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Normal-weight central obesity: Unique hazard of the toxic waist.
Can Fam Physician. 2019 06; 65(6):399-408.CF

Abstract

OBJECTIVE

To examine the mortality risk presented by normal-weight central obesity, to identify a clinical measure to aid in the identification of this phenotype, and to explore the means for mitigation of this risk.

QUALITY OF EVIDENCE

Only prospective cohort studies (level II) comparing participants with central obesity at normal weight with those at higher levels of body mass index (BMI) were found. Good level I studies were available to demonstrate the effect of diet and exercise interventions on central obesity and mortality.

MAIN MESSAGE

Participants with atherogenic dyslipidemia who are centrally obese at normal BMI are at similar, and possibly higher, mortality risk compared with those who are centrally obese and overweight or obese according to their BMI. Waist-to-height ratio might be the most pragmatic clinical measure of central obesity. The Mediterranean diet is an effective intervention to prevent ongoing weight gain while reducing abdominal girth. Low levels of exercise can also reduce waist circumference. Weight loss need not be an objective.

CONCLUSION

A waist-to-height ratio exceeding 0.5 at normal BMI identifies elevated mortality risk for cardiometabolic disease. This risk might equal or exceed that of centrally obese patients who are overweight or obese. Modest dietary and exercise interventions can be effective in mitigation of this risk.

Authors+Show Affiliations

Honorary Lecturer in the Department of Family Practice at the University of British Columbia in Vancouver. jbosomworth@gmail.com.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31189627

Citation

Bosomworth, N John. "Normal-weight Central Obesity: Unique Hazard of the Toxic Waist." Canadian Family Physician Medecin De Famille Canadien, vol. 65, no. 6, 2019, pp. 399-408.
Bosomworth NJ. Normal-weight central obesity: Unique hazard of the toxic waist. Can Fam Physician. 2019;65(6):399-408.
Bosomworth, N. J. (2019). Normal-weight central obesity: Unique hazard of the toxic waist. Canadian Family Physician Medecin De Famille Canadien, 65(6), 399-408.
Bosomworth NJ. Normal-weight Central Obesity: Unique Hazard of the Toxic Waist. Can Fam Physician. 2019;65(6):399-408. PubMed PMID: 31189627.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Normal-weight central obesity: Unique hazard of the toxic waist. A1 - Bosomworth,N John, PY - 2019/6/14/entrez PY - 2019/6/14/pubmed PY - 2020/9/23/medline SP - 399 EP - 408 JF - Canadian family physician Medecin de famille canadien JO - Can Fam Physician VL - 65 IS - 6 N2 - OBJECTIVE: To examine the mortality risk presented by normal-weight central obesity, to identify a clinical measure to aid in the identification of this phenotype, and to explore the means for mitigation of this risk. QUALITY OF EVIDENCE: Only prospective cohort studies (level II) comparing participants with central obesity at normal weight with those at higher levels of body mass index (BMI) were found. Good level I studies were available to demonstrate the effect of diet and exercise interventions on central obesity and mortality. MAIN MESSAGE: Participants with atherogenic dyslipidemia who are centrally obese at normal BMI are at similar, and possibly higher, mortality risk compared with those who are centrally obese and overweight or obese according to their BMI. Waist-to-height ratio might be the most pragmatic clinical measure of central obesity. The Mediterranean diet is an effective intervention to prevent ongoing weight gain while reducing abdominal girth. Low levels of exercise can also reduce waist circumference. Weight loss need not be an objective. CONCLUSION: A waist-to-height ratio exceeding 0.5 at normal BMI identifies elevated mortality risk for cardiometabolic disease. This risk might equal or exceed that of centrally obese patients who are overweight or obese. Modest dietary and exercise interventions can be effective in mitigation of this risk. SN - 1715-5258 UR - https://www.unboundmedicine.com/medline/citation/31189627/Normal_weight_central_obesity:_Unique_hazard_of_the_toxic_waist_ L2 - http://www.cfp.ca/cgi/pmidlookup?view=long&pmid=31189627 DB - PRIME DP - Unbound Medicine ER -