Neck Circumference as a Simple Screening Measure for Identifying Overweight and Obese Patients

Abstract

BEN-NOUN, LIUBOV (LOUBA), EZRA SOHAR, AND ARIE LAOR. Neck circumference as a simple screening measure for identifying overweight and obesity patients. Obes Res. 2001;9:470 -477. Objective: There are numerous methods of assessing overweight and obesity. We undertook an observational study to test a method of identifying overweight or obese patients solely by measuring the circumference of the neck. Research Methods and Procedures:A test sample and a second validation sample included 979 subjects (460 men and 519 women), who visited a family medicine clinic in a southern Israeli urban district for any reason between the randomly chosen months of January and September 1998. Main outcome included neck, waist, and hip circumferences; body mass index (BMI); and waist:hip ratio measures. Results: Pearson's correlation coefficients indicated a significant association between neck circumference (NC) and: BMI (men, r ϭ 0.83; women, r ϭ 0.71; each, p Ͻ 0.0001), age (men, r ϭ 0.33; women, r ϭ 0.36; each, p Ͻ 0.0001), weight (men, r ϭ 0.7; women, r ϭ 0.81; each, p Ͻ 0.0001), waist circumference (men, r ϭ 0.86; women, r ϭ 0.85; each, p Ͻ 0.0001), hip circumference (men, r ϭ 0.62; women, r ϭ 0.56; each, p Ͻ 0.0001), and waist:hip ratio (men, r ϭ 0.66; women, r ϭ 0.87; each, p Ͻ 0.0001). NC Ն37 cm for men and Ն34 cm for women were the best cutoff levels for determining the subjects with BMI Ն25.0 kg/m 2 using the receiver output curve analysis. In the validation unrelated group, the test characteristics were excellent with 98% sensitivity, 89% specificity, and 94% accuracy for men, and 100% sensitivity, 98% specificity, and 99% accuracy for women. NC Ն39.5 cm for men and Ն36.5 cm for women were the best cutoff levels for determining the subjects with BMI Ն30 kg/m 2 using the receiver output curve analysis. In the validation unrelated group, the test characteristics were excellent with 93% sensitivity, 90% specificity, and 91% accuracy for men, and 93% sensitivity, 98% specificity, and 97% accuracy for women. Discussion: NC measurement is a simple and time-saving screening measure that can be used to identify overweight and obese patients. Men with NC Ͻ37 cm and women with NC Ͻ34 cm are not to be considered overweight. Patients with NC Ն37 cm for men and Ն34 cm for women require additional evaluation of overweight or obesity status.

Neck Circumference and Cardio-Metabolic Syndrome

“…Ben Noun et al, [9][10][11][12] observed relationship between changes in neck circumference and changes in blood pressure. They found that changes in systolic BP and diastolic BP correlated positively with changes in NC and other components of the metabolic syndrome.…”

“…In a first cross sectional study by Ben-Noun et al, [9][10][11][12] which was done to identify overweight or obese patients solely by measuring the circumference of the neck, observed that NC >37cm for men and >34cm for women were the best cutoff levels for determining the subjects with BMI >25.0 kg/m 2 using the receiver output curve analysis. In our study we also observed same characteristics as NC 37 cm for men and 34 cm for women identified subjects with BMI >25.0 kg/m 2 with 75% to 86% sensitivity for men and 63% to 93% for women, 80% to 90% specificity for men and 80% to 100% for women.…”

The 2nd–4th digit ratio (2D:4D) and neck circumference: implications for risk factors in coronary heart disease

“…Cruz and Goran 17 ). However, Ben-Noun et al 18 tested a method of identifying overweight or obese patients solely by measuring the circumference of the neck circumference (NC). Their results indicated a significant association between NC and body mass index (BMI), age, weight, waist circumference, hip circumference, and WHR.…”

Cutoffs and cardiovascular risk factors associated with neck circumference among community-dwelling elderly adults: a cross-sectional study

“…[12][13][14][15][16][17][18][19][20][21] Moreover, there is some evidence demonstrating that NC is associated with cardiovascular risk factors, such as high waist and hip circumferences, elevated blood pressure values and high total cholesterol and glycemia levels. 12,13,17 However, even though optimal cutoff values for adults have been suggested and have been observed to be associated with cardiovascular risk factors (e.g. elevated blood pressure and insulin resistance), 20,21 there are no data in the literature regarding specific cutoffs for the elderly population.…”