Shaping America's Health: Association for Weight Management and Obesity Prevention, The Obesity Society and the American Diabetes Association (ADA) convened an expert panel to consider if measuring waist circumference could help clinicians better evaluate the presence of cardiometabolic risk factors in their patients. The panel agreed that waist circumference provides a unique indicator of body fat distribution, which can identify patients at increased risk for obesity- related cardiometabolic disease above and beyond the measurement of body mass index (BMI), however the current waist circumference cut points recommended to determine health risk are unlikely to affect clinical management when BMI and other obesity-related risk factors are already being determined. Therefore, the clinical usefulness of measuring waist circumference, when risk is based on the currently accepted guidelines, is limited.

The consensus statement was published concurrently in the journals Obesity and Diabetes Care and the report has been endorsed by the American Society for Nutrition (ASN) and was published in The American Journal of Clinical Nutrition (AJCN) as an ASN position statement.

The expert panel also determined that measuring waist circumference can be useful in monitoring a patient's response to diet and exercise because regular aerobic exercise can cause a reduction in waist circumference and cardiometabolic risk without a change in BMI. The panel concurred that further studies are needed to establish waist circumference cut points that can assess cardiometabolic risk not adequately captured by BMI and routine clinical assessments.

An earlier panel, organized by the National Heart, Lung and Blood Institute, had recommended that waist circumference be measured as part of the initial assessment and be used to monitor the efficacy of weight loss therapy in overweight and obese patients. However, waist circumference measurement has not been widely adopted in clinical practice and its implications can be confusing.

"This conference was organized to address the utility of measuring waist circumference in clinical practice by conducting a careful review of the scientific literature and by hearing from noted leaders in the field," said Samuel Klein, MD, Shaping America's Health board member and William H. Danforth Professor of Medicine and Nutritional Science, Washington University School of Medicine. "The panel concluded that measuring waist circumference can identify patients who are at increased risk for cardiometabolic diseases, such as coronary heart disease and diabetes. Unfortunately, the currently recommended waist circumference cutpoints are unlikely to have an important impact on clinical management, because it would likely identify only a small number of patients who would not otherwise be detected by routine medical evaluation. However, it should be possible to determine more useful waist circumference cut points than are currently recommended, by reevaluating datasets available from existing population studies."

The panel was comprised of experts in obesity management, obesity-related epidemiology, adipose tissue metabolic pathophysiology, statistics and nutrition science and met from December 17-20, 2006 in Washington, D.C. Specifically, the experts were charged to provide answers to four questions:

-- What does waist circumference measure?

-- What are the biological mechanisms responsible for the association between waist circumference and metabolic and cardiometabolic risk?

-- What is the power of waist circumference to predict cardiometabolic outcomes?

-- Should waist circumference be measured in clinical practice?

"At Shaping America's Health, one of the roles we play is to convene the foremost experts to address obesity prevention issues," stated Gary Deverman, Executive Vice President & CEO, Shaping America's Health. "This consensus conference was a vital next step to better understand waist circumference as it relates to cardiometabolic risk."

About Shaping America's Health

Shaping America's Health is addressing the country's greatest healthcare challenge. Founded by the American Diabetes Association, its mission is to prevent and treat excess weight and obesity, and to facilitate a better scientific understanding of weight management. It combats obesity by providing tools, programs, and processes that empower individuals, families, and health professionals to build community environments that reduce overweight and obesity. For more information, visit http://www.shapingamericashealth.org.

About The Obesity Society

The Obesity Society is the leading scientific society dedicated to the study of obesity. Since 1982 The Obesity Society has been committed to encouraging research on the causes and treatment of obesity, and to keeping the medical community and public informed of new advances. For more information about The Obesity Society and obesity, visit http://www.naaso.org.

About the American Society for Nutrition

The American Society for Nutrition (ASN) is the preeminent professional organization for nutrition research scientists and clinicians around the world. ASN is dedicated to bringing together the top nutrition researchers, medical practitioners, policy makers and industry leaders to advance our knowledge and application of nutrition. Founded in 1928, ASN publishes The Journal of Nutrition (JN) and The American Journal of Clinical Nutrition (AJCN). JN, published monthly since 1928, carries original, peer-reviewed research in key areas of nutrition research. AJCN, published since 1952, is one of the highest ranked peer-reviewed journals in nutrition and dietetics and carries basic and clinical studies relevant to human nutrition. Visit ASN online at http://www.nutrition.org.

About the ADA

The American Diabetes Association is the nation's premier voluntary health organization supporting diabetes research, information and advocacy. The Association's mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. Founded in 1940, the Association provides services to hundreds of communities across the country.

Shaping America's Health
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