AdiposeMetabolicRatioSurrogate for abdominalHigh waist circumferenceDual-energy X-ray aHypertensionInsulin resistanceIndicesIntra-abdominalMeasurementAccumulation of abdominal fatVisceral fat areaType 2 diabetRiskPredictivePercentage of body fatPrevalenceDepositionMortalitySerumSociodemographicExcess fatTriglyceridesOverweight or obesePredictComorbiditiesMetabolically0.82MethodsChronicMeasurementsPositivelyWomenSuprailiac skinfoldHigherHealthTestosteroneHealthy
Adipose11
- However, BMI may not accurately predict which women will develop complications during pregnancy as it does not determine amount and distribution of adipose tissue. (bvsalud.org)
- It is characterized by adipose tissue accumulation predominantly around the waist and trunk. (wikipedia.org)
- A dysfunctional HPA-axis causes high cortisol levels to circulate, which results in raising glucose and insulin levels, which in turn cause insulin-mediated effects on adipose tissue, ultimately promoting visceral adiposity, insulin resistance, dyslipidemia and hypertension, with direct effects on the bone, causing "low turnover" osteoporosis. (wikipedia.org)
- The purpose of the study was to validate indirect Dual-energy X-ray Absorptiometry technique and abdominal circumference measurement as tools to predict visceral adipose tissue in rats. (biomedcentral.com)
- Lipohypertrophy is defined as excess fat deposition in abdominal defined as visceral adipose tissue (VAT) as well as in the dorsocervical region, breasts, trunk, and along with possible fat deposition in liver, muscle, myocardium and epicardium. (eventscribe.net)
- Total body adiposity correlates with the amount of epicardial adipose tissue (EAT), a specific visceral fat accumulation around the myocardium in the proximity to the coronary arteries [ 2 ]. (biomedcentral.com)
- Testosterone has been found to inhibit triglyceride uptake and lipoprotein lipase activity and cause a rapid turnover of triglycerides in abdominal adipose tissue (Martin et al, 1996). (bhma.org)
- 1 Waist circumference has been shown to be the anthropometric index that best predicts the distribution of adipose tissue in fat compartments such as the abdominal region. (psychiatrist.com)
- Metabolic syndrome is characterized by a large waist circumference (due to excess abdominal adipose tissue), hypertension, abnormal fasting plasma glucose or insulin resistance, and dyslipidemia. (msdmanuals.com)
- Elevated waist circumference, a crude anthropometric index of the absolute amount of visceral adipose tissue, better predicts the risk of developing the metabolic syndrome and related disorders than BMI. (myhealthywaist.org)
- of PRT on circulating adiponectin and the physiological role Moreover, it is known that an excess of abdominal adipose tis- of adiponectin on the improvement of metabolic and cardio- sue is a better predictor of the development of insulin resistance, vascular risk factors with either body or fat mass loss are as yet type 2 diabetes and cardiovascular disease than the total amount incompletely understood (1,13). (hmamedicalclinic.com)
Metabolic24
- We therefore believed that an exami- lar risk [ 3 ] and increased risk of metabolic nation of waist circumference in a group complications [ 4 ]. (who.int)
- However, even in the absence of the hyperglycaemic state which characterizes type 2 diabetic patients, non diabetic individuals with a specific form of obesity, named abdominal obesity, often show clustering metabolic abnormalities which include high triglyceride levels, increased apolipoprotein B, small dense low density lipoproteins and decreased high density lipoproteins-cholesterol levels, a hyperinsulinemic-insulin resistant state, alterations in coagulation factors as well as an inflammatory profile. (researchgate.net)
- This agglomeration of abnormalities has been referred to as the metabolic syndrome which can be identified by the presence of three of the five following variables: abdominal obesity, elevated triglyceride concentrations, low HDL-cholesterol levels, increased blood pressure and elevated fasting glucose. (researchgate.net)
- Metabolic syndrome linked to abdominal obesity is also predictive of recurrent coronary events both in post-myocardial infarction patients and among coronary artery disease men who underwent a revascularization procedures. (researchgate.net)
- It is suggested that until the epidemic progression of obesity is stopped and obesity prevented or at least properly managed, cardiologists will be confronted to an evolving contribution of risk factors where smoking, hypercholesterolemia and hypertension may be relatively less prevalent but at the expense of a much greater contribution of abdominal obesity and related features of the metabolic syndrome. (researchgate.net)
- Your health care provider who is familiar with metabolic syndrome will make the diagnosis by obtaining the necessary tests, including blood pressure monitoring, waist circumference monitoring, blood glucose, serum insulin, and lipid profile (triglycerides and HDL). (lowcarbneurologist.com)
- Metabolic syndrome is a clustering of at least three of the following five medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein (HDL). (wikipedia.org)
- The key sign of metabolic syndrome is central obesity, also known as visceral, male-pattern or apple-shaped adiposity. (wikipedia.org)
- Metabolic syndrome can lead to several serious and chronic complications, including type-2 diabetes, cardiovascular diseases, stroke, kidney disease and nonalcoholic fatty liver disease. (wikipedia.org)
- Rather than total adiposity, the core clinical component of the syndrome is visceral and/or ectopic fat (i.e., fat in organs not designed for fat storage) whereas the principal metabolic abnormality is insulin resistance. (wikipedia.org)
- Because abdominal obesity is predisposed to various metabolic disorders, it is of major importance to assess and track the changes with time of this specific fat mass. (biomedcentral.com)
- Studies on the accumulation of abdominal fat mass in animals could help to better understand the mechanisms of metabolic syndrome development but the techniques of investigation are lacking. (biomedcentral.com)
- Metabolic and anthropometric parameters were measured at week 26 in patients with and without DC fat (Table 2). (eventscribe.net)
- Sugars in a liquid form may induce less satiety than in a solid form [ 9 ] and may promote the over-consumption of energy, contributing to the development of obesity and excess adiposity, and associated comorbidities (e.g. metabolic syndrome and diabetes). (biomedcentral.com)
- Participants free of CVD/stroke and not underweight ( n = 3,743) were stratified by BMI categories and metabolic risk, defined as having two or more International Diabetes Federation metabolic syndrome criteria, excluding waist circumference. (diabetesjournals.org)
- Sustained metabolic health in obese participants was associated with age ≤40 years and lower waist circumference. (diabetesjournals.org)
- The metabolic syndrome (MetS) is a constellation of metabolic risk factors (including hypertension, dyslipidaemia, abdominal obesity and impaired glucose metabolism), which is associated with a twofold increased risk of cardiovascular disease (CVD) (Ford, 2005), and an even higher risk of T2DM (Grundy, 2008). (bhma.org)
- Anthropometric measurements, body composition assessment, and metabolic parameters were measured at baseline and after 60 days of intervention. (biomedcentral.com)
- In addition to its ties to abdominal obesity, the metabolic syndrome has also been linked to blood lipid disorders, an inflammatory and pro-thrombotic state, hypertension, and insulin resistance. (myhealthywaist.org)
- 3] found that the best predictors of incident metabolic syndrome over a 5 year follow-up were waist circumference, HDL cholesterol, and proinsulin levels. (myhealthywaist.org)
- The authors suggested that steps should be taken to address components of the metabolic syndrome, such as waist circumference, in order to reduce the risk of developing the syndrome and related complications such as type 2 diabetes and cardiovascular disease. (myhealthywaist.org)
- This study also showed that waist circumference was a better predictor of metabolic syndrome than directly measuring insulin sensitivity with an oral glucose tolerance test. (myhealthywaist.org)
- Significantly, the lifestyle intervention program reduced waist circumference by 4.4 ± 5.2 cm and improved both glucose-insulin homeostasis variables and lipoprotein-lipid parameters associated with the metabolic syndrome. (myhealthywaist.org)
- This could yield highly favorable changes in circulating anthropometric variables adiponectin and, as a result, to the metabolic and cardio- Height of the barefoot subjects was measured to the nearest 0.1 cm. vascular risk. (hmamedicalclinic.com)
Ratio14
- It measures waist to hip ratio. (medicscientist.com)
- Central fatness, mostly intra-abdominal circumference is a better index of android fat, is medically more important than (abdominal) obesity than waist-to-hip ratio subcutaneous fat in the trunk. (who.int)
- Treatment with liraglutide (dose range: 0.3 to 0.9 mg/day) for 20.0 ± 6.4 days significantly reduced waist circumference, waist/hip ratio, eVFA. (biomedcentral.com)
- Body mass index (BMI), waist-to-hip ratio, and waist circumference are commonly used measures for estimating abdominal adiposity (6,7). (cdc.gov)
- This has led to an increasing evidence for abdominal obesity indices such as waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) as predictors of CVD [ 16 , 17 ]. (hindawi.com)
- Among the indicators of central adiposity, the waist-to-height ratio (WHR) has been shown to be more sensitive for predicting future health hazards than waist circumference alone. (bvsalud.org)
- A waist-to-hip ratio higher than 0.85 in women and 0.90 in men is indicative of abdominal obesity and may suggest a higher level of visceral fat. (wellaholic.com)
- DNA methylation levels at the ABCG1 cg27243685 site positively correlated with plasma triglyceride concentration (r = 0.510, p = 0.008), body mass index (r = 0.556, p = 0.013) and waist-to-hip ratio (r = 0.504, p = 0.012) in SAT samples. (biomedcentral.com)
- Multivariate analysis (after correction for sex, age, family history of type 2 diabetes mellitus, obesity, cardiovascular disease, hypertension and dyslipidaemia) showed that waist circumference/height ratio and IGF-I SDS were the only variables independently correlated with the presence of retinopathy. (biomedcentral.com)
- Waist-to-Hip Ratio is a measurement that assesses the distribution of fat in the body by dividing the waist circumference by the hip circumference. (puredripiv.com)
- By exploring alternatives such as Waist-to-Hip Ratio, Body Composition Analysis, and Waist Circumference, individuals can gain a more comprehensive understanding of their health status. (puredripiv.com)
- Excess central adiposity (called apple shape), particularly when it results in a high waist-to-hip ratio (reflecting a relatively low muscle-to-fat mass ratio), increases risk. (msdmanuals.com)
- The syndrome is less common among people who have excess subcutaneous fat around the hips (called pear shape) and a low waist-to-hip ratio (reflecting a higher muscle-to-fat mass ratio). (msdmanuals.com)
- Race/ethnic comparisons of waist-to-height ratio for cardiometabolic screening: The study of women's health across the nation. (rush.edu)
Surrogate for abdominal2
- It has the Recent studies in children showed that a ability to act as a surrogate for abdominal greater deposition of central fat correlates fat [ 9 ]. (who.int)
- Two common methods to assess the degree of obesity are measuring waist circumference, a surrogate for abdominal fat, and calculating the body mass index (BMI). (psychiatrist.com)
High waist circumference3
- Central obesity is a key feature of the syndrome, as both a sign and a cause, in that the increasing adiposity often reflected in high waist circumference may both result from and contribute to insulin resistance. (wikipedia.org)
- High waist circumference confers an increased health risk. (dasefxofficial.com)
- Very high waist circumference confers a high health risk. (dasefxofficial.com)
Dual-energy X-ray a3
- Routine evaluation of an expression of weight not adiposity [ 11 ] regional fat distribution on a wide scale and it provides no information on body fat requires methods that are simpler than distribution, so it can mask true obesity- dual-energy X-ray absorptiometry (DXA), related risk in children [ 3 ]. (who.int)
- Body composition was measured by both dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance (BIA) methods. (frontiersin.org)
- In women with polycystic ovary syndrome and normal body mass index, both dual-energy X-ray absorptiometry and the adiposity indices, visceral adiposity index and lipid accumulation product, are the most sensitive methods to evaluate total body fat and fat accumulation in the central abdominal region. (scielo.org)
Hypertension3
- Circumference With Hypertension and Diabetes in African American Women, South Carolina, 2007-2009. (cdc.gov)
- After controlling for all variables, waist circumference was independently associated with a 5-fold risk in hypertension and diabetes in African American women. (cdc.gov)
- We hypothesize that the risk of hypertension and diabetes would be higher for women with larger waist circumference, independent of sociodemographic and health-related variables. (cdc.gov)
Insulin resistance4
- However, medical problems associated with the insulin resistance of this syndrome and its corresponding complications may develop over time and themselves present with clinical symptoms. (lowcarbneurologist.com)
- Polycystic ovary syndrome (PCOS) is strongly associated with abdominal obesity and insulin resistance and effective approaches to nutrition (e.g., omega-3 fatty acids intake) might improve the cardiometabolic risk profile. (frontiersin.org)
- Some experts think that chronic stress causes hormonal changes that contribute to abdominal obesity, insulin resistance, and low blood lipid (HDL) levels. (msdmanuals.com)
- The contribution of various lifestyle and therapeutic interventions to reducing body weight, abdominal fat in particular, and preventing insulin resistance and type 2 diabetes is examined below. (myhealthywaist.org)
Indices1
- Blood pressure, anthropometrics, and biochemical indices were measured. (hindawi.com)
Intra-abdominal1
- As aforementioned, the accumulation of intra-abdominal fat can be measured by direct weighing of fat after dissection. (biomedcentral.com)
Measurement2
- It advises the measurement of waist circumference to supplement this in individuals with a BMI under 35 kg/m 2 . (dasefxofficial.com)
- A family history plus measurement of waist circumference and blood pressure are part of routine care. (msdmanuals.com)
Accumulation of abdominal fat1
- Post-mortem analyses of coronary arteries have indicated that obesity (associated with a high accumulation of abdominal fat measured at autopsy) was predictive of earlier and greater extent of large vessels atherosclerosis as well as increase of coronary fatty streaks. (researchgate.net)
Visceral fat area3
- We assessed the estimated visceral fat area (eVFA) by abdominal bioelectrical impedance analysis, glycemic control by the 75-g oral glucose tolerance test (OGTT) and eating behavior by the Japan Society for the Study of Obesity questionnaire. (biomedcentral.com)
- The results showed that the L_K56 group had significant decreases in percent body fat ( p = 0.004), visceral fat area ( p = 0.0007), total body fat mass ( p = 0.018), trunk body fat mass ( p = 0.003), waist circumference ( p = 0.003), glycosylated hemoglobin( p = 0.002) at the end of the study compared with baseline. (biomedcentral.com)
- However, mean changes in body fat mass, visceral fat area, weight, body mass index, waist circumference and hip circumference were not significantly different between groups. (biomedcentral.com)
Type 2 diabet5
- To examine the effects of liraglutide, a glucagon-like peptide-1 (GLP-1) analogue, on visceral fat adiposity, appetite, food preference, and biomarkers of cardiovascular system in Japanese patients with type 2 diabetes. (biomedcentral.com)
- Short-term treatment with liraglutide improved visceral fat adiposity, appetite, food preference and the urge for fat intake in obese Japanese patients with type 2 diabetes. (biomedcentral.com)
- In the present study, we investigated the effects of liraglutide on visceral fat adiposity, eating behavior, and cardiovascular biomarkers in controlled hospitalized patients with type 2 diabetes. (biomedcentral.com)
- HPA-axis dysfunction may explain the reported risk indication of abdominal obesity to cardiovascular disease (CVD), type 2 diabetes and stroke. (wikipedia.org)
- If patients with a family history of type 2 diabetes mellitus, particularly those ≥ 40 years, have a waist circumference greater than that recommended for their race and sex, fasting plasma glucose and a lipid profile must be determined. (msdmanuals.com)
Risk15
- INTRODUCTION: Maternal obesity increases the risk of multiple maternal and infant pregnancy complications, such as gestational diabetes and pre-eclampsia. (bvsalud.org)
- Current UK guidelines use body mass index (BMI) to identify which women require additional care due to increased risk of complications. (bvsalud.org)
- METHODS AND ANALYSIS: This prospective cohort study (SHAPES, Study of How Adiposity in Pregnancy has an Effect on outcomeS) aims to evaluate the prognostic performance of adiposity measures (either alone or in combination with other adiposity, sociodemographic or clinical measures) to estimate risk of adverse pregnancy outcomes. (bvsalud.org)
- However, abdominal adiposity may be more predictive of CVD risk than BMI. (cdc.gov)
- Abdominal adiposity is a risk factor for obesity-related complications, and there is increasing evidence that abdominal adiposity may be a contributing factor to complications not related to adiposity at the waist (4,5). (cdc.gov)
- however, few studies have examined the association between waist circumference and risk factors in African Americans (9,12,13). (cdc.gov)
- Stroke Abdominal obesity appears to predict the risk of stroke in men. (slideserve.com)
- Among the indicators of central obesity, diagnosis requires that the levels of risk are waist circumference together with the waist-to- identified. (bvsalud.org)
- They found that central adiposity - a large waist- was regularly associated with a greater risk of all-cause death. (wellaholic.com)
- Therefore, it is important to keep track of your waist size and maintain a healthy lifestyle to reduce your risk of health complications associated with visceral fat. (wellaholic.com)
- The study, which analyzed over 350,000 people across Europe, found that a waist size greater than 94 cm (37 inches) for men and 80 cm (31.5 inches) for women can significantly increase the risk of premature death. (wellaholic.com)
- Abdominal fat is closely associated with an increased risk of chronic diseases, such as cardiovascular disease and diabetes. (puredripiv.com)
- Low waist circumference confers no increased health risk. (dasefxofficial.com)
- [ 4 ] Using BMI and waist circumference to assess risk of health problems, 40% of adults were at high or very high risk of chronic disease. (dasefxofficial.com)
- Several lifestyle intervention trials have highlighted the fact that increasing physical activity and adopting healthy eating habits can reduce body weight and waist circumference and lower the risk of developing diabetes in patients with impaired glucose tolerance. (myhealthywaist.org)
Predictive2
- In obese individuals, the concentration of fat in the abdominal region is a predictive marker for future health problems. (bvsalud.org)
- concentration of fat in the abdominal region has a Obesity and even overweight are generally higher predictive sensitivity for diseases and health not difficult to recognise, but a more accurate problems. (bvsalud.org)
Percentage of body fat3
- For both sexes a highly positive correlation was found between waist circumference and BMI, percentage of body fat, subscapular and suprailiac skinfold thicknesses, and the sum of skinfold measures. (who.int)
- Body fat is then calculated based on accepted values for the density of fat and lean tissue to identify the percentage of body fat that will produce the overall measured density 6,34 . (bodybuilding.com)
- Measuring body fat can be cumbersome (ie, measuring the percentage of body fat). (psychiatrist.com)
Prevalence2
- 447 preschool children showed a prevalence of the indicators of adiposity in the diagnosis of excess weight of 28.9%, concluding that the overweight and obesity, without the need to population of children aged two and three years of determine body composition6,7. (bvsalud.org)
- Prevalence of obesity-related comorbidities is also high techniques were used to obtain anthropometric measures among Canadian First Nation people. (cdc.gov)
Deposition2
- The main issue for clinicians or researchers is to use techniques for assessing abdominal fat deposition and its accumulation or changes over time, without sacrificing of experimental subjects. (biomedcentral.com)
- At week 26, on average, the patients with DC fat deposition had higher BMI and waist circumference (WC) than the group without DC fat. (eventscribe.net)
Mortality2
- Complications occurring during admission and mortality during hospital stays were also evaluated. (hindawi.com)
- MAIN OUTCOMES AND MEASURES: All-cause, cardiovascular disease, and ischemic heart disease mortality. (cdc.gov)
Serum2
- These observations reinforce the with less favourable patterns of serum importance of using waist circumference in lipoprotein concentrations, increased blood clinical practice [ 10 ]. (who.int)
- Serum omega-3 fatty acid levels were measured with the gas chromatography method. (frontiersin.org)
Sociodemographic1
- Early pregnancy adiposity measures and clinical and sociodemographic data will be collected. (bvsalud.org)
Excess fat1
- Central adiposity (excess fat around the waist) is known to be more detrimental to health than fat distributed in other areas of the body. (puredripiv.com)
Triglycerides1
- Prospective studies have confirmed that lower endogenous androgens predict central adiposity in men (Rosmond et al, 2003) and that these low testosterone levels are significantly inversely associated with levels of blood pressure, fasting plasma glucose, triglycerides, and body mass index and positively correlated with HDL-cholesterol (Zmuda et al, 1997). (bhma.org)
Overweight or obese1
- The abdominal circumference measure appears useful in studying overweight or obese rats. (biomedcentral.com)
Predict1
- Regression methods will be used to compare the different adiposity measures with BMI in terms of their ability to predict pregnancy complications. (bvsalud.org)
Comorbidities1
- screening for comorbidities of obesity should be applied in a hierarchal, logical manner for early identification before more serious complications result. (medscape.com)
Metabolically1
- Another belief is that metabolically healthy obesity might be a transient state which is linked with prolonged medical complications. (dibesity.com)
0.821
- Children exposed to maternal T2D had smaller mean head circumference (−0.82 cm, 95% CI: −1.33, −0.31) than children exposed to normoglycemia. (nature.com)
Methods3
- Statistical methods were used to discriminate the best region of interest allowing the in-vivo measure of Central Fat Mass by DXA. (biomedcentral.com)
- Both of the previous methods seek to measure overall body density. (bodybuilding.com)
- Methods A total of 51 Spanish girls (age 7-16 years) with abdominal obesity underwent 8 weeks of a multidisciplinary intervention for weight loss. (unav.edu)
Chronic3
- Background and Aims Chronic kidney disease (CKD) is a frequent complication to diabetes. (researchgate.net)
- We conducted a screening study of diabetes and diabetes al health than does the general Canadian population (1), complications in 2003, from which we drew a representa- specifical y in terms of chronic diseases, chronic disease tive sample of Manitoba First Nation adults (N = 483). (cdc.gov)
- Waist circumference is associated with length of incarceration and directly influences the development of chronic noncommunicable diseases. (scielo.org)
Measurements4
- ABSTRACT This cross-sectional study of 1283 healthy children (681 boys, 602 girls) aged 6-11 years tested the degree of correlation between waist circumference measurements and adiposity. (who.int)
- However, degree of correlation between waist circum- studies on the efficacy of anthropometric ference measurements of a sample of techniques for identifying children with Egyptian schoolchildren with their adipo- high central adiposity are scare. (who.int)
- There is a sity (whether total or central), and to quan- suggestion that waist circumference alone tify the association of waist circumference may be a more useful and accurate tool in measurements with age and degree of BMI children than DXA etc. [ 6 ]. (who.int)
- The following data were collected: personal (sex and date of birth), anthropometric (weight, height, waist, and hip measurements) were taken. (springeropen.com)
Positively1
- The expression of miR-221-3p was positively correlated with body weight, BMI and waist circumference, and negatively correlated with quantitative insulin sensitivity check index. (unav.edu)
Women4
- A waist circumference of more than 94 cm in men and 80 cm in women is considered unsafe. (medicscientist.com)
- Some adiposity measures (eg, waist circumference, ultrasound measures of abdominal visceral fat) can better identify where body fat is stored, which may be useful in predicting those women who need additional care. (bvsalud.org)
- Abdominal adiposity change in white and black midlife women: The study of women's health across the nation. (rush.edu)
- Janssen I, Powell LH, Jasielec MS, Kazlauskaite R. Covariation of change in bioavailable testosterone and adiposity in midlife women. (rush.edu)
Suprailiac skinfold1
- Children exposed to GDM had greater suprailiac skinfold thickness than unexposed children, despite having lower mean weight, BMI and mid-upper arm circumference, and both GDM and T2D were associated with smaller mean head circumference. (nature.com)
Higher1
- A higher WHR indicates central adiposity, which is associated with increased health risks. (puredripiv.com)
Health6
- 1 ]. A central fat pattern has adverse health - abdominal fat), abdominal subcutaneous implications in both children and adults. (who.int)
- The WHR is a useful tool in basic health care for children at the beginning of preschool age, for the assessment of nutritional status and central adiposity. (bvsalud.org)
- Additionally, 69.2% of the population aged 20 to 79 years not only are undiagnosed and unaware of its complications in SSA alone [ 3 ] but also unable to access the correct educations and health services [ 16 ]. (biomedcentral.com)
- Measuring waist circumference can be a simple yet effective method to evaluate health risks. (puredripiv.com)
- A waist circumference exceeding certain thresholds can be an indicator of potential health issues, regardless of BMI. (puredripiv.com)
- Municipalities should plan actions to expand the coverage and quality of antenatal care in order to prevent premature births and avoid diseases and health complications for mothers and babies. (scielo.org)
Testosterone1
- There are several reasons to believe that adiposity is a significant factor in lowering levels of testosterone, which can be seen in men as young as 40 (Goncharov et al, 2009). (bhma.org)
Healthy1
- Therefore, it is important to pay attention to waist size and take appropriate measures to maintain a healthy waist circumference for a longer, healthier life. (wellaholic.com)