Kim, Jin Eui;
Park, Dahyun;
Lee, Dong Hoon;
Jo, Garam;
Kindred, Madison;
Jaggers, Jason;
Sui, Xuemei;
... Oh, Hannah; + view all
(2025)
Associations of body mass index, waist circumference, and weight-adjusted waist index with body composition and biomarkers: A multinational pooled analysis.
The American Journal of Clinical Nutrition
10.1016/j.ajcnut.2025.09.007.
(In press).
![[thumbnail of 1-s2.0-S0002916525005234-main.pdf]](https://discovery.ucl.ac.uk/style/images/fileicons/text.png) |
Text
1-s2.0-S0002916525005234-main.pdf - Accepted Version Access restricted to UCL open access staff until 29 March 2026. Download (9MB) |
Abstract
BACKGROUND: The widely-used anthropometric indices, such as body mass index (BMI) and waist circumference (WC), have limitations in their use as indicators of body composition. Recent studies proposed weight-adjusted waist index (WWI=WC/√(body weight)) as an alternative index for body composition but it is unclear whether WWI reflects body composition in different racial/ethnic groups. OBJECTIVE: We examined the associations of WWI, BMI, and WC with dual-energy x-ray absorptiometry (DEXA)-measured body composition, biomarkers (fasting blood glucose, HDL-cholestrol, LDL-cholestrol, triglyceride), and handgrip strength. METHODS: A multinational pooled analysis was conducted among 81,215 racially diverse participants (aged ≥20 years) with whole-body DEXA-measured body composition data in the UK Biobank, U.S. National Health and Nutrition Examination Survey (NHANES) and Korea NHANES. Weight, height, and WC were mesaured by medical staff. We performed logistic and linear regression models, adjusting for age, sex, and race/ethnicity, to estimate the associations of WWI, BMI, and WC with DEXA-measured body composition and related markers. RESULTS: WWI (highest compared with lowest quintiles) was monotonically inversely associated with the prevalence of "high fat-free/low fat mass" body composition type (odds ratio [95% confidence interval]: 0.29 [0.27, 0.30]) and was monotonically positively associated with the prevalence of "low fat-free/high fat mass" body type (3.70 [3.21, 4.26]). BMI and WC showed inverse U-shaped relationships with these body composition types. BMI, WC, and WWI were all positively associated with blood glucose and triglyceride (all P-trend<0.01) but only WWI was inversely associated with handgrip strength (P-trend<0.01). Consistent results were observed in each sex, race/ethnicity, and country. CONCLUSIONS: Our data suggest that WWI is associated with unhealthy body composition (high fat, low fat-free mass) in populations of diverse age, sex, and race/ethnicities and may serve as an alternative index to BMI and WC.
| Type: | Article |
|---|---|
| Title: | Associations of body mass index, waist circumference, and weight-adjusted waist index with body composition and biomarkers: A multinational pooled analysis. |
| Location: | United States |
| DOI: | 10.1016/j.ajcnut.2025.09.007 |
| Publisher version: | https://doi.org/10.1016/j.ajcnut.2025.09.007 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Adiposity, anthropometric, obesity, sarcopenia, sarcopenic obesity, skeletal muscle |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10214366 |
Archive Staff Only
 |
View Item |
