although this characteristic of IMAT does not differ by sex, and thus does not explain why we observed relationships between IMAT and metabolic state in men but not in women, it should be noted that such sexually dimorphic relationships are not without precedent: in the STRRIDE cohort, associations between VAT and lipoprotein particle size and other metabolic variables were stronger in women (35), in direct opposition to the current observation in the peripheral limb.…”

Section: Discussioncontrasting

confidence: 77%

Relationships between exercise-induced reductions in thigh intermuscular adipose tissue, changes in lipoprotein particle size, and visceral adiposity

Durheim

Slentz²,

Bateman³

et al. 2008

American Journal of Physiology-Endocrinology and Metabolism

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Small LDL and HDL particle size are characteristic of a proatherogenic lipoprotein profile. Aerobic exercise increases these particle sizes. Although visceral adipose tissue (VAT) has been strongly linked with dyslipidemia, the importance of intermuscular adipose tissue (IMAT) to dyslipidemia and exercise responses is less well understood. We measured exercise-associated changes in thigh IMAT and VAT and examined their relationships with changes in LDL and HDL particle size. Sedentary, dyslipidemic, overweight subjects (n = 73) completed 8-9 mo of aerobic training. Linear regression models were used to compare the power of IMAT change and VAT change to predict lipoprotein size changes. In men alone (n = 40), IMAT change correlated inversely with both HDL size change (r = -0.42, P = 0.007) and LDL size change (r = -0.52, P < 0.001). That is, reduction of IMAT was associated with a shift toward larger, less atherogenic lipoprotein particles. No significant correlations were observed in women. After adding VAT change to the model, IMAT change was the only significant predictor of either HDL size change (P = 0.034 for IMAT vs. 0.162 for VAT) or LDL size change (P = 0.004 for IMAT vs. 0.189 for VAT) in men. In conclusion, in overweight dyslipidemic men, exercise-associated change in thigh IMAT was inversely correlated with both HDL and LDL size change and was more predictive of these lipoprotein changes than was change in VAT. Reducing IMAT through aerobic exercise may be functionally related to some improvements in atherogenic dyslipidemia in men.

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Section: Discussioncontrasting

confidence: 77%

Relationships between exercise-induced reductions in thigh intermuscular adipose tissue, changes in lipoprotein particle size, and visceral adiposity

Durheim

Slentz²,

Bateman³

et al. 2008

American Journal of Physiology-Endocrinology and Metabolism

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“…Minimal waist was used as our laboratory previously showed that it was more highly correlated with metabolic health than umbilical waist measures (34).…”

Section: Subjects (Screening Inclusion and Exclusion Criteria)mentioning

confidence: 99%

The effects of aerobic, resistance, and combination training on insulin sensitivity and secretion in overweight adults from STRRIDE AT/RT: a randomized trial

AbouAssi

Slentz

Mikus

et al. 2015

Journal of Applied Physiology

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Most health organizations recommend a combination of aerobic training (AT) and resistance training (RT), yet few studies have compared their acute (within 24 h of the last exercise bout) and sustained (after 14 days of no exercise training) effects alone and in combination on glucose metabolism. The present study (Studies Targeting Risk Reduction Interventions through Defined Exercise-Aerobic Training and/or Resistance Training) compared the effects of AT, RT, and the combination (AT/RT) on insulin action at both acute and sustained phases. Subjects (N = 196) were 18-70 yr old (mean age = 50 yr), overweight (mean body mass index = 30 kg/m2), sedentary with moderate dyslipidemia, and were randomized into one of three 8-mo exercise groups: 1) RT: 3 days/wk, 8 exercises, 3 sets/exercise, 8-12 repetitions/set; 2) AT: equivalent to ∼19.2 km/wk (12 miles/wk) at 75% peak O2 consumption; 3) AT/RT: the combination of AT and RT. One hundred forty-four subjects completed the intervention. Eighty-eight subjects completed all pre- and postintervention testing visits. Insulin sensitivity, glucose effectiveness, and disposition index were measured via a frequently sampled intravenous glucose tolerance test with subsequent minimal model analyses. AT/RT resulted in greater improvements in insulin sensitivity, β-cell function (disposition index), and glucose effectiveness than either AT or RT alone (all P < 0.05). Approximately 52% of the improvement in insulin sensitivity by AT/RT was retained 14 days after the last exercise training bout. Neither AT or RT led to acute or chronic improvement in sensitivity index. In summary, only AT/RT (which required twice as much time as either alone) led to significant acute and sustained benefits in insulin sensitivity

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“…156 This variability in measurements at different locations may be problematic, because as one might expect, all WC sites do not provide the same measurement estimate. [157][158][159][160][161][162] Although the umbilicus has been found to be the least reproducible site, most of these sites have very high reproducibility and do not appear to be influenced by age or BMI. 157 Although measurement of WC at the iliac crest has been shown to have lower precision and may require more training and experience to locate, 159 bony structures are stable landmarks that are not affected by changes in weight, which confers certain advantages, especially for longitudinal tracking of body composition.…”

Section: Waist Circumferencementioning

confidence: 99%

Assessing Adiposity

Cornier¹,

Després²,

Davis³

et al. 2011

Circulation

726

356

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T he prevalence of obesity in the United States and the world has risen to epidemic/pandemic proportions. This increase has occurred despite great efforts by healthcare providers and consumers alike to improve the health-related behaviors of the population and a tremendous push from the scientific community to better understand the pathophysiology of obesity. This epidemic is all the more concerning given the clear association between excess adiposity and adverse health consequences such as cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). The risks associated with overweight/obesity are primarily related to the deposition of adipose tissue, which leads to excess adiposity or body fatness. Furthermore, weight loss, specifically loss of body fat, is associated with improvement in obesity-related comorbidities. Before weight loss interventions can be recommended, however, patients must be assessed for their adiposity-related risk. Unfortunately, healthcare providers and systems have not done a good job of assessing for excess adiposity even in its simplest form, such as measuring body mass index (BMI). It is for these reasons that we must emphasize the importance of assessing adiposity in clinical practices. Although it can be argued that the entire population should be targeted as an important public health issue with a goal of prevention of weight gain and obesity, there are currently so many "at risk" individuals that simple strategies to identify and treat those individuals are necessary. We must identify those individuals at highest risk of comorbidities in order to identify those who might benefit the most from aggressive weight management.This scientific statement will first briefly review the epidemiology of obesity and its related comorbidities, supporting the need for improved assessment of adiposity in daily clinical practice. This will be followed by a discussion of some of the challenges and issues associated with assessing adiposity and then by a review of the methods available for assessing adiposity in adults. Finally, practical recommendations for the clinician in practice will be given with a goal of identifying more at-risk overweight/obese individuals.

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Minimal versus Umbilical Waist Circumference Measures as Indicators of Cardiovascular Disease Risk

Cited by 58 publications

References 28 publications

Relationships between exercise-induced reductions in thigh intermuscular adipose tissue, changes in lipoprotein particle size, and visceral adiposity

Relationships between exercise-induced reductions in thigh intermuscular adipose tissue, changes in lipoprotein particle size, and visceral adiposity

The effects of aerobic, resistance, and combination training on insulin sensitivity and secretion in overweight adults from STRRIDE AT/RT: a randomized trial

Assessing Adiposity

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