Waist and hip circumferences, and waist-hip ratio in 19 populations of theWHO MONICA Project

OBJECTIVE: To assess differences in waist and hip circumferences and waist- to-hip ratio (WHR) measured using a standard protocol among populations wit h different prevalences of overweight. In addition, to quantify the associa tions of these anthropometric measures with age and degree of overweight. DESIGN: Cross-sectional study of random population samples. SUBJECTS: More than 32 000 men and women aged 25-64y from 19 (18 in women) populations participating in the second MONItoring trends and determinants in CArdiovascular disease (MONICA) survey from 1987-1992. RESULTS: Age standardized mean waist circumference range between population s from 83-98 cm in men and from 78-91cm in women. Mean hip circumference ra nged from 94-105cm and from 97-108cm in men and women, respectively, and me an WHR from 0.87-0.99 and from 0.76-0.84, respectively. Together, height, b ody mass index (BMI), age group and population explained about 80% of the v ariance in waist circumference. BMI was the predominant determinant (77% in men, 75% women). Similar results were obtained for hip circumference. Howe ver, height, BMI, age group and population, accounted only for 49% (men) an d 30% (women) the variation in WHR. CONCLUSION: Considerable variation in waist and hip circumferences and WHR were observed among the study populations. Waist circumference and WHR, bot h of which are used as indicators of abdominal obesity, seem to measure dif ferent aspects of the human body: waist circumference reflects mainly the d egree of overweight whereas WHR does not.