Journal of Preventive Medicine and Public Health

Original Articles

Associations of Body Mass Index and Waist Circumference With Falls Among Community-dwelling Older Adults in Korea: Seonho Kim, Jeong-Soo Im, Beomman Ha; J Prev Med Public Health. 2026;59(3):328-336. Published online March 31, 2026; DOI: https://doi.org/10.3961/jpmph.26.092

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Abstract Summary PDF: Objectives
This study aimed to investigate the association between obesity and falls among community-dwelling older adults in Korea and to assess whether body mass index (BMI) or waist circumference (WC) more accurately predicts fall risk.
Methods
This study included 4378 community-dwelling older adults aged ≥65 years from the seventh Korea National Health and Nutrition Examination Survey (2016–2018). Complex-sample logistic regression analyses were conducted to examine the associations between general and central obesity and falls, stratified by sex and age group. Predictive accuracy was evaluated using Harrell’s C-index, and differences between WC and BMI were assessed using the ΔC-index and the DeLong test.
Results
BMI-defined general obesity was not significantly associated with falls. In contrast, WC-defined central obesity was significantly associated with falls among older adults overall (adjusted odds ratio, 1.82; 95% confidence interval, 1.20 to 2.76). In sex-stratified analyses, central obesity remained significantly associated with falls in both males and females. Age-stratified analyses showed a significant association between central obesity and falls among adults aged 65–74 years, but not among those aged ≥75 years. WC demonstrated a modest but statistically significant improvement in predictive ability compared with BMI (ΔC-index=0.047, p=0.044), although subgroup differences were not statistically significant.
Conclusions
Central obesity, but not general obesity defined by BMI, was significantly associated with falls among community-dwelling older Korean adults. WC showed slightly better predictive performance than BMI. These findings suggest that WC may be a more appropriate indicator than BMI for identifying older adults at increased risk of falls.; Summary

Korean summary
본 연구는 지역사회 거주 노인을 대상으로 비만과 낙상 간의 관련성을 분석하고, 체질량지수(BMI)와 허리둘레(WC)의 낙상 예측력을 비교하였다. 분석 결과, BMI 기반 일반 비만은 낙상과 유의한 관련이 없었으나, WC 기반 복부비만은 낙상 위험 증가와 유의하게 관련되었으며, 허리둘레가 BMI보다 낙상 예측에 더 우수한 지표로 나타났다. 따라서 노인 낙상 위험 선별 시 BMI보다 허리둘레를 우선적으로 고려할 필요가 있다.

Key Message
Central obesity defined by waist circumference was significantly associated with falls among community-dwelling older adults in Korea, whereas BMI-defined general obesity was not. Waist circumference also demonstrated slightly better predictive performance for falls than BMI. These findings suggest that waist circumference may be a more appropriate anthropometric indicator for identifying older adults at increased risk of falls.

Smoking Is Associated With Abdominal Obesity, Not Overall Obesity, in Men With Type 2 Diabetes: Ji Eun Yun, Heejin Kimm, Young Ju Choi, Sun Ha Jee, Kap Bum Huh; J Prev Med Public Health. 2012;45(5):316-322. Published online September 28, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.5.316

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21 Crossref

Objectives

Abdominal obesity increases mortality and morbidity from cardiovascular disease and there is a possibility that smoking effects obesity. However, previous studies concerning the effects of smoking on obesity are inconsistent. The objective of this study was to examine whether smoking is positively related to abdominal obesity in men with type 2 diabetes.

Methods

Subjects consisted of 2197 type 2 diabetic patients who visited Huh's Diabetes Center from 2003 to 2009. Indices of abdominal obesity were defined as visceral fat thickness (VFT) measured by ultrasonography and waist circumference (WC). Overall obesity was defined as body mass index (BMI).

Results

Statistically significant differences in WC and VFT by smoking status were identified. However, there was no statistical difference in BMI according to smoking status. Means of WC and VFT were not significantly higher in heavy smokers and lower in mild smokers. Compared to nonsmokers, the BMI confounder adjusted odds ratio and 95% confidence interval for VFT in ex-smokers and current-smokers were 1.70 (1.21 to 2.39) and 1.86 (1.27 to 2.73), respectively.

Conclusions

Smoking status was positively associated with abdominal obesity in type 2 diabetic patients.

Summary

Citations

Citations to this article as recorded by

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Prevalence of Metabolic Syndrome and Waist Circumference Estimation in Some Korean Adults.: Young Seoub Hong, Byoung Gwon Kim, Baek Geun Jeong, Yong Woo Park, Jong Tae Park, Kap Yeol Jung, Joon Youn Kim; J Prev Med Public Health. 2004;37(1):51-58.

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Abstract PDF: OBJECTIVE
The purpose of this study was to estimate the prevalence of metabolic syndrome, as defined by the ATP III report, in some Korean adults and use the Asian-Pacific proposed waist circumference to investigate waist circumference in some Korean adults using ROC curves. METHODS: Study subjects were seventy-five thousands and ninety one persons (47, 979 men and 27, 111 women) who were selected among the patients who visited hospital for health evaluation from January 2000 to December 2001. All subjects were measured by height, weight, waist and hip circumferences, blood pressure and blood chemistry (lipid profile). RESULTS: The mean age was 41.6+/-8.5 years in men, 41.1+/-10.4 years in women (p< 0.05). Body mass index was in the normal range in 35.3% of men, and 55.9% of women. In both men and women, blood pressure, blood sugar, total cholesterol and triglyceride were positively correlated with BMI. waist circumference, and Broca's index (p< 0.01). However HDL. choloesterol was correlated negatively (p< 0.01). Using ROC curve, the calculated waist circumferences were 84 cm in men (sensitivity 61.4% and specificity 64.1%) and 74 cm in women (sensitivity 65.0% and specificity 73.2%). The age adjusted prevalences of the metabolic syndrome as defined by NCEP ATP III were different for men (6.4%) and women (14.6%). The prevalence increased from 1.2% among participants aged 20 through 29years to 15.0% among participants aged over 60years in men (p< 0.05) and from 1.6% to 27.4% respectively, in women. The age adjusted prevalences, as defined by using the waist circumference that was recommended by WHO's regional office for the western Pacific, were 10.6% in men and 18.5% in women. The age adjusted prevalences, as defined by using the waist circumference that was calculated by the ROC curves, were 17.1% in men and 22.4% in women. And All prevalences were increased following increased BMI and Broca's index. CONCLUSIONS: The prevalence of metabolic syndrome in some Korean adults was lower than that in western adults. Nevertheless because waist circumference was differed among race and region, application of the same criteria was not proper. Morcover, a higher awareness was required in women, because the prevalence of metabolic syndrome was rapidly increased with increment of age.; Summary

English Abstract

Health Behavior Factors Affecting Waist Circumference as an Indicator of Abdominal Obesity.: Kyung Won Paek, Yoon Mi Hong; J Prev Med Public Health. 2006;39(1):59-66.

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Abstract PDF: OBJECTIVES
This study was performed to identify the socioeconomic factors, the psychosocial factors and the heath behavior factors that have an influence on abdominal obesity, as measured by using the waist circumference. METHODS: Data was obtained from individuals aged above 20 years who had their waist circumference measured on the Korean National Health and Nutrition Examination Survey 2001, which was a cross-sectional health survey. RESULTS: Regression analysis of the factors that affect abdominal obesity showed that the education level, income, smoking, duration of smoking, drinking consumption, frequency of exercises and sleeping were the associated factors for abdominal obesity. For men, the duration of smoking, education level, income and drinking consumption were the associated factors for abdominal obesity. For woman, the education level, income, duration of smoking, drinking consumption and frequency of exercise were the associated factors for abdominal obesity. CONCLUSIONS: Abdominal obesity is a risk factor for morbidity and mortality, and it is associated with chronic diseases, including cardiovascular disease and diabetes. Based on the findings, it is essential to modify heath behaviors for preventing abdominal obesity, which is a condition associated with the incidence of chronic disease.; Summary

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