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Waist size reflects whole health

By Staff Sgt. C. Todd Lopez

WASHINGTON (Oct. 30, 2003) -- The waist-measurement portion of the Air Force's new fitness standard serves as a gauge for total health, said the Air Force chief of health promotion operations.

“The waist measurement is used to determine visceral or intra-abdominal fat,” said Maj. Lisa Schmidt. Air Force officials chose this measurement because there is ample evidence that links an increase in visceral fat with an increase in risk for disease.

One of the new three-pronged fitness standards being adopted by the Air Force is the waist measure. Taken with a tape wrapped around the abdomen, and placed midway between the bottom rib and top of the pelvic bone, the waist measure serves as a total-health gauge. The primary indicator being measured is visceral or intra-abdominal fat. The waist measure is independent of age or height. U.S. Air Force photo by Master Sgt. Jim Varhegyi.

"When we looked at developing health-based standards, we reviewed a lot of literature of the best ways to predict health risks for members, and abdominal circumference kept surfacing," Schmidt said. "With more abdominal fat, you have more risk for diabetes, heart disease, stroke and some types of cancer."

Agencies like the American Medical Association and the National Institute of Health have produced such studies, Schmidt said.

Individuals can perform the measurement on themselves by using a tape measure, she said. The measurement is taken with the tape wrapped around the abdomen above the right iliac crest, or right above the top of the right hip bone, while ensuring the loop created by the tape remains parallel to the floor. The measurement is taken the same way for both males and females.

Air Force officials use two tables for measuring waists, one for males and one for females, Schmidt said. There are no variations in regards to height or age.

"The risk for disease is independent of your height," Schmidt said. "Other things considered, if you are 5 foot 2 inches tall or you are 6 foot 2 inches tall, your risk for disease is the same if you have a 40-inch waist. The same applies with your age. If you are 20 years old or 50 years old, the risk is the same based on waist measurements."

Additionally, unlike other body parts, the size of the waist does not grow proportionally with height, Schmidt said.

"As you get taller, it isn't as if you grow out as well," Schmidt said. "It is not proportional growth. The area you are measuring does not include any bone."

While there is no variance allowed for height when it comes to waist measurements, it is important to consider the fitness evaluation as a whole in regards to the total-fitness score, Schmidt said.

"When you look at the fitness score, it is a composite score," Schmidt said. "If you have a 20-year-old and a 50-year-old, both with a 39-inch waist, they are going to get the same points for abdominal circumference. However, that 20-year-old is going to have to run faster and do more crunches and more pushups to get the same composite score as the 50-year-old."

For airmen who have measured their waists and determined they are not within an acceptable range, there is hope, she said. Visceral fat is generally the first to go when people begin an exercise program. While it may take several months of running, crunches and weight lifting to knock an inch or two off the waist circumference, that effort pays off in more than just the one or two points gained on the waist-measurement portion of the evaluation, Schmidt said.

"A lot of airmen will look at the chart and say it is difficult to lose an inch in abdominal circumference, and that they only get a point for it," Schmidt said. "But if you are engaged in some kind of program to lose that inch and to gain that point, some aerobic and fitness program, then in the process of gaining that extra point for waist measure you will improve your performance on the running and strength portions. They are all interrelated. This is about total health."

Airmen who look at the chart for the first time become fixated on the top numbers for their age group -- those numbers needed to score a perfect 100 on the evaluation, Schmidt said. She said airmen should concentrate instead on getting a “good” or “excellent” fitness score.

The expectation is not for most airmen to achieve a perfect score. The expectation is for everyone to participate in a regular fitness program, which will result in improvements in overall fitness, she said.