British Journal of Nutrition

Full Papers

Dietary Survey and Nutritional Epidemiology

Cut-off points for anthropometric indices of adiposity: differential classification in a large population of young women

Sarah L. Dugglebya1a2, Alan A. Jacksona2, Keith M. Godfreya1, Siân M. Robinsona1, Hazel M. Inskipa1 c1 and the Southampton Women's Survey Study Groupa1

a1 Medical Research Council Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK

a2 Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK


Anthropometric indices of adiposity include BMI, waist circumference and waist:height ratio. In the recruitment phase of a prospective cohort study carried out between 1998 and 2002 we studied a population sample of 11 786 white Caucasian non-pregnant women in Southampton, UK aged 20–34 years, and explored the extent to which proposed cut-off points for the three indices identified the same or different women and how these indices related to adiposity. Height, weight and waist circumference were measured and fat mass was estimated from skinfold thicknesses; fat mass index was calculated as fat mass/height1·65. Of the subjects, 4869 (42 %) women were overweight (BMI ≥ 25 kg/m2) and 1849 (16 %) were obese (BMI ≥ 30 kg/m2). A total of 890 (8 %) subjects were not overweight but had a waist circumference ≥ 80 cm and 748 (6 %) subjects were overweight but had a waist circumference < 80 cm (6 %). Of the women, 50 % had a BMI ≥ 25 kg/m2 or a waist circumference ≥ 80 cm or a waist:height ratio ≥ 0·5. Of the variation in fat mass index, 85 % was explained by BMI, 76 % by waist circumference and 75 % by waist:height ratio. Our findings demonstrate that many women are differentially classified depending on which index of adiposity is used. As each index captures different aspects of size in terms of adiposity, there is the need to determine how the three indices relate to function and how they can be of use in defining risk of ill health in women.

(Received October 31 2007)

(Revised April 07 2008)

(Accepted April 24 2008)

(Online publication July 18 2008)


c1 Corresponding author: Professor H. M. Inskip, fax +44 23 8070 4021, email


Abbreviations: FMI, fat mass index