WHR vs Waist Circumference (especially in Asians)

Medical Q&A [Moderated]
1

Hey Jordan/Austin,

Just wondering some things about waist circumference.

  1. Do you think there is some role for “leeway” in waist circumference for individuals at the extremes of size? For example, I believe the waist circumference cutoffs are lower for Asians due to an average smaller structural build + height across the general Asian population, leading to a greater propensity to accumulate visceral fat even below 40 inches. It’s totally reasonable that a 1.6m individual with a waist of 38" would probably have too much central adiposity.

That said, looking at an extreme population (e.g NBA players) it seems reasonable that as an individual’s waist circumference would go up as his/her height goes up. I read somewhere that Lebron’s waist is 38 inches, but he has visible abs.

BMI also seems to be highly inaccurate for individuals at the extreme of height (i believe Yao Ming had a BMI of 33)? So I was wondering if WHR might be more useful both in very tall or very short individuals. I’ve read it may even be superior to Waist circumference alone for certain populations

  1. Not sure if you saw many Asians in your residency/practice but it does seem (superficially) that Asians growing up in a western-type culture/diet do seem to exhibit some differences in bodily phenotype (size/structure) compared to their peers in Asian countries. Would you continue to advocate <37" as a strict cutoff for Asians or consider using the general cutoff of 40" or WHR in “larger” individuals?

Just asking as I used to compete in strongman and many individuals (myself included), while definitely carrying too much adiposity in our competitive days, seem to be closer to a caucasian build in terms of size and bone structure. I think my best waist circumference was around 31-32" while also being 7-8% BF while competing for a bodybuilding show at 84kg, about 12 years ago. Currently it’s sitting around 37.5-38" at around 18-20% BF (working on getting it down) but can’t really see it going way down below 34-35" when I hit around 15% which is still pretty close to the Asian cutoff of 37. I’m also 185cm/104kg so slightly off the end of the Asian bell curve, as it were.

2

BSZA,

  1. No, not really. BMI isn’t anymore inaccurate in taller than shorter people, in general. The current recommendations are to use WC, BMI, and clinical judgement to determine adiposity so I’m not sure it’s fair to compare isolated parameters.

  2. A lot. I would advocate for 90cm for men and 80 cm for women. I don’t think WHR is useful here in isolation. If someone does not have the smaller skeleton size associated with individuals of Asian descent, then it probably makes sense to use the Europids cut-offs of 94cm for men and 80cm for women.

3

Got it, thanks! Will continue to bring my own WC/WHR down.