Waist Circumference as the Newest Vital Sign: An Evaluation of Abdominal Obesity in the Healthcare Setting

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Date
2024
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Introduction/Purpose: Body mass index (BMI), which is based on the height and weight of an individual, has traditionally been the sole screening tool to identify obesity in the clinical setting. However, this measure alone does not take into account muscles mass, bone density, body composition, race and sex differences when it comes to detecting obesity. Waist circumference along with BMI help to better define cardio-metabolic risk factors for disease. For clinicians, combining BMI and waist circumference provides opportunities for counseling and effective interventions in managing obesity and other related metabolic diseases associated with abdominal obesity. The purpose of this project is to implement waist circumference measurement in addition to lifestyle education to better assess abdominal obesity and potential cardiometabolic risk in the primary care setting.

Methods: A convenience sample of 30 patients, (12 male and 18 female) underwent measurement of their height, weight, as well as waist circumference over a 6-week period. A BMI was calculated for each patient and the waist circumference of each participant was measured. Educational handouts and counseling based on the recommendations of the American Heart Association were provided. Following the educational/counseling session, each participant was asked to complete a survey using a Likert-type scale to identify their willingness to make lifestyle changes in regard to exercise, diet, sleep and alcohol intake.

Results: Pertaining to waist circumference and BMI, data were evaluated utilizing SPSS version 29. These results yielded a strong Pearson correlation co-efficient of 0.855 between BMI and waist circumference which was significant at the 0.01p-level (2-tailed). Normality P-P plots of the measured variables were found to be consistent with normally distributed data. Linear regression yielded the equation BMI=-15.579 + 1.173* WC with a two-tailed p-value of <.005. Applying the regression equation to a waist circumference of 40 yielded a calculated BMI of 31. The accepted BMI cut-off value as reported by the American Heart Association for obesity is 30.

Discussion: The linear relationship between BMI and waist circumference indicates that waist circumference may be an alternative option for BMI in the clinical setting to predict central obesity and potential cardiovascular risk. Utilizing waist circumference and patient education on lifestyle change indicated patients who were classified as overweight or obese were motivated to adapt lifestyle changes in diet, exercise, sleep habits and alcohol use. Patients who were classified as having a normal BMI and waist circumference were not motivated to make any changes.

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