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Abstract
Objectives To assess the benefit of waist circumference (WC) measurements during routine conscription medical examination in two military conscription centres in Switzerland. We compared the prevalence of overweight and obesity assessed by body mass index (BMI) with the prevalence of elevated disease risks assessed by WC and waist-to-height ratio (WHtR). We investigated how these measures were associated with systolic blood pressure, physical fitness performance and socioeconomic determinants.
Design Cross-sectional survey.
Setting Two Swiss conscription centres in 2016.
Participants 1548 Swiss male conscripts, 18–22 years old.
Main outcome Prevalences of elevated WC, WHtR and BMI values according to WHO categories. Secondary outcomes include systolic blood pressure, physical fitness performance and endurance performance.
Results Using BMI cut-points, 25.0% of all conscripts were overweight or obese. When applying WC cut-points, 9.2% had an increased disease risk, while 14.8% of the conscripts were at risk using WHtR cut-points. In the BMI range of 25.0–27.4 kg/m2, 3.6% showed an increased disease risk when using WC and 24.6% when using WHtR cut-points. Of the conscripts with a BMI of 27.5–29.9 kg/m2, 72.4% had an increased disease risk using WHtR, and 42.5% when using WC cut-points. Determinants of elevated BMI, WC and WHtR were low occupational status, rural residential area, older age and location in central and Northwest Switzerland. Systolic blood pressure increased with increasing BMI, WC and WHtR. Physical fitness and endurance test performances decreased with increasing BMI, WC and WHtR.
Conclusion In addition to BMI, WC and WHtR add relevant information to the health assessment of young men. However, the prevalence of overweight/increased health risk differed when using BMI, WC or WHtR. Further studies should include measures of body composition to test whether these differences arise from muscular young men within the overweight BMI range, who had a normal WC.
- obesity
- body mass index
- waist circumference
- waist to height ratio
- blood pressure
- physical fitness test results
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Footnotes
Contributors Conceived and designed the WC measurements: KS, NB, JF and NK. Coordinated collection of data and prepared data for analysis: AN, SSM and AT. Analysed the data: KS and NB. Wrote first draft: NB and KS. Commented on paper: all authors. Obtained funding: KS, FJR and NB. Obtained routine army data: KS, FJR and NB.
Funding This work was supported by the Swiss Federal Office of Public Health FPO (contract number 16.008898) and Mäxi Foundation (Zurich).
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The data are generated and owned by the Swiss Armed Forces. The data and the permission to use them are available from the Swiss Armed Forces (Logistikbasis der Armee-LBA San) on submission and approval of a study protocol.