Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity

Ashwell, Margaret; Hsieh, Shiun Dong

doi:10.1080/09637480500195066

Cited by 819 publications

(829 citation statements)

References 18 publications

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“…WHtR has received considerable interest, and the results suggest keeping one's waist to less than half one's height25, 26, 27. A Chinese study reported that waist‐to‐stature ratio (or saying WHtR) is the best simple anthropometric indicator in predicting a wide range of cardiovascular risk factors and related health conditions.…”

Section: Discussionmentioning

confidence: 99%

Optimal cut‐off levels of obesity indices by different definitions of metabolic syndrome in a southeast rural Chinese population

Pan

Wang

et al. 2016

J of Diabetes Invest

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Aims/IntroductionThe aim of the present study was to compare the cut‐off values and prediction effect of different obesity indices by different definitions of metabolic syndrome (MetS) in Zhejiang Province of China.Materials and MethodsWe carried out a cross‐sectional survey of 10,100 individuals (age 40 years and older) in Jiashan, Zhejiang Province. Receiver operating characteristic analysis was used to examine discrimination and find optimal cut off values of waist circumference (WC), body mass index (BMI), waist‐to‐hip ratio (WHR) and waist‐to‐height ratio (WHtR) to predict two or more non‐adipose components of MetS by The National Cholesterol Education Program Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) definition modified by the Asia–Pacific region criteria, International Diabetes Federation definition for the Chinese population and Chinese Diabetes Society definitions of MetS.ResultsThe age‐standardized prevalence of MetS was 23.78% vs 28.76% vs 19.37% by The National Cholesterol Education Program Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III), International Diabetes Federation and Chinese Diabetes Society definitions, respectively. Cut‐off values of BMI were approximately 24 kg/m2 both in men and women by three definitions; the average cut‐off values of WC, WHR and WHtR were 83 cm in men vs 81 cm in women, 0.89 in men vs 0.86 in women and 0.50 in men vs 0.51 in women, respectively. The area under receiver operating characteristic curve of BMI was larger than WC both in men and women (P < 0.05); in women, the area under receiver operating characteristic curve of WHtR was larger than WC, and WHR was smaller.ConclusionsMetS is prevalent in Zhejiang Province of China, especially in the female population. BMI and WHtR might be more useful than WC and WHR for predicting two or more non‐adipose components of MetS.

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Section: Discussionmentioning

confidence: 99%

Optimal cut‐off levels of obesity indices by different definitions of metabolic syndrome in a southeast rural Chinese population

Pan

Wang

et al. 2016

J of Diabetes Invest

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“…Previous literature has found that the WHtR, rather than BMI and WC, was more strongly correlated with cardiovascular comorbidities and was better at predicting the metabolic syndrome in adults and cardiovascular health risks, such as high BP and high blood lipids, in adults and children (18,(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) .…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that a cut-off of 0?5 is suitable to apply to children and adolescents, independent of age and sex. Although we have previously shown that this index is a statistically acceptable index for use in children and adolescents (19) , the sensitivity of using a cut-off of 0?5 to identify abdominal obesity or risk of CVD in children and adolescents has not been investigated (18,(20)(21)(22)(23)(24)(25)28,29) .…”

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confidence: 99%

Developing waist-to-height ratio cut-offs to define overweight and obesity in children and adolescents

Nambiar

Hughes

Davies

2010

Public Health Nutr.

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Objective: The waist-to-height ratio (WHtR) assesses abdominal adiposity and has been proposed to be of greater value in predicting obesity-related cardiovascular health risks in children than BMI. The present study aims to develop WHtR cutoffs for overweight and obesity based on the 85th and 95th percentiles for the percentage body fat (%BF) in a cohort of children and adolescents. Design: Waist circumference (WC), height, triceps and subscapular skinfolds were used to calculate WHtR and %BF. Correlations between WHtR and %BF and WHtR/mid-abdominal skinfold were made. Receiver-operating characteristic (ROC) curve analysis was used to select WHtR cut-offs to define overweight and obesity. Subjects were grouped by WHtR cut-offs, and mean values for anthropometry, blood lipids and blood pressure (BP) variables were compared. Setting: Australian primary and secondary schools. When comparing the highest WHtR group to the lowest, both sexes had significantly higher means for weight, WC, %BF, TG (male subjects only), systolic BP (female subjects only) and lower means for HDL cholesterol (P , 0?05). Conclusions: WHtR is useful in clinical and population health as it identifies children with higher %BF at greater risk of developing weight-related CVD at an earlier age.

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“…The present study has confirmed that WC was comparable to WHpR and WHtR in association with cardiovascular risk factors, although some studies have shown WC is better associated with cardiovascular risk factors and outcome when compared to WHpR 3,26-28 and some studies advocate WHtR as a better indicator. 8,29 However, further prospective cohort studies need to be conducted to determine the association of these obesity indices with cardiovascular risk factors and their optimal cutoff points. For public health stand point, waist measurement could be a simple index for public as a self-monitoring measurement because it is relatively simpler and easier to measure and interpret as compared to BMI and others.…”

Section: Discussionmentioning

confidence: 99%

Obesity indices and cardiovascular risk factors in Thai adults

2006

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Objective: To examine the relationship of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) with cardiovascular risk factors and diabetes in Thai population. Design: A national cross-sectional survey of cardiovascular risk factors. Subjects: Five thousand and three hundred five Thai adults aged X35 years. Measurements: Body weight, height, waist and hip circumference and cardiovascular risk factors including blood pressure, total plasma cholesterol, high-density lipoprotein, triglyceride and fasting plasma glucose were measured. Age-and sex-specific means and prevalence of cardiovascular risk factors were calculated and compared among anthropometric measurements. Results: There were increasing trends of severity of cardiovascular risk factors and prevalence of morbidity conditions across increasing levels of BMI, WC, WHpR and WHtR categories. For age group X65 years, WC, WHpR and WHtR provided more consistent association with cardiovascular risk factors than BMI. Area under the curve indicated that measurement of central obesity could predict cardiovascular risk better than BMI. The optimal cutoff points for anthropometric measurements were in line with the Asia-Pacific recommendation; however, similar cutoff point for men and women between 82 and 85 cm was observed. Conclusion: Central obesity indices were slightly better associated with cardiovascular risk factors compared to BMI in Thai adults aged X35 years.

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Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity

Cited by 819 publications

References 18 publications

Optimal cut‐off levels of obesity indices by different definitions of metabolic syndrome in a southeast rural Chinese population

Optimal cut‐off levels of obesity indices by different definitions of metabolic syndrome in a southeast rural Chinese population

Developing waist-to-height ratio cut-offs to define overweight and obesity in children and adolescents

Obesity indices and cardiovascular risk factors in Thai adults

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