Since BMI alone can’t assess a person’s overall health, waist circumference should also be measured to screen for increased visceral adiposity (fat between and around organs within the abdomen). Increased visceral adiposity is associated with cardiometabolic risk factors including high blood sugar and dyslipidemia.[1]
Guidelines from the American Association of Clinical Endocrinologists and American College of Endocrinology recommend the following cutoff values for waist circumference:[2]
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In people of European or African descent, a waist circumference of ≥37 in (94 cm) for men and ≥31.5 in (80 cm) for women is considered at risk of increased visceral adiposity.
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In people of South Asian, Southeast Asian, or East Asian descent, a waist circumference of ≥33.5 in (85 cm) for men and ≥29–31.5 in (74–80 cm) for women is considered at risk of increased visceral adiposity.
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The official guidelines from the United States and Canada have higher cutoffs than those proposed by the American Association of Clinical Endocrinologists and American College of Endocrinology: a waist circumference of ≥40 in (102 cm) for men and ≥35 in (89 cm) for women is considered at risk of increased visceral adiposity.
Similar to BMI, increased waist circumference alone does not necessarily indicate increased visceral adiposity or health status. The Visceral Adiposity Index (VAI), a relatively new index which combines waist circumference, triglycerides, and HDL cholesterol levels, may correlate more accurately with visceral adiposity dysfunction and cardiometabolic risk for some populations. However, more research is needed to establish which populations, and what the optimal cut-off values are for these populations. In the meantime, perhaps the best advice is to pay attention to all of the above to assess health status: BMI, waist circumference, and blood lipids.[3][4]