Neck circumference and wrist circumference as a screening tool for obesity in early adolescents: a cross-sectional study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20263620Keywords:
Adolescents, BMI-for-age Z-score, Neck circumference, Obesity, Rural adolescents, Wrist circumferenceAbstract
Background: Obesity in adolescents is a growing public health problem. Neck circumference (NC) and wrist circumference (WrC) were suggested as simple and cheap alternatives for obesity screening. The objective of this study was to determine the prevalence of obesity and the utility of NC and WrC in rural adolescent.
Methods: A community based cross-sectional study was conducted among 318 rural adolescents aged 11-14 years. Anthropometric measurements of height, body weight, NC and WrC were performed using standard procedures. Obesity was defined as BMI-for-age Z score (BAZ). Pearson correlation and receiver operating characteristic (ROC) curve analysis was done.
Results: Prevalence of obesity was 4.1% (13/318). NC showed statistically significant negative correlation with BAZ (r=-0.180, p=0.001) while WrC showed a stronger negative correlation with BAZ (r=-0.390, p<0.001). The ROC analysis showed acceptable diagnostic performance for NC (AUC=0.707, 95% CI: 0.549-0.865) and good diagnostic performance for WrC (AUC=0.832, 95% CI: 0.748-0.917). The optimal cutoff values were 29.25 cm for NC and 16.25 cm for WrC.
Conclusions: Both NC and WrC were able to identify obesity in rural adolescents, with WrC performing better in diagnosis than NC. WrC could be a simple and feasible anthropometric marker for screening of obesity in community settings. These findings need to be confirmed in further studies.
References
United Nations Children’s Fund (UNICEF). Adolescent development and participation. Available at: https://www.unicef.org/india/what-we-do/adolescent-development-participation. Accessed on 22 April 2026.
World Health Organization. Obesity and overweight. Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Accessed on 23 February 2026.
Nair GG, Ashok U, Prashant D, Jayaseelan O. Neck circumference as a screening tool for obesity in pre-and primary school children in Puducherry India- a cross-sectional study. Nat J Community Med. 2024;15(11):896-903.
Subramanian SK, Kuldeep GB, Rajendran R, Varsha Y. The Role of neck circumference in predicting body fat distribution: a cross-sectional study among healthy female medical students. Indian J Public Health Res Develop. 2025;16(2):304.
Preis SR, Massaro JM, Hoffmann U, D’Agostino RB, Levy D, Robins SJ, et al. Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart Study. J Clin Endocrinol Metab. 2010;95(8):3701-10.
Cho NH, Oh TJ, Kim KM, Choi SH, Lee JH, Park KS, et al. Neck circumference and incidence of diabetes mellitus over 10 years in the Korean Genome and Epidemiology Study (KoGES). Sci Rep. 2015;5.
Noudeh YJ, Hadaegh F, Vatankhah N, Momenan AA, Saadat N, Khalili D, et al. Wrist circumference as a novel predictor of diabetes and prediabetes: results of cross-sectional and 8.8-year follow-up studies. J Clin Endocrinol Metab. 2013;98(2):777–84.
Namazi N, Djalalinia S, Mahdavi-Gorabi A, Asayesh H, Mansourian M, Noroozi M, et al. Association of wrist circumference with cardio-metabolic risk factors: a systematic review and meta-analysis. Eat Weight Disord. 2018;25(1):151-61.
Panda A, Parida J, Jena S, Behera SS, Pradhan A, Patra PK, et al. Prevalence and associated risk factors of overweight and obesity among adolescent population of India: a scoping review. BMC Nutr. 2025;11(1).
Jain B, Jain S, Mittal C, Chopra H, Chaudhary P, Bargayary H, et al. Obesity in adolescents: prevalence and association with sociodemographic and lifestyle factors. Indian J Community Health. 2023;35(2):152-8.
Kaur V, Loumi S. Prevalence and awareness of obesity among adolescents in Punjab: a cross-sectional study. Int J Sci Res. 2026;78-81.
Dongre SS, Dagdiya KR, Dani A, Hajare ST. Neck circumference as a screening tool for childhood obesity: a cross-sectional study. Indian J Community Health. 2024;36(4):531-7.
Halpara SV, Kakkad KM, Parmar HR, Prajapati VJ. A cross-sectional study to validate neck circumference, waist circumference, wrist circumference and mid upper arm circumference as a screening tool for overweight in adolescents at school of Ahmedabad city. Panacea J Med Sci. 2022;12(1):102-9.
Shreedhar S, Naik PM, Havale NG. Neck circumference as a screening tool to predict obesity: a cross sectional study in coastal Karnataka, India. Nat J Community Med. 2022;13(11):782-7.
Shafiee G, Qorbani M, Heshmat R, Djalalinia S, Motlagh ME, Arefirad T, et al. Wrist circumference as a novel predictor of obesity in children and adolescents: the CASPIAN-IV study. J Pediatr Endocrinol Metab. 2018;717-25.
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