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Background <p>For physically demanding job standards, simple anthropometric screening tools are useful. Using military personnel as a model, this study evaluated waist-to-height ratio (WHtR) for its relationship with health and performance indicators.</p> Methods <p>Data were analyzed from 2153 active-duty U.S. Marines (1421 men; 732 women). Relationships were assessed between WHtR, a circumference-based “tape test” (TT), body mass index (BMI), and a criterion measure of dual-energy X-ray absorptiometry (DXA)-derived percent body fat (%BF). Associations between WHtR and physical readiness were evaluated using composite scores from the Physical and Combat Fitness Tests (PFT, CFT), and individual performance metrics (pull-ups, crunches, 880-yard sprint time, 3-mile run time, ammo can overhead lifts).</p> Results <p>WHtR was strongly correlated with DXA %BF (<i>r</i> = 0.754, <i>p</i> &lt; 0.001, men; <i>r</i> = 0.677, <i>p</i> &lt; 0.001, women) and moderately negatively with PFT (<i>r</i> = −0.33, <i>p</i> &lt; 0.001) and CFT (<i>r</i> = −0.30, <i>p</i> &lt; 0.001) scores for men. A graded decline in physical fitness scores was observed with increasing WHtR, with a clear inflection in performance outcomes occurring between WHtR values of approximately 0.48–0.50. Receiver Operating Characteristic (ROC) analysis to identify high %BF showed the TT (AUC: 0.889 men, 0.876 women) performed better than WHtR (AUC: 0.851 men, 0.848 women) and BMI.</p> Conclusions <p>WHtR is a simple and effective screening tool to identify personnel at potential risk for poor performance outcomes. These findings support use of WHtR as a screening metric and a potential replacement for traditional height-weight screening tables, with a pragmatic threshold of 0.50 to identify individuals who may benefit from secondary assessment, such as from multi-frequency bioelectrical impedance analysis.</p>

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A waist-to-height ratio of 0.50 marks declining physical performance in active adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月30日

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  • Adam W. Potter,
  • Christy L. Christopoulos,
  • Lynn Cialdella-Kam,
  • Karl E. Friedl

摘要

Background

For physically demanding job standards, simple anthropometric screening tools are useful. Using military personnel as a model, this study evaluated waist-to-height ratio (WHtR) for its relationship with health and performance indicators.

Methods

Data were analyzed from 2153 active-duty U.S. Marines (1421 men; 732 women). Relationships were assessed between WHtR, a circumference-based “tape test” (TT), body mass index (BMI), and a criterion measure of dual-energy X-ray absorptiometry (DXA)-derived percent body fat (%BF). Associations between WHtR and physical readiness were evaluated using composite scores from the Physical and Combat Fitness Tests (PFT, CFT), and individual performance metrics (pull-ups, crunches, 880-yard sprint time, 3-mile run time, ammo can overhead lifts).

Results

WHtR was strongly correlated with DXA %BF (r = 0.754, p < 0.001, men; r = 0.677, p < 0.001, women) and moderately negatively with PFT (r = −0.33, p < 0.001) and CFT (r = −0.30, p < 0.001) scores for men. A graded decline in physical fitness scores was observed with increasing WHtR, with a clear inflection in performance outcomes occurring between WHtR values of approximately 0.48–0.50. Receiver Operating Characteristic (ROC) analysis to identify high %BF showed the TT (AUC: 0.889 men, 0.876 women) performed better than WHtR (AUC: 0.851 men, 0.848 women) and BMI.

Conclusions

WHtR is a simple and effective screening tool to identify personnel at potential risk for poor performance outcomes. These findings support use of WHtR as a screening metric and a potential replacement for traditional height-weight screening tables, with a pragmatic threshold of 0.50 to identify individuals who may benefit from secondary assessment, such as from multi-frequency bioelectrical impedance analysis.