Weight-height indices * Choice of the most suitable index and its association with selected variables among 10 , 000 adult males of heterogeneous origin

Weight/height2 (W/H2) was found to be the 'best' power-type weight-height index for men of all ages above 40 when examining the 10,000 Israel civil servants. These were all men aged 40 and over from six major areas of birth in Europe, North Africa, the Middle East, and Israel. This finding confirms other work done with widely different cultural groups. The association of this W/H2 index was examined in respect of several demographic and other socioeconomic variables. The major findings were as follows: W/H2 rises with age until 50, then plateaus until 60, after which there appears to be a slight drop. Israeli-born subjects showed the highest index and those born in the Middle East the lowest index. A general increase in the index occurred over the five years of observation except at age 60 and over. Low values were associated with 'professionals' on the one hand, and 'labourers' and those with 'no schooling' on the other. Immigrants who came during or immediately after the second world war were the 'leanest' of all immigrants when examined about 20 years later. The previous finding that cigarette smokers (particularly medium and heavy smokers) showed a low value in comparison with ex-smokers and those who had never smoked was confirmed. Ex-smokers, particularly those who had previously smoked heavily, were more overweight than smokers and those who had never smoked. The findings suggest that ex-smokers gain weight fairly rapidly and then gradually reduce to the weight of those who never smoked but not to that of smokers. In order to verify this finding, a follow-up of ex-smokers is needed. Self-reported physical activity was associated with a lower W/H2 index for smokers, and to a lesser extent for ex-smokers, but did not seem to have an appreciable effect on those who had never smoked. Dietary variables as measured by our questionnaire were not found to be associated with the W/H2 index. INTRODUCTION During the past 10 years increasing attention has been paid to properties of indices based on weight and height. Obesity or overweight has been established as a risk factor in coronary heart disease in our study as well as in several other studies (Shapiro, Weinblatt, Frank, and Sager, 1969; Gordon and Kannel, 1973; Medalie et al., 1973a, b), in diabetes (West and Kalbfleisch, 1966; Medalie et al., 1974), and in hypertension (Kahn et al., 1972). Indices of obesity or overweight were generally based on one of two systems: (1) relative weight, namely the ratio of a person's weight to a standard weight for his sex and height (sometimes an additional characteristic), and (2) W/HP (weight divided by the pth power of height). Presented here is the evaluation of the 'best' power-type index, standard weight, and the correlation between the different accepted W/HP indices and skinfolds in the population of the Israeli Ischemic Heart Disease Project. The association of this 'best' index with selected variables (age, occupation, education, physical activity, diet, and smoking) of the study population is also reviewed.