Abstract
BackgroundMeasures of central adiposity are better predictors of adverse health events than BMI. Nonetheless, BMI is more widely used in health research. One reason for this may be the limited research supporting the self-measurement of waist and hip circumference. The lack of validity studies is particularly acute in Asia. The main objective was to establish the validity of self-measurement of waist and hip circumference in a community setting and the correlation of those measures with BMI, blood pressure, and blood glucose levels.MethodsA community based, cross-sectional survey. A “healthy living expo” at a shopping mall in a rural town on peninsular Malaysia One hundred and thirty six (136) individuals volunteered to participate in the study, 125 of whom met the inclusion criteria. The ethnic distribution of the participants was 80% Chinese, 17% Malay and 3% Indian. Most participants were female (60%), with participants’ ages ranging from 18 to 78 years (mean, 47.2). Self and assisted measurements of waist and hip were taken. Blood pressure, non-fasting blood glucose, height, and weight were also measured. Bland Altman plots and Lin’s concordance coefficient were used to measure agreement between self and assisted measures. Pearson’s correlation was used to examine the association of self and assisted measures with blood pressure, blood glucose, and BMI.ResultsThere was a downwards bias in self measured waist (-0.81 cm) and hip (-1 cm) circumferences compared with assisted measures. The concordance for the self and assisted measures of waist, hip and the ratio of the two were, respectively, .96, .93 , and .84. The correlation between measures of central adiposity and BMI, blood pressure and blood glucose were similar for self and assisted measures.ConclusionThe results provide additional support for the use of self-measurement of waist and hip circumference studies of central adiposity, but is limited by the specificity of the setting.
Highlights
Overweight and obesity are associated with an increased risk of diabetes, arthritis, cardiovascular disease, and certain cancers [1,2,3]
In 2011, for instance there were 13,909 papers listed in PubMed related to body mass index (BMI) and less than one fifth as many papers related to waist circumference (WC) or waist to hip ratio (WHR) (n = 2,422)
We examined the validity of the measures for scientific research; we examined the extent to which the measurement approach affected statistical relationships with BMI, diastolic and systolic blood pressure, and non-fasting blood glucose
Summary
Overweight and obesity (excess adiposity) are associated with an increased risk of diabetes, arthritis, cardiovascular disease, and certain cancers [1,2,3]. There is evidence, that proxy measures of central adiposity – waist circumference (WC) and waist to hip ratio (WHR) – are better predictors of adverse health events, including mortality, than BMI [9,10,11]. A tape measure is an easier piece of equipment to carry into the field than a stadiometer and a set of weighing scales. Notwithstanding these advantages BMI remains the adiposity metric of choice in most medical research. BMI is more widely used in health research One reason for this may be the limited research supporting the self-measurement of waist and hip circumference. The main objective was to establish the validity of self-measurement of waist and hip circumference in a community setting and the correlation of those measures with BMI, blood pressure, and blood glucose levels
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