Utility of waist circumference‐to‐height ratio as a screening tool for generalized and central obesity among Iranian children and adolescents: The CASPIAN‐V study

Ejtahed, Hanieh‐Sadat; Kelishadi, Roya; Qorbani, Mostafa; Motlagh, Mohammad Esmaeil; Hasani‐Ranjbar, Shirin; Beshtar, Shaghayegh; Ziaodini, Hasan; Taheri, Majzoubeh; Heshmat, Ramin

doi:10.1111/pedi.12855

Cited by 23 publications

(19 citation statements)

References 34 publications

(46 reference statements)

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“…Although many authors have produced specific WHtR boundary values for populations (24,27,61,62) , many suggest that the simple boundary value of 0•5 can be used to indicate increased risk and used universally for primary screening (29) . Since it was first advocated in 2006 (63) , the simple message 'Keep your waist to less than half your height' has been recommended often (20,34,(64)(65)(66) .…”

Section: Very Simple Screening Based On Waist-to-height Ratio 0•5: Thmentioning

confidence: 99%

“…More than 20 years ago, a boundary value of WHtR 0•5 was first suggested as a risk assessment tool and this translates into the simple message 'keep your waist to less than half your height' (1,(11)(12)(13) . Studies in many populations have supported the premise that WHtR is a simple and effective anthropometric index to identify health risks in adults of all ages (6,7,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) and in children and adolescents (26)(27)(28)(29) . Not only does WHtR have a close relationship with morbidity, but also it has a clearer relationship with mortality compared with BMI (13,30) .…”

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confidence: 99%

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A simple cut-off for waist-to-height ratio (0·5) can act as an indicator for cardiometabolic risk: recent data from adults in the Health Survey for England

Gibson

Ashwell

2019

Br J Nutr

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The National Institute for Health and Care Excellence (NICE) has acknowledged the value of waist-to-height ratio (WHtR) as an indicator for ‘early health risk’. We used recent UK data to explore whether classification based on WHtR identifies more adults at cardiometabolic risk than the ‘matrix’ based on BMI and waist circumference, currently used for screening. Data from the Health Survey for England (4112 adults aged 18+ years) were used to identify cardiometabolic risk, indicated by raised glycated Hb, dyslipidaemia and hypertension. HbA1c, total/HDL-cholesterol and systolic blood pressure (BP) were more strongly associated with WHtR than the ‘matrix’. In logistic regression models for HbA1c ≥ 48 mmol/mol, total/HDL-cholesterol > 4 and hypertension (BP > 140/90 mmHg or on medication), WHtR had a higher predictive value than the ‘matrix’. AUC was significantly greater for WHtR than the ‘matrix’ for raised HbA1c and hypertension. Of adults with raised HbA1c, 15 % would be judged as ‘no increased risk’ using the ‘matrix’ in contrast to 3 % using WHtR < 0·5. For hypertension, comparative values were 23 and 9 %, and for total/HDL-cholesterol > 4, 26 and 13 %. Nearly one-third of the ‘no increased risk’ group in the ‘matrix’ had WHtR ≥ 0·5 and hence could be underdiagnosed for cardiometabolic risk. WHtR has the potential to be a better indicator of cardiometabolic risks associated with central obesity than the current NICE ‘matrix’. The cut-off WHtR 0·5 in early screening translates to a simple message, ‘your waist should be less than half your height’, that allows individuals to be aware of their health risks.

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Section: Very Simple Screening Based On Waist-to-height Ratio 0•5: Thmentioning

confidence: 99%

mentioning

confidence: 99%

A simple cut-off for waist-to-height ratio (0·5) can act as an indicator for cardiometabolic risk: recent data from adults in the Health Survey for England

Gibson

Ashwell

2019

Br J Nutr

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“…WHtR is considered a more accurate measure of abdominal or central obesity among adolescents [50]; thus, it was used instead of waist circumference. The cutoff point of 0.5 was used to differentiate between normal and abdominally obese [51][52][53].…”

Section: Assessment Of Indicators Of Overweight Obesity and Body Comentioning

confidence: 99%

Animal Protein Intake Is Associated with General Adiposity in Adolescents: The Teen Food and Development Study

et al. 2019

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Protein plays a crucial role in the growth and development of adolescents. However, being a secondary energy source, protein’s role in obesity has been sidelined. We examined whether intake of protein (total, animal, plant), branched-chain (BCAAs), and sulfur-containing (SCAAs) amino acids are associated with general body and central obesity and body composition in a cross-sectional study among healthy adolescents. Students aged 12–18 years old (n = 601) in schools near two major Adventist universities in California and Michigan provided dietary data via a validated web-based food frequency questionnaire (FFQ) and anthropometric data during school visits. Intakes of total, animal, and plant proteins, and BCAAs and SCAAs were derived from FFQ data. We defined general body obesity with body-mass-index-for-age (BMIz) z-scores and central obesity with waist-to-height ratios (WHtR). After full adjustment for covariates, multiple regression analyses showed significant positive associations between intakes of total protein (β = 0.101, 95% CI: 0.041, 0.161), animal protein (β = 0.118, 95% CI: 0.057, 0.178), BCAAs (β = 0.056, 95% CI: 0.025, 0.087), and SCAAs (β = 0.025, 95% CI: 0.012, 0.038) with general body adiposity. Animal protein (β = 0.017, 95% CI: 0.001, 0.033) and SCAAs (β = 0.004, 95% CI: 0.000, 0.008) were also associated with central obesity. Total and animal protein and BCAA and SCAA were also significantly associated with fat mass. Our findings suggest that high protein intake may pose a possible detriment to adolescent health. Longitudinal and safety evaluation studies are recommended.

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“…WHtR, another widely used traditional anthropometric index, is superior to BMI and WC in the assessment of central obesity (10)(11)(12)29). As a simple and effective anthropometric index, it has been recommended by many scholars as a screening tool for cardiometabolic risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…However, BMI cannot distinguish between muscle and adipose tissue, whereas WC depends on body size (9). WHtR is another traditional anthropometric indice which has been shown to be superior to BMI and WC in screening central obesity (10)(11)(12). Several studies found it is well correlated with multiple cardiometabolic components (13), which was not supporteded by others.…”

Section: Introductionmentioning

confidence: 96%

Novel and traditional anthropometric indices for identifying metabolic syndrome in non-overweight/obese adults

Zhu

Qiao

et al. 2020

Preprint

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Background: Metabolic syndrome (MetS) in non-overweight/obese people is insidiously associated with cardiovascular disease (CVD). Novel anthropometric indices can reflect central obesity better than the traditional anthropometric indices. Therefore, we hypothesize that these newly developed anthropometric indices can better identify MetS in non-overweight/obese people than conventional indices.Methods: Cross-sectional data of sociodemographic, biochemical and anthropometric indices were collected from 2916 non-overweight/obese Chinese people. A body shape index (ABSI), body roundness index (BRI), waist-to-height ratio (WHtR), weight-adjusted-waist index (WWI) and abdominal volume index (AVI) were calculated. Partial correlation analysis was used to clarify the correlation between anthropometric indices and MetS variables. Binary logistic regression analysis was applied to assess the association between anthropometric indices and MetS and its components. Receiver-operating characteristic (ROC) curve was used to identify the diagnostic ability of anthropometric indices for MetS and its components. The area under curve (AUC) difference between WHtR and each new anthropometric index was compared in pairs.Results: After adjusting for covariates, AVI had the optimal ability of identifying MetS (AUC: 0.743 for male, 0.819 for female) and the strongest correlation with high-density lipoprotein cholesterol (HDL-C) (coe: -0.227 for male, -0.207 for female) and the highest odds rations (OR) with low HDL-C group (male: OR = 1.37, female: OR = 1.55). The WHtR was comparable to BRI in assessing MetS (AUC: 0.739 for male, 0.817 for female). WHtR or BRI could also well identify hypertension (AUC: 0.602 for male, 0.688 for female) and dysglycemia (AUC: 0.669 for male, 0.713 for female) and female's high triglyceride level (AUC 0.712). The recognition ability of the two was equivalent. The ability of ABSI and WWI to identify MetS was weak.Conclusions: AVI is the optimal anthropometric indices to identify MetS in non-overweight/obese Chinese adults. BRI and WHtR can also be considered as discriminators, while ABSI and WWI are weak discriminators. WHtR is easy to measure. So, it is recommended as an early preliminary screening method for the MetS in non-overweight/obese people.

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Utility of waist circumference‐to‐height ratio as a screening tool for generalized and central obesity among Iranian children and adolescents: The CASPIAN‐V study

Cited by 23 publications

References 34 publications

A simple cut-off for waist-to-height ratio (0·5) can act as an indicator for cardiometabolic risk: recent data from adults in the Health Survey for England

A simple cut-off for waist-to-height ratio (0·5) can act as an indicator for cardiometabolic risk: recent data from adults in the Health Survey for England

Animal Protein Intake Is Associated with General Adiposity in Adolescents: The Teen Food and Development Study

Novel and traditional anthropometric indices for identifying metabolic syndrome in non-overweight/obese adults

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