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OBJECTIVE -- While the measurement of waist circumference (WC) is recommended in current clinical guidelines, its clinical utility was questioned in a recent consensus statement. In response, we sought to [...]

Background: Waist circumference (WC) is positively associated with morbidity and mortality with or without control for hip circumference (HC) or body mass index (BMI; in kg/[m.sup.2]). This association is thought to be explained by an expanded visceral adipose tissue (VAT) depot. Conversely, HC and BMI are negatively associated with morbidity and mortality after control for WC. Whether this inverse association is explained in part by the ability of HC and BMI to identify subjects with increased subcutaneous adipose tissue (SAT), increased skeletal muscle (SM) mass, or decreased VAT after control for WC is unclear. Objective: We examined the independent associations between WC, HC, thigh circumference (ThC), and BMI with VAT and total, lower-body, and abdominal SAT and SM. Design: Total and regional body composition were measured in 256 white men and women with magnetic resonance imaging. Results: WC, HC, ThC, and BMI were all positively correlated with total, lower-body, and abdominal SAT and SM and with VAT. After statistical control for WC, HC, ThC, and BMI remained positively associated with total, lower-body, and abdominal SAT and SM (men only) but were negatively associated with VAT (P < 0.05). HC (P < 0.05) but not BMI (P > 0.10) or ThC (P = 0.06) remained negatively associated with VAT after further control for age. Conclusions: HC, ThC, and BMI are positively associated with total, lower-body, and abdominal SAT and SM but negatively associated with VAT after control for WC. However, only HC remained negatively associated with VAT after control for age and WC. KEY WORDS Body composition, magnetic resonance, obesity, skeletal muscle

OBJECTIVE--Weight loss among metabolically healthy obese (MHO) individuals may be unnecessary or result in elevated cardio-metabolic risk. We studied the effects of exercise- or diet-induced weight loss on cardio-metabolic risk [...]

In the present review, it is argued that while weight loss is associated with substantial reduction in obesity-related cardiovascular disease risk and remains a desired outcome of relevant treatment strategies, increasing physical activity is associated with marked reduction in waist circumference, visceral fat and cardiometabolic risk factors, concurrent with an increase in cardiorespiratory fitness despite minimal or no change in body weight. Failure to recognize the benefits of exercise independent of weight loss masks opportunities to counsel and educate patients whose sole criteria for gauging obesity reduction success is the bathroom scale.