Last week while at work I walked up to the front desk and happened to notice Dr. Oz on the television show The View.  He was talking about waist circumference. As he was reviewing the guidelines from the United States Department of Health and Human Services he pulled out a tape measure and attempted to take measurements of Barbara Walters and her crew. I was mortified by what I saw.  I couldn't believe the all knowing Dr. Oz was doing it wrong. Not only was his explanation of how to take a waist circumference wrong, he demonstration was equally incorrectly.  He explained: to find your waist circumference you should find the smallest part of your middle, hold your breath then measure. This is completely the wrong way about doing it! So, before you whip out your tape measure let's talk about how measure waist circumference the right way.

We all know that circumference is the perimeter of or the distance around a circle. In this case that circle is your abdomen. It's important to understand when we are talking about “HEALTH” we discuss waist circumference, and when we are determining clothing size we get a waist measurement. Two completely different things. What Dr. Oz was doing was not totally wrong, he demonstrated how to measure your waist the way you would if you were trying to determine what size pants to order from your favorite on-line store. Even though ordering the right size pants is important, more important is your health.

Waist circumference is one of the most practical tools to assess abdominal fat for chronic disease risk. A high waist circumference or a greater level of abdominal fat puts and individual at increased risk for type 2 diabetes, high cholesterol, high blood pressure and heart disease. Since obtaining my Certificate in Adult Weight Management last June, not only do I calculate my patients BMI I also obtain a waist circumference. This is also helpful in monitoring success of my weight loss clients.

 According to the United States Department of Health and Human Services (HHS) the following individuals are at increased risk for developing chronic diseases:

•Women with a waist circumference of more than 35 inches.

•Men with a waist circumference of more than 40 inches.

Now you know where you should be, how do you measure your waist circumference accurately? First stand up tall, locate your Iliac Crest (top of the hip bone) Place the tape measure evenly around the bare abdomen at the level of this bone.  For the most accurate measurement, breathe out normally (do not “suck in” the stomach) and make sure the tape is snug but does not push tightly into your skin.  

I've had some clients ask me if waist circumference measurements were better at assessing health risk than BMI? The most commonly used method for classifying an individual as overweight or obese is the BMI (Body Mass Index). BMI is based on body weight and height. When used solely to determine a person's increased health risk it has it's limitations,  esp. for and those with increased muscle mass or the elderly.   When BMI and waist circumference are used together, it's a more definitive indictor of health risk.  Waist circumference  is particularly useful in patients who are categorized as overweight on the BMI scale (BMI of 25-34), but is also helpful for those in the normal category as well.  You can have a “normal” BMI but still be at increased health risk if your waist circumference is larger than recommended.  The only time waist circumference is not beneficial is for someone with a BMI of 35 or over (obese).  In this case waist circumference has little added predictive power of disease risk beyond that of BMI. It is therefore not necessary to measure waist circumference in individuals with BMIs of 35 or over.

So what do you do if you've determined you're at increased health risk?  Call our office and schedule an appointment today? What do you have to lose? Pounds and inches.  Better yet, what do you have to gain? Better overall health!  

If you have a nutrition question you'd like answered in this column send it to with “Question for the Breeze” as the subject title.

Lisa Eisele, RD, CSO, LD is a Registered and Licensed Dietitian. She also holds a Board Certification as a Specialist in Oncology Nutrition. Lisa and her partner Stacy Paine, RD, LD own Oconee Nutrition Consultants, LLC located at Cowles Clinic.  706-473-5801

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