When does your waist circumference become a health risk?  A waist circumference of over 80cm for women and 94cm for men* increases your risk of developing chronic disease!  A waist measurement of over 88 cm for women and 102 cm for men* means a greatly increased risk. 

For most people **a waist measurement of greater than 94cm for men or 80cm for women is an indicator of internal fat deposits, which can coat the heart, kidneys, liver and pancreas, and increase the risk of chronic disease. This fat is called visceral or intra-abdominal fat. Subcutaneous fat is the fat right under the skin. Both types of fat play a role in contributing to health problems, however, intra-abdominal fat contributes more.  It is not yet clear exactly what links intra-abdominal fat with chronic disease, but what is clear is that even a small deposit of this fat increases the risk that you will have serious health problems.

How do you correctly measure your waist circumference? Learn how to work out your individual Body Mass Index and find out why it is important.

* Waist circumference should only be used for adults to check the risk of developing a chronic disease. Measurements that indicate increased risks for children and teenagers have not yet been developed.

**The waist measurements above are recommended for Caucasian men and Caucasian and Asian women. Recommended waist measurements are yet to be determined for all ethnic groups. It is believed that they may be lower for Asian men than for Caucasian men and are likely to be higher for Pacific Islanders and African Americans (men and women). The limited data currently available indicates that the risk factors in Aboriginal populations appear to be similar to those in Asian populations; and the risk factors in Torres Strait Islander populations appear to be similar to those found in Pacific Islander populations. 

This information has been adapted from the MeasureUp Campaign - an Australian Government initiative.

Chronic Disease and MeasureUp

It is never too late to make positive changes - eating well and keeping active can improve long term health and quality of life. There are no “magical” solutions to losing weight. It takes time to put on weight and it takes time to lose it. You’re most likely to have long term success if you lose weight slowly and make changes to your lifestyle that you can stick with for life. This includes building more physical activity into your daily life. For tips about how to do this, go to Helpful tips.

Dietary Guidelines for Australian Adults - amongst other recommendations these dietary guidelines encourage people to enjoy a wide variety of nutritious foods:

Care should be taken to:

• limit saturated fat and moderate total fat intake
• choose foods low in salt
• limit your alcohol intake if you choose to drink and
• consume only moderate amounts of sugars, and foods and drinks containing added sugars

Be active every day in as many ways as you can:

• avoid short trips in the car - walk or cycle instead
• take the stairs, rather than the lift
• aim for 30 minutes or more of physical activity per day

More Resources - to help you MeasureUp

Community Health/Fitness Programs - General / In your State or Territory 
Especially for chronic disease patients - SA 'Do It For Life' Program 
Frequently Asked Questions
Resources in other languages
Resources for Aboriginal & Torres Strait Islanders
Supporting info - MeasureUp Program

How to keep fit and healthy when you have kidney failure

The benefits of staying fit and healthy for everyone Regular exercise can make you feel that you have more control over your life. You can use a health action plan to get you motivated.

As well as the benefits of giving you more energy, keeping your muscles strong and strengthening your heart and lungs, staying active will add to your overall sense of well-being. In other words, it will make you feel good. The body’s natural painkillers or ‘happy drugs’, called endorphins, are released into your blood stream during exercise and can continue to produce pleasant feelings for several hours. Deep breathing and relaxation exercises help to relax the mind and body and reduce stress.  

Regular physical activity helps you by:

Types of exercise to help you get fit - There are usually three types of exercise in a fitness program:

Flexibility - Exercises that help your joints work smoothly and help you bend, stoop, reach, and move more easily. Flexibility exercises use gentle muscle stretching and slow movements.

Strengthening - These exercises make your muscles stronger. They use resistance to make muscles work harder e.g. weights, elastic bands or your own body weight.

Cardio or aerobic - Cardiovascular exercises are designed to improve your staying power so you can be active longer without getting tired. Aerobic or endurance exercises help to make your heart, lungs and blood circulation work better. These exercises use continuous, regular movements of your arms and/or legs e.g. walking, bicycling, swimming or dancing.

Less active family members need encouragement and support, especially when starting an exercise program.  Ideally, find an activity you can do together. Here are some ways to get everyone moving:

• play actively with your children – kick a footy around, skip, jump on the trampoline
• go on a family bike ride
• take your dog (or the neighbour’s dog) for a walk
• walk your children to school
• buy a fitness DVD and get the whole family to join in – a great way to have a laugh and be active.
• Include physical activity in family outings
• keep a box full of bats, balls, kites, frisbees etc – both at home and in the car and you will be always ready for action
• walk and talk – practice spelling and maths homework on the move; or go for a walk while you all catch up on each others day

Getting started In the beginning, a chat with your doctor is a good idea to make sure there is nothing to stop you exercising safely. The key to getting fit is to start slowly and gradually increase the time and intensity of your activities. If you are only starting out, aim to do some physical activity for at least 30 minutes three – four times weekly. The 30 minutes can be broken down into smaller blocks, e.g. three sessions of ten minutes, which can be increased as you become fitter. Read Physical Activity Guidelines for adults

Easy ways to increase your exercise Enjoy regularly walking your dog, take the stairs, get off the bus a stop earlier or mow your lawns. There are four steps recommended for better health for Australian adults:

Step 1 - Think of movement as an opportunity, not an inconvenience
Step 2 - Be active every day in as many ways as you can
Step 3 - Do 30 minutes of moderate-intensity physical activity on most, preferably all, days
Step 4 - If you can, also enjoy regular, vigorous activity for extra health and fitness

Moderate-intensity activity will cause a slight but noticeable increase in your breathing and heart rate. Vigorous activity is where you “huff and puff”; for example, where talking in a full sentence between breaths is difficult.

Stretching before any exercise helps prevent injury Stretching is an important part of getting fit. It gets the blood to the body parts that are working when you are exercising.  It is also helpful to stretch your legs, arms and back before starting any other form of physical activity. Stretching reduces cramping and helps you to move more comfortably. It also helps you to unwind when you are finished. Some simple rules for stretching include:

• think about which muscle(s) you want to stretch. Stretch gently until you feel slight tension. Hold it for 10 to 20 seconds without bouncing. The muscle should feel more relaxed as you hold your stretch. If it doesn’t, relax a bit more until you can hold the stretch comfortably.
• take it easy!  Stretches are gentle, not painful.  If they are, relax the stretch and breathe deeply. Pain can be a sign that you are over-stretching.
• it is important to breathe slowly and deeply as you stretch. Breathe in as you stretch then slowly out as you hold the position.
• sit or stand up straight between stretches. Good posture is important during all your exercises.

When to STOP .... Important signs to watch for!  It is important to stop exercising, cool down and tell your health care team if you get:

• chest pain or pressure
• dizziness or light-headedness
• irregular or very fast heart rate
• excessive shortness of breath
• nausea
• severe leg cramps
• pain or pressure in neck or jaw
• excessive tiredness
• blurring of vision

If you feel mild soreness after exercising that lasts for more than two hours, next time do less or don’t do the actiivties that seem to be causing problems

• don’t stop your physical activity all together
• avoid the very hot or cold times of the day if you are exercising outside
• don’t exercise if you are feeling unwell
• maintain your motivation by finding an exercise buddy
• local community centres and gyms often offer low impact exercise and resistance/strength training classes 

  

Kidney Health Australia, in partnership with the Australian Better Health Initiative encourage all Australians to MeasureUp, but particularly people with kidney disease.

The role of our kidneys is often underrated when we think about our health. Although only small organs, the kidneys are responsible for removing waste and fluid from the body, helping to control blood pressure, assisting with the production of red blood cells, and helping to keep our bones strong. You can lose up to 90 per cent of kidney function without realising it, by which time it is almost impossible to prevent further serious problems. Be kind to your kidneys - take positive measures to avoid this diagnosis. There are a number of ways you can reduce your risk of kidney disease:

Be aware of your family medical history - if close blood family relatives have had kidney disease or other chronic diseases, you may be 'at risk' too? Ask what their health problems were and be aware of the risk.
If you are at increased risk' of developing kidney disease ask your doctor for an annual kidney health check
Eat a healthy diet full of fresh fruit and vegetables
Maintain healthy cholesterol levels
Maintain healthy weight for your height - being overweight increases your risk of developing diabetes and high blood pressure, which are major risk factors for kidney disease. Check your Body Mass Index (BMI)
Be a non-smoker - smokers are three times more likely to have reduced kidney function, not to mention four to five times greater risk of heart attack and stroke
Make physical activity a regular habit - 30 minutes of regular moderate-intensity physical activity (See Simple indoor exercise for people on dialysis DaVita USA)
Drink water instead - water satisfies thirst without any kilojoules
Drink alcohol in moderation - limit alcohol to two standard drinks per day for men, and one per day for women
If you have diabetes maintain good blood glucose control
Taking medications as prescribed by your doctor
Maintain a positive 'stay well' attitude, do things that help you to relax and reduce stress

Live a healthy lifestyle The risk of type 2 diabetes can be reduced by up to 60% by adopting a healthy and active lifestyle. Some of the risk factors for developing diabetic kidney disease relate everyday choices.

If you have diabetes you are in a 'high risk' group, so ensure you:

• make sure your blood sugar control is excellent
• have good blood pressure control
• choose the right foods - it is important to consult a doctor or dietitian about a suitable diet
• be a non-smoker
• have your urine checked for microalbuminuria at least once a year
• have a blood test for kidney function at least once a year
• treat urine infections immediately
• maintain healthy cholesterol levels
• drink alcohol in moderation
• maintain a healthy weight
• make moderate physical activity a habit
• ask your doctor to inform you about new developments in the treatment of diabetes
• maintain a positive 'stay well' attitude, do things that help you to relax and reduce stress

Control proteinuria Any treatment that lowers levels of protein in the urine can help to reduce the rate of progression to kidney failure. Two important drugs used to treat proteinuria are angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB). These drugs should be used even if blood pressure is in the desired range. Reduction in salt intake to ‘low normal’ can also help to reduce proteinuria.

Control cholesterol levels Cholesterol is a type of fat or lipid. There are two types of cholesterol – low-density lipoprotein (LDL) or ‘bad’ cholesterol and high-density lipoprotein (HDL) or ‘good’ cholesterol. Triglycerides are a form of stored body fat. Some studies have shown that high cholesterol can increase the progression of diabetic kidney disease. It is important to control your blood cholesterol and triglyceride levels with diet and medication if necessary.

Become a non-smoker It is well known that smoking harms the body. Smoking causes a narrowing of the arteries, including the small vessels in the kidney filters. This reduces the kidneys’ ability to work properly. If you have diabetes and smoke, the risk of developing proteinuria is much higher. Smoking also increases blood pressure. For reasons that are not well understood, smoking appears to speed up the progression of diabetic kidney disease to kidney failure. QUIT  Ring 13 78 48 and ask for Quit Pack to be sent free of charge or Smokenders Australia  Helpline 1800 021 000.

Physical exercise Some people with CKD find strenuous sport or activities too tiring - but enjoy gentler exercise such as walking, yoga and Tai Chi. Others throw themselves enthusiastically into fitness programs and compete nationally and internationally in the Transplant Games. Keep in mind that some contact sports such as football may need to be avoided, particularly after a transplant. If you are on peritoneal dialysis, you need to protect your catheter while exercising. If you have advanced kidney disease but not yet on dialysis or had a transplant, you may find it difficult to improve your fitness – do as much as is comfortable. Refer info from DaVita USA on Exercise for people with chronic kidney disease  I  Exercise for dialysis patients – Of course, you can exercise  I  Indoor exercises for people on dialysis

Contact Dietitians Association of Australia Hotline 1800 812 942 for the name of a local renal dietician. If you are confused with implementing the information given by your dietician, ring:

    For hearing impaired - TTY/Voice 133 677  |  Speak & Listen (SSR) 1300 555 727