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Waist-to-hip ratio superior to body size measurements as a risk assessment tool for myocardial infarction.

The waist-to-hip ratio is calculated by dividing the waist by the hip measurement and is a 3 fold stronger predictor of the risk for myocardial infarction than BMI.

Waist to hip ratio of 0.85 or higher form women or 0.90 or higher or men additional risk factors for increased risk of myocardial infarction.

Individuals with an apple shape, i.e., excess abdominal fat compared to pear shaped people with excess lower body fat, have an increased cardiovascular risk.

In an analysis of 221,934 patients 17 countries found that fat distribution was no better than cardiovascular disease risk factors such as blood pressure, diabetes and lipids in predicting cardiovascular disease.

Lower body fat associated with protection of cardiovascular risk.

Abdominal fat is an independent predictor of health risks associated with obesity and is associated with increased risk of metabolic abnormalities, dyslipidemia, cardiovascular disease, hypertension, and diabetes.

Abdominal visceral obesity is the obesity phenotype conveying the most unfavorable health profile.

Visceral fat is more closely related to cardiometabolic risk factors, such is fasting glucose, lipids, and endothelial function, as well as the presence of coronary atherosclerosis band stroke, than total and subcutaneous adiposity.

Regional fat compartments differ in metabolic function: compared with fat stored in leg and hip, visceral adiposity is more insulin resistant, and secretes more pro inflammatory cytokines.

Visceral fat has greater lipolytic activity which can lead to higher levels of free fatty acids.

In contrast adipocytes in gynoid and leg regions have greater lipoprotein lipase activity, more effective storage of free fatty acids and secrete more anti-inflammatory cytokines.

The proportion of abdominal to gluteofemoral body fat correlates with obesity-associated diseases and mortality.

Population studies show that an increased gluteofemoral fat mass is independently associated with a protective lipid and glucose profile, as well as a decrease in cardiovascular and metabolic risk.

Studies of adipose tissue physiology confirm distinct properties of the gluteofemoral fat depot with regards to lipolysis and fatty acid uptake it appears to be more passive than the abdominal depot and it exerts its protective properties by long-term fatty acid storage.

Leptin and adiponectin levels are positively associated with gluteofemoral fat while the level of inflammatory cytokines is negatively associated.

Loss of gluteofemoral fat, as observed in Cushing’s syndrome and lipodystrophy is associated with an increased metabolic and cardiovascular risk.

Gluteofemoral fat is a determinant of health by entrapment of excess fatty acids, thus protecting from the adverse effects associated with ectopic fat deposition.

Relative risk with waist circumference > 40 inches for men and > 35 inches for women.

Muscle is denser than fat, so someone who builds muscle while keeping the same body weight will occupy less volume.

If two people weigh the same, and are the same height, but have different lean body mass percentages, the one with more muscle will appear thinner

An association between waist circumference and mortality among 48500 men and 56343 women, 50 years or older in the Cancer Prevention Study II Nutrition Cohort revealed that very high levels of waist circumference was associated with a 2 fold higher risk of mortality (Jacobs EJ).

Variation in body fat distribution, independent of generalized adiposity, is associated with differential metabolic risk factors.

In a Chinese study children trunk fat mass and abdominal fat mass are positively associated with all cardiometabolic risk factors and their clustered risk independent of fat mass in other regions (Yan Y).

Leg fat mass gynoid and fat mass are negatively associated with most cardiometabolic risk factors (Yon Y).

Tall stature is associated with lower risk of cardiovascular disease, but higher risks of many cancers, hip fractures, and pulmonary emboli.

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