Lean, his PhD student Han, and other colleagues in Glasgow using under-water weighing, MRI, CT and a range of biochemical measures, proposed that the waist circumference is the best simple indictor of total body fat content and of increased visceral fat in thin people.

The waist cut-offs >102 cm for men, >88 cm for women, indicated high risk from a range of diseases demanding professional help, and did not need to be adjusted for height, hips or any other dimension. Lower waist cut-offs, >94 cms in men, >80 cms in women, mark the point where body-fat accumulation begins to increase the risks, and so personal action should be taken.

These figurers have now been adopted for health promotion world-wide, and form the key diagnostic criterion for Metabolic Syndrome, whose other criteria all result from body fat accumulation. The first paper arguing for waist measurement as a single identification of people who might be at risk from being overweight was published in 1995.

Lean’s research offered the world a new, simple concept as a focus for highly cost-effective weight management bringing multiple health benefits. Diabetes and CHD are best prevented, and the waist points to the way to prevent them.