WAIST CIRCUMFERENCE AS A MEASURE FOR INDICATING NEED FOR WEIGHT MANAGEMENT

Objective-To test the hypothesis that a single measurement, waist circumference, might be used to identify people at health risk both from being overweight and from having a central fat distribution. Design-A community derived random sample of men and women and a second, validation sample. Setting-North Glasgow. Subjects-904 men and 1014 women (first sample); 86 men and 202 women (validation sample). Main outcome measures-Waist circumference, body mass index, waist:hip ratio. Results-Waist circumference greater than or equal to 94 cm for men and greater than or equal to 80 cm for women identified subjects with high body mass index (greater than or equal to 25 kg/m(2)) and those with lower body mass index but high waist:hip ratio (greater than or equal to 0.95 for men, greater than or equal to 0.80 women) with a sensitivity of > 96% and specificity > 97.5%. Waist circumference greater than or equal to 102 cm for men or greater than or equal to 88 cm for women identified subjects with body mass index greater than or equal to 30 and those with lower body mass index but high waist:hip ratio with a sensitivity of > 96% and specificity > 98%, with only about 2% of the sample being misclassified. Conclusions-Waist circumference could be used in health promotion programmes to identify individuals who should seek and be offered weight management. Men with waist circumference greater than or equal to 94 cm and women with waist circumference greater than or equal to 80 cm should gain no further weight; men with waist circumference greater than or equal to 102 cm and women with waist circumference greater than or equal to 88 cm should reduce their weight.