Piece of string can assess cardiovascular risk, study findsBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h2434 (Published 11 May 2015) Cite this as: BMJ 2015;350:h2434
All rapid responses
It is nice to know that measurement of waist circumference (WC) by a piece of string helps in quick assessement of cardiovascular risk(1), An individual may have lower cardiovascular risk if WC is less than half of their height.(1). According to WHO if WC of men and women is greater than 94 cm and 80 cm respectively there is a risk of metabolic complications and WC of men more than 102 cm for men and more than 88 cm for women increases the risk of metabolic conditions like risk of cardiovascular disease (2,3). Performance of regular daily physical activity improves cardiovascular health, reduces risk of type-2 diabetes mellitus and . improves psychological well-beingness. Physical activity recommend by WHO is about 150 minutes per week or 22 minutes per day (2,3).
Performance of leisure time physical activity in adults leads to an increase in lean body mass (LBM) and a decrease in fat mass (4). The waist circumference standards are different for African Americans than for Whites.(5).Waist circumference of obese girls is associated with cardiovascular risk(6). Fat mass trunk in men and fat mass in arm are associated cardiovascular risk (7). Increase in physical activity is associated with higher lean body mass and this may be negatively associated with cardiovascular risk factors. Increased physical fitness in individuals with higher body mass index (BMI) is associated with lower prevalence of cardiovascular risk factors (8). Anthropometric prediction equations for estimation of lean body mass and appendicular lean soft tissue in Indian men and women have been developed (9). LBM serves as a good parameter in addition to BMI in prediction of long term survival (10).
In our opinion LBM and WC together would better predict cardiovascular risk and long term survival than than WC alone.Hence simpler indices for predicting LBM need to be developed.
1.Wise J. Piece of string can assess cardiovascular risk, study finds BMJ 2015;350:h2434
2. An increase in physical activity may reduce mortality risk in inactive people http://www.eufic.org/page/en/show/latest-science- news/fftid/An_increase_in_physical_activity_may_reduce_mortality_risk_in_inactive_people/ 8th April 2015
3. Ekelund U, Ward HA, Norat T, Luan J, May AM1, Weiderpass E, Sharp SJ, Overvad K, Østergaard JN, Tjønneland A, Johnsen NF, Mesrine S, Fournier A, Fagherazzi G, Trichopoulou A, Lagiou P, Trichopoulos D, Li K, Kaaks R, Ferrari P, Licaj I, Jenab M, Bergmann M, Boeing H, Palli D, Sieri S, Panico S, Tumino R, Vineis P, Peeters PH, Monnikhof E, Bueno-de-Mesquita HB, Quirós JR, Agudo A, Sánchez MJ, Huerta JM, Ardanaz E, Arriola L, Hedblad B, Wirfält E, Sund M, Johansson M, Key TJ, Travis RC, Khaw KT, Brage S, Wareham NJ, Riboli E
Physical activity and all-cause mortality across levels of overall and abdominal adiposity inEuropean men and women: the European Prospective Investigation into Cancer and NutritionStudy (EPIC). Am J Clin Nutr. 2015 Mar;101(3):613-21. doi: 10.3945/ajcn.114.100065. Epub 2015 Jan 14.
4. Bann D, Kuh D, Wills AK, Adams J, Brage S, Cooper R; National Survey of Health and Development scientific and data collection team Physical activity across adulthood in relation to fat and lean body mass in early old age: findings from the Medical Research Council National Survey of Health and Development, 1946-2010 Am J Epidemiol. 2014 May 15;179(10):1197-207. doi: 10.1093/aje/kwu033. Epub 2014 Apr 9.
5. Clark VR1, Greenberg B, Harris TS, Carson BL Body mass index and waist circumference predictors of cardiovascular risk in African Americans Ethn Dis. 2012 Spring;22(2):162-7.
6. Maffeis C1, Corciulo N, Livieri C, Rabbone I, Trifirò G, Falorni A, Guerraggio L, Peverelli P, Cuccarolo G, Bergamaschi G, Di Pietro M,Grezzani A Waist circumference as a predictor of cardiovascular and metabolic risk factors in obese girls Eur J Clin Nutr. 2003 Apr;57(4):566-72.
7. Joseph L1, Wasir JS, Misra A, Vikram NK, Goel K, Pandey RM, Chandra M, Poddar P, Kondal D Appropriate values of adiposity and lean body mass indices to detect cardiovascular risk factors in Asian Indians Diabetes Technol Ther. 2011 Sep;13(9):899-906. doi: 10.1089/dia.2011.0014. Epub 2011 Jun 29.
8. Navaneethan SD, Kirwan JP, Arrigain S, Schold JD. Adiposity measures, lean body mass, physical activity and mortality: NHANES 1999-2004 BMC Nephrol. 2014 Jul 8;15:108. doi: 10.1186/1471-2369-15-108.
9. Kulkarni B, Kuper H, Taylor A, Wells JC, Radhakrishna KV, Kinra S, Ben-Shlomo Y, Smith GD, Ebrahim S, Byrne NM, Hills AP. Development and validation of anthropometric prediction equations for estimation of lean body mass and appendicular lean soft tissue in Indian men and women
J Appl Physiol (1985). 2013 Oct 15;115(8):1156-62. doi: 10.1152/japplphysiol.00777.2013. Epub 2013 Aug 15.
10. Huang JW, Lien YC, Wu HY, Yen CJ, Pan CC, Hung TW, Su CT, Chiang CK, Cheng HT, Hung KY. Lean body mass predicts long-term survival in Chinese patients on peritoneal dialysis PLoS One. 2013;8(1):e54976. doi: 10.1371/journal.pone.0054976. Epub 2013 Jan 25.
Dr Mahantayya V Math
Associate Professor in Physiology
MGM Medical College, Kamothe, Navi Mumbai-410209, Maharashtra State, India
Dr Sachin M Patel
Assistant Professor in Physiology
MGM Medical College, Kamothe, Navi Mumbai-410209 Maharashtra State, India
Competing interests: No competing interests