Body fat distribution and noncommunicable diseases in populations: overview of the 2008 WHO Expert Consultation on Waist Circumference and Waist–Hip Ratio

Abstract

A World Health Organization (WHO) Expert Consultation on Waist Circumference (WC) and Waist-Hip Ratio (WHR) was convened in Geneva from 8 to 11 December 2008 to consider approaches to developing international guidelines for indices and action levels in order to characterize health risks associated with these measures of body fat distribution-alternative or complementary to the existing WHO guidelines for assessments of generalized obesity on the basis of body mass index. Six background papers prepared for the Consultation are compiled in this issue. These six papers examine a range of health outcomes and issues, including whether there is a basis for choosing WC over WHR and whether different action levels by gender, age, ethnicity, country or region are warranted. Although guidelines involving WC and WHR are potentially useful and clearly required, the challenges in identifying cutoffs for international guidelines should not be underestimated or oversimplified. The final report and outcomes of the Expert Consultation will be published by WHO. European Journal of Clinical Nutrition IntroductionChronic noncommunicable diseases (NCDs), such as heart disease, hypertension and stroke, diabetes mellitus, as well as various forms of cancer, are significant causes of disability, premature death, impaired quality of life and increasing health-care costs, in low-and middle-income, as well as in high-income countries (WHO, 2000a(WHO, , 2004(WHO, , 2008. Obesityreflecting the accumulation of a potentially harmful level of excess body fat-is a major contributor to the development of NCDs (WHO, 2000b), and has become a global epidemic affecting children and adults alike. Addressing obesity through population-level strategies that promote optimal nutrition, such as appropriate dietary intake and physical activity, is a major focus of the Global Strategy and Action Plan of the World Health Organization (WHO) for the Prevention and Control of Noncommunicable Diseases (NCDs) (WHO, 2000a(WHO, , 2004(WHO, , 2008, complementary to strategies developed to address other aspects of dietary quality, tobacco use and harmful use of alcohol.Surveillance to quantify and track NCDs and their risk factors is a key component of the NCD Action Plan (WHO, 2008), which requires clearly specified diagnostic criteria and classifications. Diagnostic criteria and classifications for obesity potentially relate to both generalized obesity and also to obesity subtypes defined by the distribution of body fat, such as abdominal or central obesity. With respect to generalized obesity in adults, reports of the 1993 WHO Expert Committee (WHO, 1995) kilograms divided by the square of height in metres (kg/m 2 ): overweight (BMI of X25.0) and obesity (BMI of X30), with further gradations of obesity defined by BMI ranges of 30.0-34.9, 35.0-39.9 and X40 based on the severity of the associated risk of comorbidities. These BMI cutoff points were recommended for international use with awareness that the risks are graded along a continuum, and that the risk ...

Effects of body size and sociodemographic characteristics on differences between self-reported and measured anthropometric data in middle-aged men and women: the EPIC-Norfolk study

“…More recently, however, measures of body fat distribution, especially abdominal fatness, as reflected by waist circumference or waist-to-hip ratio (WHR), have been suggested as a better indicator of the adverse metabolic effects of obesity (Snijder et al, 2006). A wide range of disease outcomes, especially chronic noncommunicable diseases have been examined in relation to obesity using either BMI or WHR in numerous studies (Pischon et al, 2006;Vazquez et al, 2007;Huxley et al, 2010) and the World Health Organization (WHO) has recently convened a consultation to discuss cut-points for waist circumference and WHR (Nishida et al, 2009).…”

Obesity and Obese-related Chronic Low-grade Inflammation in Promotion of Colorectal Cancer Development

“…Particularly, obesity with central visceral fat accumulation (VAT) has been associated with a higher risk of the metabolic syndrome (MetS) and may enhance the endocrine avtivity of the tissue (Nishida et al, 2010). In fact, the European Prospective Investigation into Cancer and Nutrition (EPIC) reported that visceral obesity (VAT), rather than the total amount of fat, is linked to a strong risk factor for CRC regardless of the gender, age, or ethnic background (Pischon et al, 2006).…”

“…WC equal to or higher than 88 cm (in women) or 94 cm (in men) and WHR above 0.90 for males and 0.85 for females are cut off points associated with a high metabolic risk (Nishida et al, 2010). A recent meta-analysis of 21 studies has revealed that a 10-cm increase in WC is related to an increased risk of colorectal adenoma (CRA), regardless of the geographic region, gender, and confounders: alcohol use, smoking status, and family history of colorectal cancer (Hong et al, 2012;Kaneko et al, 2014).…”

Relación entre el control autonómico cardíaco e índices antropométricos normales en hombres jóvenes. Tunja, Boyacá, Colombia, 2014

“…Se define como sobrepeso un . El Índice Cintura-Cadera (ICC) es un coeficiente que relaciona la disposición del tejido adiposo de un individuo, siendo un cociente entre la circunferencia de la cadera en centímetros y la circunferencia de la cintura en centímetros y definiendo como obesidad, un ICC mayor o igual a 0,9 para los hombres y un ICC mayor o igual a 0,85 para las mujeres 2,3 . La prevalencia de sobrepeso y obesidad está aumentando de forma alarmante, tanto en países desarrollados como en vía de desarrollo 4,5 , relacionándose con la aparición de enfermedades cardíacas, metabólicas, renales, desórdenes del sueño, cáncer y problemas mentales [6][7][8][9][10][11][12] .…”