Silhouettes and waist circumferences representing normal, overweight, and obese There are various ways of measuring<unk>  including: *Absolute waist circumference (> in men and > in women) *Waist–hip ratio (the circumference of the waist divided by that of the hips of >0.9 for men and >0.85 for women) *Waist-stature ratio (waist circumference divided by their height, >0.5 for adults under 40 and >0.6 for adults over 50) *Sagittal<unk>  Diameter Overweight teenage boy holding his excess<unk>  fat In those with a body mass index (BMI) under 35, intra-abdominal body fat is related to negative health outcomes independent of total body fat. Intra-abdominal or visceral fat has a particularly strong correlation with cardiovascular disease. BMI and waist measurements are well recognized ways to characterize obesity. However, waist measurements are not as accurate as BMI measurements. For this reason, it is recommended to use both methods of measurements. An adult man with<unk>  While central obesity can be obvious just by looking at the naked body (see the picture), the severity of central obesity is determined by taking waist and hip measurements. The absolute waist circumference in men and in women and the waist–hip ratio (>0.9 for men and >0.85 for women) are both used as measures of central obesity. A differential diagnosis includes distinguishing central obesity from ascites and intestinal bloating. In the cohort of 15,000 people participating in the National Health and Nutrition Examination Survey (NHANES III), waist circumference explained obesity-related health risk better than BMI when metabolic syndrome was taken as an outcome measure and this difference was statistically significant. In other words, excessive waist circumference appears to be more of a risk factor for metabolic syndrome than BMI. Another measure of central obesity which has shown superiority to BMI in predicting cardiovascular disease risk is the Index of Central Obesity (waist-to-height ratio, WHtR), where a ratio of >=0.5 (i.e. a waist circumference at least half of the individual's height) is predictive of increased risk. Another diagnosis of obesity is the analysis of intra-abdominal fat having the most risk to one's personal health. The increased amount of fat in this region relates to the higher levels of plasma lipid and lipoproteins as per studies mentioned by Eric Poehlman (1998) review. An increasing acceptance of the importance of central obesity within the medical profession as an indicator of health risk has led to new developments in obesity diagnosis such as the Body Volume Index, which measures central obesity by measuring a person's body shape and their weight distribution. The effect of<unk>  adiposity occurs not just in those who are obese, but also affects people who are non-obese and it also contributes to insulin sensitivity. Index of central obesity Index of Central Obesity (ICO) is the ratio of waist circumference and height first proposed by a Parikh et al. in 2007 as a better substitute to the widely used waist circumference in defining metabolic syndrome. The National Cholesterol Education Program Adult Treatment Panel III suggested cutoff of and for males and females as a marker of central obesity. The same was used in defining metabolic syndrome. Misra et al. suggested that these cutoffs are not applicable among Indians and the cutoffs be lowered to and for males and females. Various race specific cutoffs were suggested by different groups. The International Diabetes Federation defined central obesity based on these various race and gender specific cutoffs. The other limitation of waist circumference is that it the measurement procedure has not been standardized and in children there are no, or few, comparison standards or reference data. Parikh et al. looked at the average heights of various races and suggested that by using ICO various race- and gender-specific cutoffs of waist circumference can be discarded. An ICO cutoff of 0.53 was suggested as a criterion to define central obesity. Parikh et al. further tested a modified definition of metabolic syndrome in which waist circumference was replaced with ICO in the National Health and Nutrition Examination Survey (NHANES) database and found the modified definition to be more specific and sensitive. This parameter has been used in the study of metabolic syndrome and cardiovascular disease. Central obesity in individuals with normal BMI is referred to as normal weight obesity. Sex differences 50% of men and 70% of women in the United States between the ages of 50 and 79 years now exceed the waist circumference threshold for central obesity. When comparing the body fat of men and women it is seen that men have close to twice the visceral fat as that of pre-menopausal women. Central obesity is positively associated with coronary heart disease risk in women and men. It has been hypothesized that the sex differences in fat distribution may explain the sex difference in coronary heart disease risk. There are sex-dependent differences in regional fat distribution. In women, estrogen is believed to cause fat to be stored in the buttocks, thighs, and hips. When women reach menopause and the estrogen produced by ovaries declines, fat migrates from their buttocks, hips, and thighs to their belly. Males are more susceptible to upper-body fat accumulation, most likely in the belly, due to sex hormone differences.<unk>  in males is correlated with comparatively low testosterone levels. Testosterone administration significantly increased thigh muscle area, reduced subcutaneous fat deposition at all levels measured, but slightly increased the visceral fat area. Even with the differences, at any given level of central obesity measured as waist circumference or waist to hip ratio, coronary artery disease rates are identical in men and women.
Abdominal obesity
Obesity
Normal weight obesity
Vegetarianism
Risky sexual behavior
Childhood obesity
Body mass index
Dry sex