Reliability of anthropometric indicators for assessing abdominal obesity

The rising burden of abdominal obesity (AO) has emerged as a significant global public health concern. Three commonly used measures for assessing AO are waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). This raises an important question: which of these indicators provides the most reliable assessment of abdominal obesity? This commentary addresses this issue from two key perspectives: (a) comparative evaluation of the strengths and limitations, and (b) understanding the predictive power in assessing cardiometabolic risk of these three indicators. The available evidence suggests that, due to conceptual and clinical limitations, WHR is the least robust indicator of AO among the three. Furthermore, a comparative analysis indicates that WHtR not only overcomes several limitations associated with WC and WHR in estimating AO, but also serves as a more consistent and reliable predictor of cardiovascular risk across children, adolescents, and adults globally.