Fatness: sagittal diameter (sad) and abdominal diameter index (adi)

FATNESS: SAGITTAL DIAMETER (SAD) AND ABDOMINAL DIAMETER INDEX (ADI)
Abdominal fat distribution is reflected in an extended abdomen or 'pot belly'. This consists of expanded subcutaneous fat cells as well as increased visceral fat. Its extent could, therefore, presumably be measured through a measure of sagittal diameter, i.e. the width of the waist from back to front. This has recently been investigated and a device developed for determining the measure by Dr Henry Kahn from the University of Georgia. The device, called a sagittal diameter scale, measures the thickness of the abdomen at the umbilicus in either the lying or standing position.
The higher the SAD measure, the greater the risk of disease, and although norms have yet to be established for this measure, indications from the Georgia laboratory suggest that a SAD measure of greater than 25cm indicates an elevated health risk.
The abdominal diameter index, also developed by the Kahn team, is an attempt to compensate for the lack of perfect predictability of the SAD measure of visceral fatness.10 Because the sagittal measure includes not just visceral fat but bone, muscle and subcutaneous fat, the Georgia team have attempted to adjust for the non-visceral tissues that are incorporated in the SAD measure by dividing waist thickness by the girth of the mid-thigh. This also adjusts for overall body size as thigh thickness can be a good indication of total body size. ADI then becomes almost twice as powerful for the prediction of cardiovascular risk as the SAD alone.
Again there are, as yet, no well established norms for ADI. Early indications are that ADI measurements of over 0.5 (i.e. the cross-sectional thickness of the waist is over half the circumference of the mid-thigh) are highly predictive of risk for coronary heart disease.

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