Adult BMI and Waist Circumference (WC): Purpose, Uses, Methodology, and Significance
Waist circumference (WC) is a clinical assessment tool that is related to the body mass index (BMI). Despite the BMI being the most widely used assessment tool for obesity risk and nutritional status, the WC diagnostic tool brings an independent ability to predict the risk of obesity-related disorders such as type II diabetes mellitus, hypertension, cardiovascular disease, and dyslipidemia (Ball et al., 2019; NHLBI, n.d.). WC is used in healthcare to predict the risk of developing disorders associated with obesity such as cardiovascular disease of type II diabetes. It is widely recommended that WC be used in addition to the usual BMI. Zhu et al BMI using waist circumference for adults Essay. (2004) opine that WC and BMI should be used together to enhance the predictive power of the two tests, rather than using either alone. This is also the position reported by Freiberg et al (2008), indicating that the guidelines at the time of publication of their study were that BMI and WC be used together to predict obesity-related disease risk. This is specifically for those subjects with a BMI of between 25 kg/m2 and 34.9 kg/m2 (Freiberg et al., 2008). The rationale for using WC in conjunction with the BMI comes from conclusive studies that show that the BMI does not discriminate between a rise in lean body mass and a rise in adipose tissue (LeBlond et al., 2015). That is to say that BMI does not factor in the great variation in the distribution of body fat. And it is this BMI shortcoming that WC compensates for by factoring in regional adipose tissue. As it does this, however, WC still remains an independent predictor of cardiovascular risk among overweight subjects (Zhu et al., 2004). WC is not necessary in those that have a BMI of equal to or more than 35 kg/ m2. The cut-off for high risk has been placed at over 40 inches for men, and over 35 inches for women (NHLBI, n.d.). A high WC is therefore related to an increased risk of obesity-related illness BMI using waist circumference for adults Essay.
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The Purpose of the Waist Circumference (WC)
As stated above, the waist circumference serves as an independent predictor of risk for diseases and conditions that are associated with being overweight and obese. These are diseases such as dyslipidemia, hypertension, type II diabetes, and cardiovascular disease (heart disease). WC is a good clinical indicator of abdominal obesity and internal fat. It has been shown that persons with normal weight but increased WC possess an elevated risk of heart disease. Thus a high WC of >35 inches in women and >40 inches in men is tied to an increase in the chances of occurrence of these conditions (Ball et al., 2019). As already observed, WC is very useful an indicator in persons with a normal or overweight rating on the BMI scale. But a BMI of greater than 35 renders the WC ineffective in correctly predicting risk. Because of this, it is unnecessary to conduct this test on subjects with a BMI of more than 35 kg/ m2 (class II and class III obesity) (NHLBI, n.d.) BMI using waist circumference for adults Essay.
The WC is also important in that it is clinically used to calculate the waist-height ratio. The waist-height ratio is another important clinical predictor just like the WC. It has been shown to be strongly predictive of heart disease risk and type II diabetes mellitus in the adult population (Ball et al., 2019).
How to Conduct a Waist Circumference Assessment
The WC is taken at the point at which the iliac crest is most elevated. This should be done when the subject is standing upright and preferably holding their breath or having minimal respiration (Ball et al., 2019). This immediately shows that subjects who have postural problems may not fully benefit from this clinical tool as they may not assume the required posture. It is important that the subject does not alter their intra-abdominal pressure as this may lead to a reading that is erroneous.
The Information that the Waist Circumference Gathers
The weight circumference gathers information that is indicative of the amount of abdominal fat or visceral adipose tissue that the individual has. This is regardless of the BMI, as long as the BMI is below 35 kg/ m2 (Ball et al., 2019; Zhu et al, 2004). It is this information that makes the WC have the independent power to predict the risk of developing conditions associated with being overweight or obese. The measurement makes use of a normal tape calibrated in inches and centimetres. As stated, the cut-off values are over 35 inches for women and over 40 inches for men (NHLBI, n.d.) BMI using waist circumference for adults Essay.
The Validity and Reliability of the Waist Circumference Measure
The WC as an independent predictor of disease risk is only accurate in the BMI range of 25 kg/ m2 to 34.9 kg/ m2 (Freiberg et al., 2008; NHLBI, n.d.). Above a BMI of 35 kg/ m2, the individual will have exceeded the cut-off values thereby invalidating the accuracy of the test. Within this range, however, the WC test is a dependable predictor that is strongest for the prediction of cardiovascular and obesity risk (Ball et al., 2019; Hammer & McPhee, 2018; Freiberg et al., 2008; Zhu et al., 2004; NHLBI, n.d.) BMI using waist circumference for adults Essay.
Ball, J.W., Dains, J.E., Flynn, J.A., Solomon, B.S., & Stewart, R.W. (2019). Seidel’s guide to physical examination: An interprofessional approach, 9th ed. St. Louis, MO: Elsevier Mosby.
Freiberg, M.S., Pencina, M.J., D’Agostino, R.B., Lanier, K., Wilson, P.W.F. & Vasan, R.S. (2008). BMI vs. waist circumference for identifying vascular risk. Obesity, 16(2), 463-469. Doi: 10.1038/oby.2007.75
Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8th ed. New York, NY: McGraw-Hill Education. BMI using waist circumference for adults Essay
LeBlond, R.F., Brown, D.D., & DeGowin, R.L. (2015). DeGowin’s diagnostic examination, 10th ed. New York, NY: McGraw Hill Medical.
National Heart Lung Blood Institute NHLBI. Guidelines on overweight and obesity: According to waist circumference. Retrieved 16 March 202 from https://www.nhlbi.nih.gov/health-pro/guidelines/current/obesity-guidelines/e_textbook/txgd/4142.htm
Zhu, S., Heshka, S., Wang, Z., Shen, W., Allison, W.B., Ross, R. & Heymsfield, S.B. (2004). Combination of BMI and waist circumference for identifying cardiovascular risk factors in Whites. Obesity Research, 12(4), 633-645. Doi: 10.1038/oby.2004.73 BMI using waist circumference for adults Essay
Assignment (3 pages, not including title and reference pages):
Assignment Option 1: Adult Assessment Tools or Diagnostic Tests: BMI using waist circumference for adults
Include the following:
A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
What is its purpose?
How is it conducted?
What information does it gather?
Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel\’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical. BMI using waist circumference for adults Essay
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