According to the National Center for Health Statistics data from the Department of Health and Human Services, in 2009 and 2010, the prevalence of obesity was 35.7% among adults and 16.9% among children, with a higher prevalence in adults >60 years of age and adolescents.263 265 Among the race/eth- nic groups surveyed in the United States, age-adjusted rates of obesity indicate the highest rates in non-Hispanic blacks (49.5%), followed by Mexican Americans (40.45%) and then all Hispanics (39.1%), with the lowest rate being among non- Hispanic whites (34.3%).263 265 A patient s body mass index (BMI), defined as weight in kilograms divided by the square of the height in meters, is used to distinguish overweight (BMI, 25 to 29 kg/m2 ) from obesity ) and morbid obesity (BMI >40 kg/m2 Men presenting with a waist circumference of >102 cm (40 in) and women with a waist circumference >88 cm (35 in) are catego- rized as having abdominal obesity.267 Abdominal obesity can also be measured as the waist-to-hip ratio. For every 0.01 increase in waist-to-hip ratio, there is a 5% increase in risk of CVD.268 Abdominal body fat has proved to be a stronger predictor of stroke risk than BMI.269,270 In contrast, another study reported that in men only BMI was significantly associated with stroke, whereas for women it was waist-to-hip ratio.271 Adiposity, how- ever, correlated with risk of ischemic heart disease for both sexes. When fat distribution measured by dual-energy x-ray absorpti- ometry in relation to incidence of stroke was studied, there was a significant association in both men and women between stroke and abdominal fat mass. This association, however, was not independent of diabetes mellitus, smoking, and hypertension.272 Mounting evidence shows a graded positive relationship between stroke and obesity independent of age, lifestyle, or other cardiovascular risk factors. 