tailieunhanh - The Guide to Clinical Preventive Services 2008 - part 7

Đàn ông có circumferences vòng eo lớn hơn 102 cm (40 inches) và phụ nữ có circumferences eo lớn hơn 88 cm (35 inch) có nguy cơ gia tăng bệnh tim mạch. Các ngưỡng chu vi vòng eo không đáng tin cậy cho các bệnh nhân có chỉ số BMI lớn hơn 35. | Screening for Obesity in Adults other diseases independent of obesity. Clinicians may use the waist circumference as a measure of central adiposity. Men with waist circumferences greater than 102 cm 40 inches and women with waist circumferences greater than 88 cm 35 inches are at increased risk for cardiovascular disease. The waist circumference thresholds are not reliable for patients with a BMI greater than 35. Expert committees have issued guidelines defining overweight and obesity based on BMI. Persons with a BMI between 25 and are overweight and those with a BMI of 30 and above are obese. There are 3 classes of obesity class I BMI class II BMI and class III BMI 40 and above . BMI is calculated either as weight in pounds divided by height in inches squared multiplied by 703 or as weight in kilograms divided by height in meters squared. The National Institutes of Health NIH provides a BMI calculator at bmi and a table at guidelines obesity . The most effective interventions combine nutrition education and diet and exercise counseling with behavioral strategies to help patients acquire the skills and supports needed to change eating patterns and to become physically active. The 5-A framework Assess Advise Agree Assist and Arrange has been used in behavioral counseling interventions such as smoking cessation and may be a useful tool to help clinicians guide interventions 147 Screening for Obesity in Adults for weight loss. Initial interventions paired with maintenance interventions help ensure that weight loss will be sustained over time. It is advisable to refer obese patients to programs that offer intensive counseling and behavioral interventions for optimal weight loss. The USPSTF defined intensity of counseling by the frequency of the intervention. A high-intensity intervention is more than 1 person-to-person individual or group session per month for at least the first 3 months of the .