OJEMD  Vol.2 No.3 , August 2012
Comparing Height-Adjusted Waist Circumference Indices: The Fels Longitudinal Study
Abstract: Objectives: While researchers are increasingly recognizing the importance of adjusting waist circumference (WC) for height, no standard has yet been established. In this study we contrast three standard methods for indexing WC by height (using height, root-height and height-squared) via comparisons with age-specific optimal indices. Study Design and Setting: Measurements from 722 male and 746 female Caucasian participants in the Fels Longitudinal Study were used. The three standard waist-circumference indices (as well as an optimal index) were determined for ages 2 through 18, and for every decade thereafter to 70 years of age. Pearson correlations were used to assess the suitability of all indices. Results: The three standard indices remain correlated with the original WC measures, though each was associ-ated with height at some ages. Waist-to-height ratio is suitable for some childhood ages (boys: 5 - 9, 13 - 16; girls: 4 - 7, 9, 11 - 14) but not for adult ages; Root-height works well mostly for older teenage children and adults but not in early childhood and adolescence; Height-squared is nowhere suitable. In both men and women, the optimal indexing factor ranged between root-height and height-squared in childhood, and is close to root-height in adulthood. Conclusions: No one index is most suitable, as WC indexed by root-height is suitable for use with measurements from teenage children and adults, while waist-to-height ratio is generally suitable for use in children. WC indexed by height-squared is nowhere suitable.
Cite this paper: R. Sabo, C. Ren and S. Sun, "Comparing Height-Adjusted Waist Circumference Indices: The Fels Longitudinal Study," Open Journal of Endocrine and Metabolic Diseases, Vol. 2 No. 3, 2012, pp. 40-48. doi: 10.4236/ojemd.2012.23006.

[1]   T. Khosla and C. Lowe, “Indices of Obesity Derived from Body Weight and Height,” British Journal of Preventive and Social Medicine, Vol. 21, No. 3, 1967, pp. 122-128.

[2]   S. Daniels, R. Meyer, Y. Liang and K. Bove, “Echocardiographically Determined Left Ventricular Mass Index in Normal Children, Adolescents and Young Adults,” The Journal of the American College of Cardiology, Vol. 12, No. 3, 1988, pp. 703-708.

[3]   R. Lang, M. Bierig, R. Deverux, F. Flachskampf, E. Foster and P. Pellikka, “Recommendations for Chamber Quantificaiton: A Report from the American Society of Echocardioagraphy’s Guidelines and Standard Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology,” Journal of the American Society of Echocardiography, Vol. 18, No. 12, 2005, pp. 1440-1463. doi:10.1016/j.echo.2005.10.005

[4]   R. Lauer, T. Burns, W. Clarke and Mahoney, “Childhood Predictors of Future Blood Pressure,” Hypertension, Vol. 18, No. 3, 1991, pp. 174-181. doi:10.1161/01.HYP.18.3_Suppl.I74

[5]   R. Gillum, “The Association of Body Fat Distribution with Hypertension, Hypertensive Heart Disease, Coronary Heart Disease, Diabetes and Cardiovascular Risk Factors in Men and Women Aged 18 79 Years,” Journal of Chronic Diseases, Vol. 40, No. 5, 1987, pp. 421-428. doi:10.1016/0021-9681(87)90175-5

[6]   W. Yan, H. Bingxian, Y. Hua, D. Jianghong, C. Jun, G. Dongliang, Z. Yugian, L. Ling, G. Yanying, X. Kaiti, F. Xiaohai and M. Da, “Waist-to-Height Ratio Is an Accurate and Easier Index for Evaluating Obesity in Children and Adolescents,” Obesity, Vol. 15, No. 3, 2007, pp. 748752. doi:10.1038/oby.2007.601

[7]   S.-Y. Ho, T.-H. Lam, E. Janus and H. K. C. R. F. P. S. S. Committee, “Waist to Stature Ratio Is More Strongly Associated with Cardiovascular Risk Factors than Other Simple Anthropometric Indices,” Annals of Epidemiology, Vol. 13, No. 10, 2003, pp. 683-691. doi:10.1016/S1047-2797(03)00067-X

[8]   H. Schneider, N. Friedrich, J. Klotsche, L. Pieper, M. Nauck, U. John, M. Dorr, S. Felix, H. Lehnert, D. Pittrow, S. Silber, H. Volzke, G. Stalla, H. Wallaschofski and H. Wittchen, “The Predictive Value of Different Measures of Obesity for Incident Cardiovascular Events and Mortality,” Journal of Clinical Endocrinology and Metabolism, Vol. 95, No. 4, 2010, pp. 1777-1785. doi:10.1210/jc.2009-1584

[9]   C. Lee, R. Huxley, R. Wildman and M. Woodward, “Indices of Abdominal Obesity Are Better Discriminators of Cardiovascular Risk factors than BMI: A Meta-Analysis,” Journal of Clinical Epidemiology, Vol. 61, No. 7, 2008, pp. 646-653. doi:10.1016/j.jclinepi.2007.08.012

[10]   K. Knowles, L. Paiva, S. Sanchez, L. Revilla, T. Lopez, M. Yasuda, N. Yanez, B. Gelaye and M. Williams, “Waist Circumference, Body Mass Index, and Other Measures of Adiposity in Predicting Cardiovascular Disease Risk Factors among Peruvian Adults,” International Journal of Hypertension, Vol. 2011, Article ID 931402, 10 pages.

[11]   A. Bosy-Westphal, C. Geisler, S. Onur, O. Korth, O. Selberg, J. Schrezenmeir and M. Muller, “Value of Boy Fat Mass vs Anthropometric Obesity Indices in the Assessment of Metabolic Risk Factors,” International Journal of Obesity, Vol. 30, 2005, pp. 475-483. doi:10.1038/sj.ijo.0803144

[12]   F. Hadaegh, A. Zabetian, H. Harati and F. Azizi, “Waist/Height Ratio as a Better Predictor of Type 2 Diabetes Compared to Body Mass Index in Tehranian Adult Men: A 3.6-Year Prospective Study,” Experimental and Clinical Endocrinology & Diabetes, Vol. 114, No. 6, 2006, pp. 310-315. doi:10.1055/s-2006-924123

[13]   C. Maffeis, C. Banzato, G. Talamini and G. Talamini, “Waist-to-Height Ratio, a Useful Index to Indentify High Metabolic Risk in Overweight Children,” The Journal of Pediatrics, Vol. 152, No. 2, 2008, pp. 207-213. doi:10.1016/j.jpeds.2007.09.021

[14]   L. Paniagua, V. Lohsoonthorn, S. Lertmaharit, W. Jiamjarasrangsi and M. Williams, “Comparison of Waist Circumference, Body Mass Index, Percent Body Fat and Other Measure of Adiposity in Identifying Cardiovascular Disease Risks among Thai Adults,” Obesity Research & Clinical Practice, Vol. 2, No. 3, 2008, pp. 215-223. doi:10.1016/j.orcp.2008.05.003

[15]   R. Taylor, I. Jones, S. Williams and A. Goulding, “Evaluation of Waist Circumference, Waist-to-Hip Ratio, and the Conicity Index as Screening Tools for High Trunk Fat Mass, as Measured by Dual-Energy X-Ray Absorptiometry, in Children Aged 3 19 y,” The American Journal of Clinical Nutrition, Vol. 72, 2000, pp. 490-495.

[16]   A. Roche, “Growth, Maturation and Body Composition: the Fels Longitudinal Study 1929-1991,” Cambridge University Press, Cambridge, 1992. doi:10.1017/CBO9780511661655

[17]   G. Lohman, A. Roche and R. Martorell, “Anthropometric Standardization Reference Manual,” Human Kinetics, Champaign, 1988.

[18]   Y. Weili, B. He, H. Yao, J. Dai, J. Cui, D. Ge, Y. Zheng, L. Li, Y. Guo, K. Xiao, X. Fu and D. Ma, “Waist-toHeight Ratio Is an Accurate and Easier Index for Evaluating Obesity in Children and Adolescents,” Obesity, Vol. 15, No. 3, 2007, pp. 478-752.