Should waist circumference be replaced by index of central obesity (ICO) in definition of metabolic syndrome?

OBJECTIVE: This study investigated the body composition and prevalence of hypertension in maroon women from the State of Alagoas and compared these variables with those of non-maroon women from the same state. METHODS: The data were collected from two cross-sectional surveys done in 2005 and 2008. The first study included a representative sample of mothers of children aged 0 to 5 years from the State of Alagoas, and the second study included all women aged 18 to 60 years living in maroon communities (n=39) in the same state. Data were collected during home interviews. The prevalence ratio and respective 95% confidence interval given by the Poisson regression with robust adjustment of variance was used as the measure of association. RESULTS: The study assessed 1,631 maroon women and 1,098 non-maroon mothers. Maroon women had lower education level, more children, higher prevalence of hypertension and stunting, and higher age at menarche, body mass index, waist circumference, waist-to-height ratio, and waist-to-hip ratio. After adjustment for age, the following prevalences remained higher in maroon women: hypertension (PR=1.81; 95%CI: 1.49; 2.21), WC >80cm (PR=1.23 95%CI: 1.11; 1.37), WHtR >0.5 (PR=1.11; 95%CI: 1.02; 1.21), and WHR >0.85 (PR=1.64; 95%CI: 1.43; 1.88). CONCLUSION: Maroon women belong to lower socioeconomic classes than non-maroon women and are at greater risk of abdominal obesity and hypertension, characteristics that make them especially vulnerable to the morbidity and mortality caused by cardiovascular diseases, justifying the preferential implementation of measures of care.

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“…The ratio between WC and height (WHtR) in cm was also used. In this case, the cut-off point was >0.5 24 .…”

Section: E T H O D Smentioning

confidence: 79%

Body composition and hypertension: a comparative study involving women from maroon communities and from the general population of Alagoas State, Brazil

et al. 2013

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“…For example, this value has been used in recent papers from India [16,17], in Korea [18], in China [19], in Sri Lanka [20], in Spain [21] and in Chile [22] and earlier studies from different ethnic groups were included in our meta-analysis [35]. …”

Section: Discussionmentioning

confidence: 99%

A proposal for a primary screening tool: `Keep your waist circumference to less than half your height’

Ashwell

Gibson²

2014

BMC Med

165

150

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BackgroundThere is now overwhelming scientific evidence that central obesity, as opposed to total obesity assessed by body mass index (BMI), is associated with the most health risks and that the waist-to-height ratio (WHtR) is a simple proxy for this central fat distribution. This Opinion reviews the evidence for the use of WHtR to predict mortality and for its association with morbidity. A boundary value of WHtR of 0.5 has been proposed and become widely used. This translates into the simple screening message ‘Keep your waist to less than half your height’. Not only does this message appear to be suitable for all ethnic groups, it also works well with children.DiscussionIgnoring this simple message and continuing to use BMI as a sole indicator of risk would mean that 10% of the whole UK population, and more than 25% of the UK population who are judged to be normal weight using BMI, are misclassified and might not be alerted to the need to take care or to take action.SummaryAccepting that a boundary value whereby WHtR should be less than 0.5 not only lends itself to the simple message ‘Keep your waist to less than half your height’ but it also provides a very cheap primary screening method for increased health risks: A piece of string, measuring exactly half a person’s height should fit around that person’s waist.

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“…We suggested that waist‐to‐height ratio (WHtR) provides a very good screening tool for cardiometabolic risk (2) and we proposed the boundary value of 0.5 which converted into an easily remembered public health message: ‘Keep your waist circumference to less than half your height’(3). Independently, Parikh and colleagues in India suggested that the Index of Central Obesity, namely the WHtR, should replace waist circumference (WC) in the definition of metabolic syndrome and also proposed a boundary value of 0.5 (4–6). Researchers in other parts of the world too, for example, Taiwan (7,8), Iran (9), Chile (10) and China (11) have also advocated the use of WHtR to predict cardiometabolic risk.…”

Section: Simplicity Of Universal Cut‐off Value Proposed For Whtr Contmentioning

confidence: 99%

Plea for simplicity: use of waist‐to‐height ratio as a primary screening tool to assess cardiometabolic risk

Ashwell

2012

Clinical Obesity

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Should waist circumference be replaced by index of central obesity (ICO) in definition of metabolic syndrome?

Cited by 23 publications

References 12 publications

Body composition and hypertension: a comparative study involving women from maroon communities and from the general population of Alagoas State, Brazil

Body composition and hypertension: a comparative study involving women from maroon communities and from the general population of Alagoas State, Brazil

A proposal for a primary screening tool: `Keep your waist circumference to less than half your height’

Plea for simplicity: use of waist‐to‐height ratio as a primary screening tool to assess cardiometabolic risk

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