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Download references. The authors acknowledge the financial support of the IAS and the ICCR, an independent academic organization based at Université Laval, Québec, Canada, who were responsible for coordinating the production of our report. No funding or honorarium was provided by either the IAS or the ICCR to the members of the writing group for the production of this article.

The scientific director of the ICCR J. is funded by a Foundation Grant Funding Reference Number FDN from the Canadian Institutes of Health Research. Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Departments of Cardiovascular Medicine and Community Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, Netherlands. Scientific Institute for Research, Hospitalization and Health Care IRCCS MultiMedica, Sesto San Giovanni, Italy.

Lipid Clinic Heart Institute InCor , University of São Paulo, Medical School Hospital, São Paulo, Brazil. Hospital Israelita Albert Einstein, Sao Paulo, Brazil. Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC, Canada.

Department of Clinical Nutrition and Metabolism, Clínica Las Condes, Santiago, Chile. Departments of Nutrition and Epidemiology, Harvard T. Chan School of Public Health, Boston, MA, USA.

Department of Nutritional Sciences, University of Surrey, Guildford, UK. Department of Medicine - DIMED, University of Padua, Padova, Italy.

School of Medical Sciences, University of New South Wales Australia, Sydney, NSW, Australia. Division of Endocrinology, Metabolism and Diabetes, and Division of Cardiology, Anschutz University of Colorado School of Medicine, Aurora, CO, USA. Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka, Japan.

Department of Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada. You can also search for this author in PubMed Google Scholar. and J. researched data for the article.

made a substantial contribution to discussion of the content. wrote the article. Correspondence to Robert Ross. reports receiving speaker fees from Metagenics and Standard Process and a research grant from California Walnut Commission.

reports receiving consulting and speaker fess from Amgen, Astra Zeneca, Akcea, Biolab, Esperion, Kowa, Merck, MSD, Novo Nordisk, Sanofi Regeneron, Akcea, Kowa and Esperion.

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The remaining authors declare no competing interests. Nature Reviews Endocrinology thanks R. Kelishadi and the other, anonymous, reviewer s for their contribution to the peer review of this work.

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The relative increase in the predicted probabilities for individuals who experience events and the decrease for individuals who do not. The highest value of VO 2 that is, oxygen consumption attained during an incremental or other high-intensity exercise test.

Open Access This work is licensed under a Creative Commons Attribution 4. Reprints and permissions. Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity.

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Subjects Disease prevention Metabolic syndrome Obesity Predictive markers. Abstract Despite decades of unequivocal evidence that waist circumference provides both independent and additive information to BMI for predicting morbidity and risk of death, this measurement is not routinely obtained in clinical practice.

Introduction The prevalence of adult overweight and obesity as defined using BMI has increased worldwide since the s, with no country demonstrating any successful declines in the 33 years of recorded data 1. Methodology This Consensus Statement is designed to provide the consensus of the IAS and ICCR Working Group Supplementary Information on waist circumference as an anthropometric measure that improves patient management.

Historical perspective The importance of body fat distribution as a risk factor for several diseases for example, CVD, hypertension, stroke and T2DM and mortality has been recognized for several decades.

Prevalence of abdominal obesity Despite a strong association between waist circumference and BMI at the population level, emerging evidence suggests that, across populations, waist circumference might be increasing beyond what is expected according to BMI.

Full size image. Identifying the high-risk obesity phenotype Waist circumference, BMI and health outcomes — categorical analysis It is not surprising that waist circumference and BMI alone are positively associated with morbidity 15 and mortality 13 independent of age, sex and ethnicity, given the strong association between these anthropometric variables across cohorts.

Waist circumference, BMI and health outcomes — continuous analysis Despite the observation that the association between waist circumference and adverse health risk varies across BMI categories 11 , current obesity-risk classification systems recommend using the same waist circumference threshold values for all BMI categories Importance in clinical settings For practitioners, the decision to include a novel measure in clinical practice is driven in large part by two important, yet very different questions.

Risk prediction The evaluation of the utility of any biomarker, such as waist circumference, for risk prediction requires a thorough understanding of the epidemiological context in which the risk assessment is evaluated.

Risk reduction Whether the addition of waist circumference improves the prognostic performance of established risk algorithms is a clinically relevant question that remains to be answered; however, the effect of targeting waist circumference on morbidity and mortality is an entirely different issue of equal or greater clinical relevance.

A highly responsive vital sign Evidence from several reviews and meta-analyses confirm that, regardless of age and sex, a decrease in energy intake through diet or an increase in energy expenditure through exercise is associated with a substantial reduction in waist circumference 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , Measurement of waist circumference The emergence of waist circumference as a strong independent marker of morbidity and mortality is striking given that there is no consensus regarding the optimal protocol for measurement of waist circumference.

Conclusions and recommendations — measurement of waist circumference Currently, no consensus exists on the optimal protocol for measurement of waist circumference and little scientific rationale is provided for any of the waist circumference protocols recommended by leading health authorities.

Threshold values to estimate risk Current guidelines for identifying obesity indicate that adverse health risk increases when moving from normal weight to obese BMI categories.

Table 1 Waist circumference thresholds Full size table. Table 2 Ethnicity-specific thresholds Full size table. Conclusions The main recommendation of this Consensus Statement is that waist circumference should be routinely measured in clinical practice, as it can provide additional information for guiding patient management.

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But if that extra fat piles up around your midsection you could be in trouble. Excess fat around your internal organs can impact the way your body functions. Your waist measurement is a good indicator of your overall health. To have your best chance at maintaining good health, you should aim for:.

Knowing you need to reduce your waist circumference is a lot easier than actually doing it. If your waist circumference is larger than the guidelines above, you should talk to your doctor about how to reduce it.

Specific waist and belly reducing exercises typically do little to shrink your visceral fat. Here are some ideas.

If you have a long way to go in reducing your waist circumference, it can feel overwhelming or even hopeless. Thankfully, losing just ten percent of your body weight can help to improve your health.

Your waist circumference matters more than your weight Your waist circumference matters more than your weight. Woodward, DO Jul 18, Updated Oct 25, 5 minute read.

Where you carry fat is important Obesity is linked to a variety of health problems. Tracking your waist circumference with body weight BMI over time, is an excellent way for you and your healthcare provider to understand how your body is changing as you age and to monitor your risk of heart disease and stroke.

Speak to your doctor about different lifestyle options to help you maintain or achieve a healthy waistline and weight that is right for you.

Managing your weight doesn't have to mean altering your life dramatically. Take small steps, aim modestly and realistically, and then build from there.

Learn more at Achieving and maintaining a healthy weight. Donate now. Home Healthy living Healthy weight Healthy weight and waist.

Health seekers. Healthy waists Measuring waist circumference can help to assess obesity-related health risk. Are you an apple or a pear? Here's how to take a proper waist measurement Clear your abdominal area of any clothing, belts or accessories. Stand upright facing a mirror with your feet shoulder-width apart and your stomach relaxed.

Wrap the measuring tape around your waist. Use the borders of your hands and index fingers — not your fingertips — to find the uppermost edge of your hipbones by pressing upwards and inwards along your hip bones.

Tip: Many people mistake an easily felt part of the hipbone located toward the front of their body as the top of their hips. This part of the bone is in fact not the top of the hip bones, but by following this spot upward and back toward the sides of your body, you should be able to locate the true top of your hipbones.