Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey

Clinical action thresholds

ShanKuan Zhu, ZiMian Wang, Stanley Heshka, Moonseong Heo, Myles S. Faith, Steven B. Heymsfield

Research output: Contribution to journalArticle

449 Citations (Scopus)

Abstract

Background: Waist circumference (WC) is strongly linked to obesity-associated risks. However, currently proposed WC risk thresholds are not based on associations with obesity-related risk factors but rather with body mass index (BMI; in kg/m 2). Objective: The objective was to determine the relations of WC to obesity-associated risk factors in a representative sample of US whites and to derive comparable risk thresholds for WC and BMI. Design: Data on 9019 white participants of the third National Health and Nutrition Examination Survey were divided into 2 groups according to the presence of ≥ 1 of 4 obesity-associated risk factors: low HDL cholesterol, high LDL cholesterol, high blood pressure, and high glucose. Odds ratio (OR) equations were derived from logistic regression models for WC and BMI with the use of the 25th percentile in the study population as the reference. Receiver operating characteristic curves for identifying risk factors were computed for WC and BMI. Results: At BMIs of 25 and 30, ORs were 1,19 (95% CI: 1.06, 1.35) and 2.37 (95% CI: 1.33, 4.22) for men and 1.56 (95% CI: 1.29, 1.91) and 3.16 (95% CI: 1.94, 5.28) for women, respectively. The corresponding ORs for WC were at 90 and 100 cm for men and at 83 and 93 cm for women. Minima on the receiver operating characteristic curves for men were at 96 cm for WC and at 26 for BMI and for women were at 86 cm for WC and 25 for BMI. Conclusion: WC is more closely linked to cardiovascular disease risk factors than is BMI.

Original languageEnglish (US)
Pages (from-to)743-749
Number of pages7
JournalAmerican Journal of Clinical Nutrition
Volume76
Issue number4
StatePublished - Oct 2002
Externally publishedYes

Fingerprint

National Health and Nutrition Examination Survey
Nutrition Surveys
waist circumference
Waist Circumference
obesity
risk factors
Obesity
ROC Curve
Logistic Models
low density lipoprotein cholesterol
high density lipoprotein cholesterol
odds ratio
LDL Cholesterol
HDL Cholesterol
hypertension
cardiovascular diseases
body mass index
Body Mass Index
Cardiovascular Diseases
Odds Ratio

Keywords

  • BMI
  • Body mass index
  • Cardiovascular disease risk factors
  • NHANES III
  • Obesity
  • Third National Health and Nutrition Examination Survey
  • Waist circumference

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey : Clinical action thresholds. / Zhu, ShanKuan; Wang, ZiMian; Heshka, Stanley; Heo, Moonseong; Faith, Myles S.; Heymsfield, Steven B.

In: American Journal of Clinical Nutrition, Vol. 76, No. 4, 10.2002, p. 743-749.

Research output: Contribution to journalArticle

@article{bfc55c85b9f5400ebc40712549a27daf,
title = "Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: Clinical action thresholds",
abstract = "Background: Waist circumference (WC) is strongly linked to obesity-associated risks. However, currently proposed WC risk thresholds are not based on associations with obesity-related risk factors but rather with body mass index (BMI; in kg/m 2). Objective: The objective was to determine the relations of WC to obesity-associated risk factors in a representative sample of US whites and to derive comparable risk thresholds for WC and BMI. Design: Data on 9019 white participants of the third National Health and Nutrition Examination Survey were divided into 2 groups according to the presence of ≥ 1 of 4 obesity-associated risk factors: low HDL cholesterol, high LDL cholesterol, high blood pressure, and high glucose. Odds ratio (OR) equations were derived from logistic regression models for WC and BMI with the use of the 25th percentile in the study population as the reference. Receiver operating characteristic curves for identifying risk factors were computed for WC and BMI. Results: At BMIs of 25 and 30, ORs were 1,19 (95{\%} CI: 1.06, 1.35) and 2.37 (95{\%} CI: 1.33, 4.22) for men and 1.56 (95{\%} CI: 1.29, 1.91) and 3.16 (95{\%} CI: 1.94, 5.28) for women, respectively. The corresponding ORs for WC were at 90 and 100 cm for men and at 83 and 93 cm for women. Minima on the receiver operating characteristic curves for men were at 96 cm for WC and at 26 for BMI and for women were at 86 cm for WC and 25 for BMI. Conclusion: WC is more closely linked to cardiovascular disease risk factors than is BMI.",
keywords = "BMI, Body mass index, Cardiovascular disease risk factors, NHANES III, Obesity, Third National Health and Nutrition Examination Survey, Waist circumference",
author = "ShanKuan Zhu and ZiMian Wang and Stanley Heshka and Moonseong Heo and Faith, {Myles S.} and Heymsfield, {Steven B.}",
year = "2002",
month = "10",
language = "English (US)",
volume = "76",
pages = "743--749",
journal = "American Journal of Clinical Nutrition",
issn = "0002-9165",
publisher = "American Society for Nutrition",
number = "4",

}

TY - JOUR

T1 - Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey

T2 - Clinical action thresholds

AU - Zhu, ShanKuan

AU - Wang, ZiMian

AU - Heshka, Stanley

AU - Heo, Moonseong

AU - Faith, Myles S.

AU - Heymsfield, Steven B.

PY - 2002/10

Y1 - 2002/10

N2 - Background: Waist circumference (WC) is strongly linked to obesity-associated risks. However, currently proposed WC risk thresholds are not based on associations with obesity-related risk factors but rather with body mass index (BMI; in kg/m 2). Objective: The objective was to determine the relations of WC to obesity-associated risk factors in a representative sample of US whites and to derive comparable risk thresholds for WC and BMI. Design: Data on 9019 white participants of the third National Health and Nutrition Examination Survey were divided into 2 groups according to the presence of ≥ 1 of 4 obesity-associated risk factors: low HDL cholesterol, high LDL cholesterol, high blood pressure, and high glucose. Odds ratio (OR) equations were derived from logistic regression models for WC and BMI with the use of the 25th percentile in the study population as the reference. Receiver operating characteristic curves for identifying risk factors were computed for WC and BMI. Results: At BMIs of 25 and 30, ORs were 1,19 (95% CI: 1.06, 1.35) and 2.37 (95% CI: 1.33, 4.22) for men and 1.56 (95% CI: 1.29, 1.91) and 3.16 (95% CI: 1.94, 5.28) for women, respectively. The corresponding ORs for WC were at 90 and 100 cm for men and at 83 and 93 cm for women. Minima on the receiver operating characteristic curves for men were at 96 cm for WC and at 26 for BMI and for women were at 86 cm for WC and 25 for BMI. Conclusion: WC is more closely linked to cardiovascular disease risk factors than is BMI.

AB - Background: Waist circumference (WC) is strongly linked to obesity-associated risks. However, currently proposed WC risk thresholds are not based on associations with obesity-related risk factors but rather with body mass index (BMI; in kg/m 2). Objective: The objective was to determine the relations of WC to obesity-associated risk factors in a representative sample of US whites and to derive comparable risk thresholds for WC and BMI. Design: Data on 9019 white participants of the third National Health and Nutrition Examination Survey were divided into 2 groups according to the presence of ≥ 1 of 4 obesity-associated risk factors: low HDL cholesterol, high LDL cholesterol, high blood pressure, and high glucose. Odds ratio (OR) equations were derived from logistic regression models for WC and BMI with the use of the 25th percentile in the study population as the reference. Receiver operating characteristic curves for identifying risk factors were computed for WC and BMI. Results: At BMIs of 25 and 30, ORs were 1,19 (95% CI: 1.06, 1.35) and 2.37 (95% CI: 1.33, 4.22) for men and 1.56 (95% CI: 1.29, 1.91) and 3.16 (95% CI: 1.94, 5.28) for women, respectively. The corresponding ORs for WC were at 90 and 100 cm for men and at 83 and 93 cm for women. Minima on the receiver operating characteristic curves for men were at 96 cm for WC and at 26 for BMI and for women were at 86 cm for WC and 25 for BMI. Conclusion: WC is more closely linked to cardiovascular disease risk factors than is BMI.

KW - BMI

KW - Body mass index

KW - Cardiovascular disease risk factors

KW - NHANES III

KW - Obesity

KW - Third National Health and Nutrition Examination Survey

KW - Waist circumference

UR - http://www.scopus.com/inward/record.url?scp=0036784401&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036784401&partnerID=8YFLogxK

M3 - Article

VL - 76

SP - 743

EP - 749

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

SN - 0002-9165

IS - 4

ER -