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Waist-to-height ratio: a better way to identify obesity
June 18, 2017, 1:01 pm

Calculating a person's waist-to-height ratio is the most accurate and efficient way of identifying whether or not they are at risk of obesity in clinical practice, says a new study by Leeds Beckett University in the UK.

The conventional measurement of obesity used by doctors is the BMI. Although there are benefits to this method, there is concern that a lot of people are being classified as obese by BMI when they are not, or are being missed by this classification when they need to be referred for help.

Currently the most accurate way to measure obesity in a clinical environment is by examining the whole-body fat percentage and visceral adipose tissue (VAT) mass (the fat stored around the abdominal region where most of internal organs lie) using the latest dual-energy X-ray absorptiometry (DXA) scanner.

Whole-body fat percentage and specifically VAT mass are associated with health conditions including insulin resistance, type 2 diabetes and cardiovascular disease, which are not fully accounted for through simple BMI evaluation.

The team behind the new study gathered accurate whole-body and abdominal fat data using a DXA scanner and then calculated five predictors of whole-body fat and VAT, which could be easily replicated in a GP's office, fitness center or at home. The five predictors tested were: BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and waist-to-height ratio0.5 (WHtR0.5).

The results showed that the best predictor of both whole-body fat percentage and VAT in both men and women was waist-to-height ratio (WHtR). The simple waist circumference divided by height measurement is not a new method of obesity classification; however, despite evidence supporting its use, it is still not routinely measured in clinical settings.

The waist-to-hip ratio (WHR), a measure regularly recommended by fitness instructors and used in clinical practice, was found to be a very poor predictor of obesity according to both measures.

Also, in current clinical practice, it is common to calculate BMI for an indication of whole-body fat and waist circumference for abdominal obesity.

The researchers said their research showed that WHtR is a more accurate alternative to these two measures and also a more time-efficient measure. In addition, their WHtR cut-points aligned broadly with current guidelines that adults and children should keep their waist circumference to less than half their height. Put simply, it is more important, especially for cardio-metabolic conditions that your belt notch goes down than the reading on the weighing scales.

By introducing this alternative and more accurate measure into clinical settings, more men and women would potentially be referred to programs, such as weight management, to receive help in improving their health. We have also shown how these simple measurements may be used as surrogates by GPs and other health care professionals when DXA scans are unavailable or inaccessible.

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