ArticleEuropean journal of clinical nutrition2026
A waist-to-height ratio of 0.50 marks declining physical performance in active adults.
Article in European journal of clinical nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFor 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.
methodsData 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).
resultsWHtR 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.
conclusionsWHtR 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.
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