Waist and hip circumferences, and waist-hip ratio in 19 populations of the WHO MONICA Project.

OBJECTIVE: To assess differences in waist and hip circumferences and waist-to-hip ratio (WHR) measured using a standard protocol among populations with different prevalences of overweight. In addition, to quantify the associations of these anthropometric measures with age and degree of overweight.

DESIGN: Cross-sectional study of random population samples.

SUBJECTS: More than 32000 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 populations from 83-98 cm in men and from 78-91cm in women. Mean hip circumference ranged from 94-105cm and from 97-108cm in men and women, respectively, and mean WHR from 0.87-0.99 and from 0.76-0.84, respectively. Together, height, body mass index (BMI), age group and population explained about 80% of the variance in waist circumference. BMI was the predominant determinant (77% in men, 75% women). Similar results were obtained for hip circumference. However, height, BMI, age group and population, accounted only for 49% (men) and 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, both of which are used as indicators of abdominal obesity, seem to measure different aspects of the human body: waist circumference reflects mainly the degree of overweight whereas WHR does not.