International Journal of Obesity
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May 2001, Volume 25, Number 5, Pages 652-661
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Paper
A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys
C J Dobbelsteyn, M R Joffres, D R MacLean and G Flowerdew The Canadian Heart Health Surveys Research Group

Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada

Correspondence to: M R Joffres, Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada B3H 4H7. E-mail: michel.joffres@dal.ca

Abstract

OBJECTIVE: To comparatively evaluate cut-off points of waist circumference, body mass index and waist to hip ratio with respect to their ability to predict other individual and multiple cardiovascular disease risk factors.

DESIGN: Population-based, cross-sectional surveys.

SUBJECTS: A total of 9913 men and women aged 18-74, selected using health insurance registries from five Canadian provinces.

MEASUREMENTS: Anthropometric measures, other cardiovascular risk factors, receiver operating characteristic curves, sensitivity, specificity, positive and negative predictive values.

RESULTS: Waist circumference may be the best single indicator of other individual and multiple cardiovascular risk factors. Optimal cut-off points of all anthropometric measures are dependent on age, sex and the prevalence of the risk factor(s) being considered. For waist circumference, cut-off points of 90 cm in men and 80 cm in women may be most appropriate for prediction of individual and multiple risk factors in Caucasian populations.

CONCLUSION: Health professionals should incorporate the use of waist circumference measurements in their routine clinical examination of adult patients.

International Journal of Obesity (2001) 25, 652-661

Keywords

body mass index; cardiovascular disease risk factors; obesity; waist circumference; waist-to-hip ratio

Received 4 February 2000; revised 19 September 2000; accepted 9 November 2000
May 2001, Volume 25, Number 5, Pages 652-661
Table of contents    Previous  Abstract  Next   Full text  PDF