Waist to height ratio is the anthropometric index that most appropriately mirrors the lifestyle and psychological risk factors of obesity

Aim To determine to what extent the lifestyle and psychological factors influenced the occurrence of obesity in the population of the Mediterranean island of Vis (Croatia); also to relate the examined risk factors to several obesity indicators in order to select the most sensitive one. Methods Cross-sectional population study included 960 participants of both sexes (18-93 years) in whom the obesity was estimated using anthropometric indicators. The factor analysis of 55-item Food Frequency Questionnaire (FFQ) was performed as well as the General Health Questionnaire (GHQ12) for the self-assessment of psychological health and wellbeing. FFQ and GHQ12 individual factors' scores, sex, age, physical activity, smoking and socioeconomic status were further used as independent variables in the multiple linear regression analyses with five obesity indicators as dependent variables. Results The examined risk factors explained the highest proportion of variance of the waist to height ratio (WHtR) in comparison with all other indicators of obesity (body mass index (BMI), waist to hip ratio, sum of skinfolds thicknesses, fat mass percentage). Only the dietary factors showed a significant relation to BMI, while almost all of the tested variables-dietary pattern, psychological structure, smoking habit and physical activity-had a significant association with WHtR. Conclusions WHtR is the most useful indicator of obesity as it had a profiled relation with a number of lifestyle factors as well as with psychological health. The present study also revealed the importance of psychological factors for obesity phenotype, particularly the behavioural pattern which could be described as avoidance of dealing with problems.