Neck circumference as a screening measure of overweight/obesity among Indian adults

Open access


Neck circumference (NC) is an anthropometric measurement of differentiating body fat distributions and a marker of upper subcutaneous adiposity. The present study highlights the association and importance of NC as a suitable proxy screening measure of overweight/obesity as compared to the conventional anthropometric variables used among Indian adults. The present community based cross-sectional study was undertaken among 1169 Karbi adults (males: 625; females: 544) residing in Karbi Anglong district of Assam, Northeast India, who were selected through a multistage stratified random sampling method. Height, weight, waist circumference (WC), hip circumference (HC) and NC were recorded using standard procedures. The body mass index (BMI) was calculated and prevalence of overweight/obesity was assessed using standard cut-offs. The prevalence of obesity using BMI (≥25.00 kg m-2) was 15.52% and 15.26% among males and females, respectively (p≥0.05).The prevalence of obesity using NC was observed to be significantly higher among males (48.80%) than females (19.12%) (p<0.01). The binary logistic regression analysis showed that NC predicted obesity over the conventional anthropometric variables with reasonable accuracy (p<0.01). The ROC-AUC analysis showed a relatively greater significant association between BMI, WC and HC and NC for obesity (p<0.01). Thus, NC appears to be a potentially simple, easyto- use screening measure for predicting obesity among adults. Further studies are required to validate its use for screening of obesity among other ethnic populations in India.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • Adamu LH Asuku AY Taura MG Tela IA Datti S Imam A. 2013. Neck circumference: An upcoming tool of adiposity indices. Niger J Basic Clin Sci 10:82-5.

  • Akin I Nienaber CA. 2015. “Obesity paradox” in coronary artery disease. World J Cardiol 7:603-8.

  • Al-Bachir M Ahhmad H. 2016. Detecting overweight and obesity among young Syrian boys based on skinfold thickness. Anthropol Rev 79:35-46.

  • Anuradha RK Sathyavathi RB Reddy TM Hemalatha R Sudhakar G Geetha P Reddy KK. 2015. Effect of social and environmental determinants on overweight and obesity prevalence among adolescent school children. Indian J Endocr Metab 19:283-7.

  • Argolo DF Iyengar NM Hudis CA. 2015. Obesity and Cancer: Concepts and Challenges. Indian J Surg Oncol 6:390-8.

  • Assyov Y Gateva A Tsakova A Kamenov Z. 2016. A comparison of the clinical usefulness of neck circumference and waist circumference in individuals with severe obesity. Endocr Res 6:1-9.

  • Aswathappa J Garg S Kutty K Shankar V. 2013. Neck circumference as an anthropometric measure of obesity in diabetics. N Am J Med Sci 5:28-31.

  • Aswathappa J Garg S Kutty K Shankar V. 2014. Utility of neck circumference a simple and novel measure as anthropometric marker of obesity in adults. World J Pharmacy Pharm Sci 3:1618-29.

  • Ben-Noun L Laor A. 2003. Relationship of neck circumference to cardiovascular risk factors. Obes Res 11:226-31.

  • Ben-Noun L Laor A. 2006. Relationship between changes in neck circumference and cardiovascular risk factors. Exp Clin Cardiol 11:14-20.

  • Ben-Noun L Sohar E Laor A. 2001. Neck circumference as a simple screening measure for identifying overweight and obese patients Obes Res 9:470-7.

  • Bhowmik B Munir SB Ahmed KR Siddiquee T Diep LM Wright E Hassan Z Debnath PR Mahtab H Azad Khan AK Hussain A. 2014. Anthropometric indices of obesity and type 2 diabetes in Bangladeshi population: Chandra Rural Diabetes Study (CRDS). Obes Res Clin Pract 8:e201-98.

  • Binks M. 2016. The Role of the Food Industry in Obesity Prevention. Curr Obes Rep 5: 201-7.

  • Chakraborty R Bose K Kozieł S. 2011. Waist circumference in determining obesity and hypertension among 18-60 years old Bengalee Hindu male slum dwellers in Eastern India. Ann Hum Biol 38:669-75.

  • Cheong KC Ghazali SM Hock LK Yusoff AF Selvarajah S Haniff J Zainuddin AA Ying CY Lin KG Rahman JA Shahar S Mustafa AN. 2014. Optimal waist circumference cut-off values for predicting cardiovascular risk factors in a multi-ethnic Malaysian population. Obes Res Clin Pract 8:e154-62.

  • Chopra SM Misra A Gulati S Gupta R. 2013. Overweight obesity and related non-communicable diseases in Asian Indian girls and women. Eur J Clin Nutr 67:688-96.

  • Czeglédi E. 2016. Options for stress management in obesity treatment. Orv Hetil 157:260-7.

  • Das M Bose K. 2006. Presence of high rates of overweight and obesity among adult Marwaris of Howrah West Bengal India. Coll Antropol 30:81-6.

  • Deepa M Farooq S Deepa R Manjula D Mohan V. 2009. Prevalence and significance of generalized and central body obesity in an urban Asian Indian population in Chennai India (CURES: 47). Eur J Clin Nutr 63:259-67.

  • Deurenberg-Yap M Chew SK Lin VF Tan BY van Staveren WA Deurenberg P. 2001. Relationships between indices of obesity and its co-morbidities in multi-ethnic Singapore. Int J Obes Relat Metab Disord 25:1554-62.

  • Dudeja V Misra A Pandey RM Devina G Kumar G Vikram NK. 2001. BMI does not accurately predict overweight in Asian Indians in northern India. Br J Nutr 86:105-12.

  • Feng RN Zhao C Wang C Niu YC Li K Guo FC Li ST Sun CH Li Y. 2012. BMI is strongly associated with hypertension and waist circumference is strongly associated with type 2 diabetes and dyslipidemia in northern Chinese adults. J Epidemiol 22:317-23.

  • Fink B Manning JT Neave N. 2006. The 2nd-4th digit ratio (2D:4D) and neck circumference: implications for risk factors in coronary heart disease. International Journal of Obesity 30:711-4.

  • Fink B. 2012. Neck circumference: its usage in medicine and biology. In Handbook of Anthropology: Physical Measures of Human Form in Health and Disease V.R. Preedy (eds) Springer Science 665-75.

  • Freitag Luglio H. 2016. Genetic Variation of Fatty Acid Oxidation and Obesity A Literature Review. Int J Biomed Sci 12:1-8.

  • Gurnani M Birken C Hamilton J. 2015. Childhood Obesity: Causes Consequences and Management. Pediatr Clin North Am 62:821-40.

  • Hall JG Allanson JE Gripp KW Slavotinek AM. 2007. Handbook of Physical Measurements. New York: Oxford University Press.

  • Hingorjo MR Qureshi MA Mehdi A. 2012. Neck circumference as a useful marker of obesity: A comparison with body mass index and waist circumference. J Pak Med Assoc 62:36-40.

  • Hsieh SD Muto T 2004. A simple and practical index for assessing the risk of metabolic syndrome during the routine heath checkups. Nippon Rinsho 62:1143-49.

  • Huxley R Mendis S Zheleznyakov E Reddy S Chan J. 2010. Body mass index waist circumference and waist:hip ratio as predictors of cardiovascular risk--a review of the literature. Eur J Clin Nutr 64:16-22.

  • Indian Genome Variation Consortium. 2008. Genetic landscape of the people of India: A canvas for disease gene exploration. J Genet 87:3-20.

  • Kalra S Mercuri M Anand SS. 2013. Measures of body fat in South Asian adults. Nutr Diabetes 3:e69. doi:

    • Crossref
    • Export Citation
  • Kelley CP Sbrocco G Sbrocco T. 2016. Behavioral Modification for the Management of Obesity. Prim Care 43:159-75.

  • Kelly RK Magnussen CG Sabin MA Cheung M Juonala M. 2015. Development of hypertension in overweight adolescents: a review. Adolesc Health Med Ther 6:171-87.

  • Kowalkowska J Poínhos R Franchini B Afonso C Correia F Pinhão S Vaz de Almeida MD Rodrigues S. 2016. General and abdominal adiposity in a representative sample of Portuguese adults: dependency of measures and socio-demographic factors’ influence. Br J Nutr 115:185-92.

  • Laakso M Matilainen V Keinänen-Kiukaanniemi S. 2002. Association of neck circumference with insulin resistance-related factors. Int J Obes Relat Metab Disord 26:873-5.

  • LaBerge RC Vaccani JP Gow RM Gaboury I Hoey L Katz SL. 2009. Inter- and intra- rater reliability of neck circumference measurements in children. Pediatr Pulmonol 44:64-9.

  • Low S Chin MC Ma S Heng D Deurenberg- Yap M. 2009. Rationale for redefining obesity in Asians. Ann Acad Med Singapore 38:66-9.

  • Mandviwala T Khalid U Deswal A. 2016. Obesity and Cardiovascular Disease: a Risk Factor or a Risk Marker? Curr Atheroscler Rep 18:21. doi:

    • Crossref
    • Export Citation
  • Mendes LL Nogueira H Padez C Ferrao M Velasquez-Melendez G. 2013. Individual and environmental factors associated for overweight in urban population of Brazil. BMC Public Health 13:988. doi:

    • Crossref
    • Export Citation
  • Misra A Khurana L. 2011. Obesity-related non-communicable diseases: South Asians vs White Caucasians. Int J Obes (Lond) 35:167-87.

  • Mondal N Sen J. 2014. Role of anthropometry in assessment of excess adiposity and metabolic disorders in Asian Indians. In: K Bose and R Chakraborty editors. Public Health in 21st Century: Health consequences of human central obesity. New York: Nova Biomedical 71-83.

  • Morgen CS Sørensen TI. 2014. Obesity: Global trends in the prevalence of overweight and obesity. Nat Rev Endocrinol 10:513-4.

  • Obesity in Asia Collaboration. Huxley R Barzi F Lee CM Lear S Shaw J Lam TH Caterson I Azizi F Patel J Suriyawongpaisal P Oh SW Kang JH Gill T Zimmet P James PT Woodward M. 2007. Waist circumference thresholds provide an accurate and widely applicable method for the discrimination of diabetes. Diabetes Care 30:3116-8.

  • Onat A Hergenç G Yüksel H Can G Ayhan E Kaya Z Dursunoğlu D. 2009. Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstructive sleep apnea syndrome beyond waist circumference. Clin Nutr 28:46-51.

  • Özkaya İ Tunçkale A. 2016. Neck Circumference Positively Related with Central Obesity and Overweight in Turkish University Students. Cent Eur J Public Health 24:91-4.

  • Pan WH Yeh WT. 2008. How to define obesity? Evidence-based multiple action points for public awareness screening and treatment: an extension of Asian-Pacific recommendations. Asia Pac J Clin Nutr 17:370-4.

  • Popkin BM Slining MM. 2013. New dynamics in global obesity facing low- and middle- income countries. Obes Rev 142:11-20.

  • Preis SR Massaro JM Hoffmann U D’Agostino RB Sr Levy D Robins SJ Meigs JB Vasan RS O’Donnell CJ Fox CS. 2010. Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study. J Clin Endocrinol Metab 95:3701-10.

  • Puri G Scott G Gan SK. 2013. Can neck circumference be used as a tool to identify the metabolic syndrome and insulin resistance? Practical Diabetes 30:184-5.

  • Rengma MS Sen J Mondal N. 2015. Socio- Economic Demographic and Lifestyle Determinants of Overweight and Obesity among Adults of Northeast India. Ethiop J Health Sci 25: 199-208.

  • Rosset I Strapagiel D Sitek A Majewska M Ostrowska-Nawarycz L Żądzińska E. 2016 Association of FTO and TMEM18 polymorphisms with overweight and obesity in the population of Polish children. Anthropological Review 79:17-33.

  • Sarkar D Mondal N Sen J. 2009. Obesity and blood pressure variations among the Bengali Kayastha population of North Bengal India. J Life Sci 1:35-43.

  • Sen J Mondal N Dutta S. 2013. Factors affecting overweight and obesity among urban adults: a cross-sectional study. Epidemiol Biostatistics Pub Health 10:e8741-1-8.

  • Sen J Mondal N. 2013. Fat mass and fat-free mass as indicators of body composition among Bengalee Muslim children. Ann Hum Biol 40:286-93.

  • Shafaghi K Shariff ZM Taib MN Rahman HA Mobarhan MG Jabbari H. 2014. Parental body mass index is associated with adolescent overweight and obesity in Mashhad Iran. Asia Pac J Clin Nutr 23:225-31.

  • Sitek A Rosset I Strapagiel D Majewska M Ostrowska-Nawarycz L Żądzińska E. 2014. Association of FTO gene with obesity in Polish schoolchildren. Anthropological Review 77:33-44.

  • Sjöström CD Lissner L Sjöström L. 1997. Relationships between changes in body composition and changes in cardiovascular risk factors: the SOS Intervention Study. Swedish Obese Subjects. Obes Res 5:5 19-30.

  • Stabe C Vasques AC Lima MM Tambascia MA Pareja JC Yamanaka A Geloneze B. 2013. Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance: results from the Brazilian Metabolic Syndrome Study. Clin Endocrinol (Oxf) 78:874-81.

  • Touitou Y Portaluppi F Smolensky MH Rensing L. 2004. Ethical principles and standards for the conduct of human and animal biological rhythm research. Chronobiol Int 21:161-70.

  • Ulijaszek SA Kerr DA. 1999. Anthropometric measurement error and the assessment of nutritional status. Br J Nutr 82:165-77.

  • Wang X Zhang N Yu C Ji Z. 2015. Evaluation of neck circumference as a predictor of central obesity and insulin resistance in Chinese adults. Int J Clin Exp Med 8: 19107-13.

  • Wells JCK. 2010. The evolutionary biology of human body fatness: thrift and control. Cambridge: Cambridge University Press.

  • WHO Expert Consultation. 2004. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363:157-63.

  • World Health Organization (WHO). 2000. The Asia Pacific Perspective Redefining obesity and its treatment. Geneva: World Health Organization.

  • World Health Organization (WHO). 2011. Waist circumference and waist-hip ratio: report of a WHO expert consultation Geneva 8-11 December 2008.

  • World Health Organization (WHO). 2013. Controlling the global obesity epidemic- The challenge. Avalable at:; [Accessed March 15 2013].

  • Yang GR Yuan SY Fu HJ Wan G Zhu LX Bu XL Zhang JD Du XP Li YL Ji Y Gu XN Li Y. 2010. Beijing Community Diabetes Study Group. Neck circumference positively related with central obesity overweight and metabolic syndrome in Chinese subjects with type-2 diabetes: Beijing Community Diabetes Study 4. Diabetes Care 33:2465-7.

Journal information
Impact Factor

CiteScore 2018: 0.55

SCImago Journal Rank (SJR) 2018: 0.22
Source Normalized Impact per Paper (SNIP) 2018: 0.472

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 507 260 10
PDF Downloads 205 111 3