weight-adjusted waist index (WWI)

s'nic

s'nic

Well-Known Member
Relationship to Diabetes
At risk of diabetes
I only came across this today, has anyone looked into it in any depth?

I think most people are aware that BMI as a measurement is flawed. Waist to height ratio, while useful, is also a pretty blunt tool.

It seems the weight-adjusted waist index (WWI) incorporates "the strengths of waist circumference while dampening the connection with BMI"
Apparently it deals better with different body builds and different fat distribution. A greater WWI score indicates a higher level of obesity. For the calculation a calculator or spreadsheet equation is useful.
The WWI (cm/√kg) is calculated by dividing waist circumference (cm) by the square root of weight (kg)

I found it quite hard to search for info on this because the silly internet kept throwing world war 1 stuff at me for wwi, and "weight-adjusted waist index" tends to find quite specific medical publications.

I'm happy to post links, but not all quotes below were from the results summaries, some were from the full results or discussion of the results (I dug through a fair bit of crap). Note that quotes are not provided for guidance or advice, but are purely examples from some research papers.

I started looking in relation to the liver, then followed a link for a ckd related paper, then looked for guidelines on what was a desirable wwi (or tried to)
"we determined that the WWI cut-off point used to identify NAFLD was 9.7675 in men and 9.9987 in women"
"comparison between groups suggested that participants with a WWI > 11.11 had higher rates of NAFLD and liver fibrosis"
"the prevalence of CKD considerably rose when WWI > 9.81 cm/kg"
"The optimal cutoff values of WWI for unhealthy body composition were 10.4 cm/√kg in men and 10.5 cm/√kg in women."

The link for that last one was https://onlinelibrary.wiley.com/doi/full/10.1002/jcsm.13302 dated august last year

I don't know about anyone else but an accurate waist measurement has foxed me for awhile as it varies if the tape measure is only a small amount higher or lower, and I wasn't certain exactly how high or low it should be, so I checked for the definitive waist measurement.
For an accurate waist measurement we should measure at the mid point between the bottom of the lowest rib & the top of hip bone (usually just above the belly button).

My WWI is 11.39, so I need to work on that!
 
I looked briefly into waist measurements and similar, but quickly settled on a smart bathroom weighing scales along with just eyeballing where most of the fat is on my body as an indicator of what I believe waist measurements are a proxy for - levels of visceral fat.

I went with one made by RENPHO which takes AAA batteries - currently £25 on Amazon. There are loads of competitors but chose that one at the time due the features it has vs. price. These kinds of scales can get very expensive, and as far as I can tell, the high-end ones aren't much better than the cheapest ones for most people (the most expensive ones can handle the weight of a very large person).

The RENPHO gives you body fat percentage and an indicator of visceral fat levels, along with many other metrics, though I do not at all trust that it's objectively accurate. I tested once by drinking a lot of water and watched my muscle mass and fat levels change, according to the scale. Not ideal. What it does seem to do fairly well though is indicate progress. It tells be that my BMI is now in the normal range, but my body fat percentage is still high (highlighted in red) and my skeletal muscle mass is lower than it should be. This seems to match reality - skinny arms, still have a bit of a belly. Waist measurements are probably a similar indicator of what amounts to the same thing, but standing on a scale with a phone in your hand is a lot less fiddly than trying to measure your waistline accurately I find. I doubt waist measurements are a very much better indicator than BMI relative to body fat percentage, along with just checking where that fat is on the body, even if the scale can't be trusted to measure that percentage perfectly accurately.
 
This was specifically about the medical measurement "weight-adjusted waist index" to cover the shortcomings of both bmi and waist measurement.
Though I agree the waist measurement part is too fiddly. I just measure my waist now and again, not regularly
 
s'nic said:
This was specifically about the medical measurement "weight-adjusted waist index" to cover the shortcomings of both bmi and waist measurement.
Though I agree the waist measurement part is too fiddly. I just measure my waist now and again, not regularly
Click to expand...
Yup, understood. That's what I think makes the weight-adjusted waist index a better indicator than either BMI or the waist measurement relative to height - it's a better indicator of body fat percentage and where the fat is located on the body. Low skeletal muscle mass is a risk factor for NAFLD. If I were much more muscular my BMI would be higher, my waist measurement might be largely the same, but my NAFLD risk might be lower. Weight-adjusted waist index picks that up - my waist measurement is bigger than it should be relative to my BMI - I have a bigger belly than my BMI would indicate, and while my waist measurement might not be especially high, my NAFLD risk might be higher than someone else with the same measurement relative to their height. The smart scale tells me my BMI is fine, but my body fat percentage is in the 'obese' range. I can see the fat is around my belly, so in some sense that is meaningful in the context of NAFLD risk I may still be 'obese'.
 
@PerSpinasAdAstra This is the type of thing I was looking into.
My BMI is now under 25, so that makes me a 'normal' weight (what is normal, lol 🙄). I know I still need to lose weight around my waist so I was wondering what BMI to aim for as a semi-clear target.
The WWI measurement makes it a little more clear, a waist measurement every 1-2 months isn't too irksome and will point me in the right direction.

I was just curious if others had looked into it
 
Out of curiosity I measured my waist and did the maths. My stats today are:
WWI: 11.6774 (not good)
BMI: 23.9 (fine right?)
Body fat %: 24.2 (healthy range for men my age - 11% to 21%)
Total muscle %: 72 (typical range for men my age - 73% to 86%)

So it seems the WWI metric does indeed pick up that I have an unhealthy body composition.

EDIT - I worked out the muscle % as follows (total muscle mass (Kg) / weight (Kg)) * 100. Adding up those numbers it would seem I'm 96.2% fat and muscle, which doesn't leave a lot for the rest of me 😉 Either there's something wrong with my maths, or the data from the scale, or internal organs and bone don't add up to much.
 
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Yes, I was thinking that this metric may be useful to folks here due to the potential to identify a clear target as regards the risk of NAFLD

My BMI is 24.6, but a WWI of 11.39 clearly indicates that I can't relax yet.
When I have a spare moment I may try to find if there is a medically agreed WWI to aim for in order to avoid unwanted health complications. I haven't seen any agreements on a good WWI yet
 
As regards the target for NAFLD - my thinking is that I won't try to lose more weight at this time. If my fasting blood glucose levels and triglycerides start to rise in future, an indicator that fat levels may be going up again, I'll do another round of weight loss. If I lose it all now I won't have that option in future - weight loss is the only proven way to get the fat out at this time, and if I go too low, I can't lose more without becoming unhealthily underweight. I'm going to focus instead on trying to build whatever little muscle mass I can by lifting my little weights and such. Perhaps losing the weight now would prevent NAFLD in future, though I think keeping the option open for a second depletion of liver fat might perhaps be the safer course for me.
 
A good point, but I'm nowhere near underweight atm, so I currently have a lot of wriggle room 😳
 
Hi s'nic, just wanted to say thank you. Came across your post about wwi while checking over the values in a calculator I had written and this has encouraged me to register on the forum. Looking forward to getting engaged with the community.
 
Hi, I'm glad it was useful to you. Welcome to the forum
My latest WWI would be around 11 ... so I'm moving in the right direction!
 
Problem with WWI is heading in the right direction can only be a few decimals.

11.3 myself!

I think a normal good WWI is 8.83-10.34 if I have read correctly.
 
I found it hard to find definitive values, but as indicated in my first post it did seem that under 10.5 is advisable, and under 9.8 is probably a good aim.
It seems the only people really quoting WWI atm are people doing a specific study for a specific condition.
Have you found any good links which speak of advisable WWI for the general population?
 
MrAnt said:
I think a normal good WWI is 8.83-10.34 if I have read correctly.
Click to expand...
I have not read any more than this thread but curiosity got the better of me and I did my calculation.
I always consider myself to be of “good dimensions” with a BMI close to the centre of the healthy range. So, I wasn’t overly surprised by my result.
However, it is lower than the bottom end of the range you quoted.
From your research has anything been mentioned about being too low?

I appreciate this is not most people’s findings and I also appreciate I am being lazy by asking you. So, no worries if you don’t know or think it is up to me to find out.
 
helli said:
I have not read any more than this thread but curiosity got the better of me and I did my calculation.
I always consider myself to be of “good dimensions” with a BMI close to the centre of the healthy range. So, I wasn’t overly surprised by my result.
However, it is lower than the bottom end of the range you quoted.
From your research has anything been mentioned about being too low?

I appreciate this is not most people’s findings and I also appreciate I am being lazy by asking you. So, no worries if you don’t know or think it is up to me to find out.
Click to expand...
The thing with BMI, WWI, WC, WHTR, etc is they are all approximations using some combination of height, weight and waist size. We know they don't work with every human. I have not come across anything for WWI values being too low, but I would guess the same advice would apply as for BMI. If you are at the lower end of the range then that may work for your body. One thing I have learnt is that we are all very different, all very individual and all unique individuals.
 
MrAnt said:
The authors of the paper you linked also wrote A novel adiposity index as an integrated predictor of cardiometabolic disease morbidity and mortality. In Table 1 there is a good comparison to BMI which is where I took my values from for my calculator.
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Thanks for that, it's the best indicator I've seen. For reference in this thread here's a screenshot of the table

BMI_WWI.jpg

Simply because I started looking at this as a search for a good healthy target to aim for I put the figures off the table together with the accepted BMI classifications as to under / normal / overweight.
(posting the table seems bugged, here's a screenshot I took while editing post)

bmi_wwi target.jpg

It kind of validates my thoughts that under 9.8 would be good for my personal aim - smack bang in the middle of "normal" bmi.
It also shows that BMI can't be directly translated to WWI ... my bmi is 23.63, but my WWI seems to be 11.05
so using the authors figures my bmi is ok, but my wwi is pre-obese (yes I still have a tummy to lose!)

@helli I've also seen no reference to an unhealthy wwi, so I'd assume a low wwi is fine
 
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I must be doing something wrong at 71Kg (root is 8.426) and waist circumfrance of 40cm, I get a WWI of 4.72 which indicates that I am underweight according to the charts. But I am not underweight as far as I can tell. Can anyone shed light on my error here?

Confused
 
Gwynn said:
I must be doing something wrong at 71Kg (root is 8.426) and waist circumfrance of 40cm, I get a WWI of 4.72 which indicates that I am underweight according to the charts. But I am not underweight as far as I can tell. Can anyone shed light on my error here?

Confused
Click to expand...
Have you really only got a 40cm waist? That's 16 inches in old money, which is what Victorian maidens aspired to with the help of stout whalebone corsetry (and why they were so prone to fainting).
 
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