Waist-to-height ratio as an indicator of ‘early health risk’: simpler and more predictive than using a ‘matrix’ based on BMI and waist circumference

Abstract

ObjectivesThere is now good evidence that central obesity carries more health risks compared with total obesity assessed by body mass index (BMI). It has therefore been suggested that waist circumference (WC), a proxy for central obesity, should be included with BMI in a ‘matrix’ to categorise health risk. We wanted to compare how the adult UK population is classified using such a ‘matrix’ with that using another proxy for central obesity, waist-to-height ratio (WHtR), using a boundary value of 0.5. Further, we wished to compare cardiometabolic risk factors in adults with ‘healthy’ BMI divided according to whether they have WHtR below or above 0.5.Setting, participants and outcome measuresRecent data from 4 years (2008–2012) of the UK National Diet and Nutrition Survey (NDNS) (n=1453 adults) were used to cross-classify respondents on anthropometric indices. Regression was used to examine differences in levels of risk factors (triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), TC: HDL, glycated haemoglobin (HbA1c), fasting glucose, systolic (SBP) and diastolic blood pressure (DBP)) according to WHtR below and above 0.5, with adjustment for confounders (age, sex and BMI).Results35% of the group who were judged to be at ‘no increased risk’ using the ‘matrix’ had WHtR ≥0.5. The ‘matrix’ did not assign ‘increased risk’ to those with a ‘healthy’ BMI and ‘high’ waist circumference. However, our analysis showed that the group with ‘healthy’ BMI, and WHtR ≥0.5, had some significantly higher cardiometabolic risk factors compared to the group with ‘healthy’ BMI but WHtR below 0.5.ConclusionsUse of a simple boundary value for WHtR (0.5) identifies more people at ‘early health risk’ than does a more complex ‘matrix’ using traditional boundary values for BMI and WC. WHtR may be a simpler and more predictive indicator of the ‘early heath risks’ associated with central obesity.

The Assesment of Relation Between Waist/Height Ratio and Type 2 Diabetes Risk Among Nursing Students

“…Sri Lanka'da Güney Asya kö-kenli etnik bir grupla yürütülen çalışmada da bel/boy oranının BKİ, bel çevresi ve bel/kalça oranına kıyasla tip 2 diyabet ve metabolik sendrom riskinin belirlenmesinde etkili olduğu belirlenmiş-tir (Jayawardana, Ranasinghe, Sheriff, Matthews, & Katulanda, 2013). Özetle, bel/boy oranının abdominal obeziteyle ilgili hastalık risklerinin belirlenmesinde BKİ ve bel çevresine göre daha etkili olabileceği bildirilmektedir (Ashwell & Gibson, 2016). Bu bağlamda bel/boy oranı, BKİ değerleri normal olup insülin direnci ve hiperlipidemi belirtilerinin gözlendiği metabolik obezite riskinin belirlenmesinde de etkili olabilmektedir.…”

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Gender differences in sociodemographic and behavioural factors associated with BMI in an adult population in rural Burkina Faso – an AWI-Gen sub-study

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