A proposal for a primary screening tool: 'Keep your waist circumference to less than half your height'

Area of Science:

• Public Health
• Preventive Medicine
• Anthropometry

Background:

• Central obesity, indicated by waist-to-height ratio (WHtR), is linked to greater health risks than overall obesity measured by body mass index (BMI).
• WHtR serves as a straightforward proxy for central fat distribution, a key factor in health risk assessment.
• A widely adopted threshold for WHtR is 0.5, translating to the public health message: 'Keep your waist to less than half your height'.

Purpose of the Study:

• To review the scientific evidence supporting the use of WHtR in predicting mortality and assessing morbidity.
• To highlight the efficacy of WHtR as a primary screening tool for identifying increased health risks across diverse populations.
• To emphasize the limitations of BMI as a sole health risk indicator compared to WHtR.

Main Methods:

• Review of existing scientific literature and evidence on WHtR and health outcomes.
• Analysis of the proposed WHtR boundary value of 0.5.
• Evaluation of the practicality and applicability of the 'waist to height ratio less than 0.5' screening method.

Main Results:

• The WHtR of 0.5 is a reliable indicator for predicting mortality and associated morbidities.
• The simple message 'Keep your waist to less than half your height' is effective across various ethnic groups and age ranges, including children.
• Current reliance on BMI misclassifies a significant portion of the population, potentially delaying necessary health interventions.

Conclusions:

• A WHtR below 0.5 is a simple, cost-effective primary screening method for identifying individuals at increased risk of health problems.
• The 'Keep your waist to less than half your height' guideline is a practical and universally applicable public health recommendation.
• Utilizing WHtR in conjunction with or instead of BMI can improve the accuracy of health risk assessment and public health messaging.