Neck Circumference is Associated with General and Central Obesity in Young Indian Adults

Background: Obesity has been a major concern due to its increasing prevalence and associated metabolic complications. Body mass index (BMI) assesses general obesity, but it does not distinguish between muscle and fat accumulations, so using only BMI can lead to an erroneous result. Waist circumference (WC), a marker of central obesity, predicted mortality risk better than BMI. However, WC can be affected by abdominal distension, is time-consuming, and may not be culture-sensitive. Neck circumference (NC) is devoid of these disadvantages and is believed to be an index of upper body fat distribution. This study aimed to assess the association of neck circumference with general and central obesity and to identify the cut-off points for evaluating obesity in young adults using NC. Material and Methods: Height, weight, waist, and hip circumference were measured to determine BMI and waist-hip ratio. NC was measured at the level of the mid-cervical spine and mid-anterior neck in a standing position with the arms hanging freely. For males with a laryngeal prominence, NC was measured just below the prominence. Results: In total, 357 (170 male and 187 female) young, healthy Indian adults aged 18-25 participated. Neck circumference (NC) is significantly associated with BMI and WC in both genders. We found the best cut-off for male and female participants to be >= 34 cm and >= 30.5 cm, with a sensitivity of 88.3% and 84.4% for assessing obesity. Conclusion: NC may be a better alternative to BMI and WC as a marker to assess obesity since it is more practical, simple, inexpensive, time-saving, and less invasive.