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NMU 142 – Waist Circumference and Heart Disease

Nutrition / Natural Medicine Update No 142 (September 3, 2019)

with Dr. James Meschino


Topic: Waist Circumference More Important than Total Body Fat or BMI in Predicting Heart Attack Risk

Source: North American Menopause Society (NAMS)-2019, and the Journal of the American Heart Association-2018


Do you know your waist circumference or even the correct way to measure it? I ask this because strong evidence is emerging to show that waist circumference is a very strong predictor of heart attack and heart disease risk. And according to the American Diabetic Association, it is also a strong and independent predictor of risk for type 2 diabetes, coronary heart disease, and risk of death period (or mortality rate). Large studies, such as the one reported in the journal of the American Heart Association in 2018 and another in the journal Menopause in 2019, have shown that having too much abdominal fat, as ascertained by high waist circumference, greatly increases the risk for heart disease and heart attack. And this is especially true for women. The evidence shows that fat stored in the belly area (abdominal fat or truncal fat) poses a much greater risk for heart attack compared to excess fat stored in the area of the buttocks, pelvis or even the legs. In other words, having fat legs or a big butt, which may increase a person’s total body fat and body mass index does not necessarily increase their risk for heart disease, or even diabetes. But having too much belly fat really does.

The goal is to keep that belly fat down within a safe range. So how much belly fat is too much? Well, experts vary on the exact number, but in general, women should have a waist circumference that is no higher than 33 inches (83 cm) and men should have a waist circumference no higher than 36 inches (90 cm). The Heart Foundation states that the safest waist circumference for women is at or below 31.5 inches (80 cm) and for men, it is below 37 inches (94 cm).  Very high risk for heart attack occurs once a woman’s waist circumference is above 35 inches, and for men, above 40 inches, according to the National Heart, Lung, and Blood Institute. So, everyone should have their waist circumference measured periodically.

So, how do you do it accurately?  Well, there a several landmarks that you can use, but a simple, reproducible and reliable method is to simply have a friend or family member measure the circumference around your waist at the level of your belly button (umbilicus) after you exhale. You should be standing up, in bare feet, with both feet touching and arms hanging freely. And the tape measure should not be one that is stretchable. Have them take the measurement three consecutive times after you exhale to ensure the accuracy of the first reading. If your waist circumference is higher than the numbers I cited here, then one of the wellness goals you should consider is getting into the ideal range.

Remember that if you simply eat 100 calories fewer each day, and burn an extra 100 calories via physical activity, you will lose 24 pounds of body fat over the next 12-months. To burn 100 calories from exercise is a simple as walking for 20-30 minutes, depending on your walking speed. It’s simply taking additional 2500-3,000 steps per day. Most people can take 100 steps per minute so that a 25-30-minute walk easily burns that extra 100 calories. A vigorous walk is 130 steps per minute, which enables you to take 3,000 steps in 20-25 minutes. Jogging begins at 140 steps per minute, by the way.

Ok, that’s my update for today. My recommendation is to know your exact waist circumference and track it over your lifetime and do your best to keep in the ideal range. High waist circumference is in itself a risk factor for heart disease and other important health conditions common in today’s world.

I have included the references for this information in the text below.


1. Jun-Hwan Cho, Hack-Lyoung Kim, Myung-A Kim, Sohee Oh, Mina Kim, Seong Mi Park, Hyun Ju Yoon, Mi Seung Shin, Kyung-Soon Hong, Gil Ja Shin, Wan-Joo Shim. Association between obesity type and obstructive coronary artery disease in stable symptomatic postmenopausal women. Menopause, 2019. obesity-type-and-risk-of-cardiovascular-disease-8-28-19.pdf

2. The Journal of the American Heart Association (2019)

3. The Heart Foundation

4. The American Diabetic Association:


Eat Smart, Live Well, Look Great

Dr. Meschino

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