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Cited by 10Body Composition Measurement TechniquesNutrition and Health in AgingNutrition and Health Studies

Waist-to-Height Ratio: A Sensitive Tool for Assessing the Need for Nutritional Risk Management in Elderly Populations from Brazil

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Carvalho, Vivian C. Honorato dos Santos, Moreira, Leila B., Luft, Vivian C., Fuchs, Sandra C.·2023·Healthcare
DOI 10.3390/healthcare11172406PMC PMC10486933
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Abstract

Introduction: Nutritional status assessment commonly relies on body mass index (BMI), which overlooks lean mass and adipose tissue distribution. However, waist circumference (WC) and waist-to-height ratio (WHtR) provide additional insights into fat accumulation. By combining these indices, it may be possible to identify older adults needing weight management interventions. Objectives: To assess the WC and WHtR as strategies for identifying individuals requiring weight management. Methods: A cross-sectional study was conducted with 509 elderly individuals in Northeast Brazil. Weight, height, hip circumference, and waist circumference were measured, and combined with indices such as BMI WC, WHR, and WHtR to identify those who require weight management. The DeLong test compared areas under the curves using receiver operating characteristic curves and statistical significance. Sensitivity, specificity, and positive and negative predictive values were calculated to verify usefulness for clinical application. A validation sample of 599 elderly individuals from the country’s Southern region was used to confirm the results. Results: Both WC and WHtR showed adequate diagnostic accuracy with no statistically significant difference in AUCs. WHtR ≥ 0.50 had 92% sensitivity in identifying men and women requiring nutritional management. WC presented lower sensitivity but 93% specificity, useful for excluding elderly individuals from the nutritional risk category. These results were consistent in the validation sample. Conclusion: WHtR is a valuable index for screening nutritional risk management in the elderly population, applicable to men and women. Conversely, WC performs better in excluding individuals who do not need nutritional risk management.

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  • Alternative metrics such as waist-to-hip ratio or waist-to-height ratio in addition to BMI could offer a more comprehensive assessment of body composition and associated health risks in diverse populations.

    “Exploring alternative metrics such as waist-to-hip ratio (WHR) or waist-to-height ratio (WHtR) in addition to BMI could offer a more comprehensive assessment of body composition and associated health risks in diverse populations.”

    From Advantages and Limitations of the Body Mass Index (BMI) to Assess Adult Obesity (2024) · cites this paper as [41]

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Cited by

Sorted by citations

Authors
Carvalho, V. C. H. D. S., Moreira, L. B., Luft, V. C., & Fuchs, S. C.
Affiliations
  • Universidade Federal da Bahia (BR)
  • Universidade Federal do Rio Grande do Sul (BR)
Corresponding author
Fuchs, Sandra C.
ORCID
Venue
Healthcare
Publisher
MDPI AG
Published
2023-08-28
Volume
11
Issue
17
Pages
2406
ISSN
2227-9032 (ISSN-L)
DOI
10.3390/healthcare11172406
PMC
PMC10486933
OpenAlex
W4386224067
Cited by
10
References
3
Citations by year
2026: 6 · 2025: 2 · 2024: 2
FWCI
1.78
Type
journal article
Language
en
Open access
Licence
Locations
  • Healthcare (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
Funders
  • National Council for Scientific and Technological Development (457469/2013-7, 309023/2015-7, 316802/2021-2, 16-0187, 1973/2016)
  • SCF (457469/2013-7, 309023/2015-7, 316802/2021-2, 16-0187, 1973/2016)
  • Hospital de Clinicas de Porto Alegre (457469/2013-7, 309023/2015-7, 316802/2021-2, 16-0187, 1973/2016)
  • Postgraduate Program in Epidemiology, from UFRGS, and DINTER Program (UFBA/UFRGS) (457469/2013-7, 309023/2015-7, 316802/2021-2, 16-0187, 1973/2016)
Topics
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
Keywords
waist-to-height ratio, waist circumference, older adults, obesity screening, body mass index, abdominal fat, weight management, diagnostic accuracy, nutritional assessment

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