Objective: To test the validity of internationally accepted waist circumference (WC) action levels for adult Asian Indians. Design: Analysis of data from multisite cross-sectional epidemiological studies in north India. Subjects: In all, 2050 adult subjects 418 years of age (883 male and 1167 female subjects). Measurements: Body mass index (BMI), WC, waist-to-hip circumference ratio, blood pressure, and fasting samples for blood glucose, total cholesterol, serum triglycerides, and high-density lipoprotein cholesterol. Results: In male subjects, a WC cutoff point of 78 cm (sensitivity 74.3%, specificity 68.0%), and in female subjects, a cutoff point of 72 cm (sensitivity 68.7%, specificity 71.8%) were appropriate in identifying those with at least one cardiovascular risk factor and for identifying those with a BMI 421 kg/m 2 . WC levels of X90 and X80 cm for men and women, respectively, identified high odds ratio for cardiovascular risk factor(s) and BMI level of X25 kg/m 2 . The current internationally accepted WC cutoff points (102 cm in men and 88 cm in women) showed lower sensitivity and lower correct classification as compared to the WC cutoff points generated in the present study. Conclusion: We propose the following WC action levels for adult Asian Indians: action level 1: men, X78 cm, women, X72 cm; and action level 2: men, X90 cm, women, X80 cm.

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