Vanessa Arévalo

Background/Objectives: Cardiovascular disease (CV) is the leading cause of death in Ecuador, and educational workers have been described as exposed to occupational stress and sedentary behavior, factors that may increase cardiometabolic risk. This study evaluated the concordance among three central adiposity indicators, waist circumference (WC), waist-to-hip ratio (WHR), and bioelectrical impedance analysis (BIA)-estimated visceral fat level (VFL), and their associations with cardiometabolic markers and dietary quality (DQ) in educational workers in Loja, Ecuador. Methods: Cross-sectional study of 101 workers (73 women, 28 men; mean age 37.7 years). Adiposity was classified using sex-specific cut-offs for WC (≥90/≥80 cm), WHR (≥0.90/≥0.85) (men/women) and a BIA-estimated VFL (>9). Fasting lipid profiles, fasting glucose, and DQ were assessed once, with DQ evaluated using the Diet Quality Questionnaire (DQQ). Statistical analyses included Cohen’s kappa; Spearman correlation, and binary logistic regression. Results: Overweight or obesity was present in 65.3% of participants, and 57.4% had all three central adiposity indicators simultaneously elevated. Indicator concordance was substantial (κ = 0.625–0.747). Altered cardiometabolic markers were common, notably low HDL-c (49.0%) and impaired fasting glucose (IFG, 32.3%). In exploratory sex-stratified analyses, WHR showed the strongest correlations with triglycerides (r_s = +0.607) and cumulative altered markers (r_s = +0.450). Age ≥ 40 years independently raised odds of IFG (aOR = 5.5; 95% CI: 2.0–15.3) and hypertriglyceridemia (aOR = 3.8; 95% CI: 1.2–11.8). Teaching staff exhibited lower DQ scores than support staff (p = 0.041). DQ scores showed no significant association with metabolic markers. Conclusions: Educational workers in this sample present a heavy burden of central adiposity and metabolic alterations. All three indicators showed substantial concordance; WHR displayed the broadest associations, although the small male subgroup requires larger validation. These associations reflect statistical relationships and agreement in classification, not diagnostic accuracy; no single indicator can be recommended as a standalone screening tool on the basis of these data. Older workers showed a higher burden of cardiometabolic alterations, which may warrant closer attention in future preventive research.