Central adiposity, lifestyle behaviours and utility of the Ashwell String test among urban working women: a pilot study

Background: Central adiposity and sedentary lifestyle behaviours contribute to cardiometabolic risk among working women. Simple tools such as the Ashwell String Test can aid in early identification of central adiposity. This study assessed central adiposity, lifestyle risk factors, KAP, and the utility of the Ashwell String Test among urban working women. Methods: A cross-sectional pilot study included 50 urban working women in Pune, India. Data were collected using a structured questionnaire, a Knowledge, Attitude, and Practice (KAP) assessment, the International Physical Activity Questionnaire (IPAQ), 24-hour dietary recall, bioelectrical impedance analysis, and the Ashwell String Test. Central adiposity was assessed using waist circumference, waist-to-hip ratio, and waist-to-height ratio (WHtR). Results: Mean age of participants was 31.38±5.19 years, BMI was 26.52±4.77 kg/m2, and WHtR was 0.54±0.08. Obesity was observed in 62% of participants, while 66% had a WHtR >0.5. The Ashwell String Test identified 64% as being at risk of central adiposity and was significantly associated with WHtR. Mean screen time was 6.80 hours/day and sitting duration 6.1 hours/day; only 10% achieved health-enhancing physical activity (HEPA) levels. Elevated blood pressure or hypertension was observed in 32% of participants. A knowledge-practice gap was identified despite good knowledge and positive attitudes. Conclusions: Urban working women exhibited a high prevalence of central obesity, sedentary lifestyle behaviours, and early cardiometabolic risk factors. Ashwell String Test demonstrated potential as a simple, practical screening tool for central adiposity. Large longitudinal studies are warranted to validate these findings and inform workplace lifestyle interventions.