What are the normal waist circumference, hip circumference, and waist‑to‑hip ratio for healthy adult Asian‑Pacific men and women?

Normal Waist, Hip, and Waist-Hip Ratio Values for Asia-Pacific Populations

For Asia-Pacific populations, the normal waist circumference thresholds indicating elevated cardiometabolic risk are ≥90 cm for men and ≥80 cm for women, with waist-to-hip ratio cut-offs of ≥0.95 for men and ≥0.80 for women. 1, 2

Waist Circumference Standards

Asia-Pacific Cut-Off Points

• Men: Waist circumference ≥90 cm indicates elevated cardiometabolic risk 1
• Women: Waist circumference ≥80 cm indicates elevated cardiometabolic risk 1

These thresholds are significantly lower than Caucasian standards (≥102 cm for men, ≥88 cm for women) because Asian populations develop metabolic complications at lower levels of adiposity 2, 3, 4

Country-Specific Variations Within Asia

Some East Asian countries use different cut-points:

• Japan: ≥85 cm (men), ≥90 cm (women) 1
• China: ≥85 cm (men), ≥80 cm (women) 1
• Indonesia: May require even lower cut-points tailored to specific ethnic groups 1

Measurement Technique

Measure waist circumference at the midpoint between the superior iliac crest and the lower margin of the last rib, in a horizontal plane 1, 3

Waist-to-Hip Ratio Standards

Standard Cut-Off Points

• Men: Waist-to-hip ratio ≥0.95 indicates high cardiovascular risk 2
• Women: Waist-to-hip ratio ≥0.80 indicates high cardiovascular risk 2

These values are derived from European Society of Cardiology recommendations but apply to risk assessment across populations 2

Important Clinical Caveat

Waist circumference alone is superior to waist-to-hip ratio for predicting cardiovascular risk, though it may be more prone to measurement error 2. The European Society of Cardiology recommends using waist circumference as the primary anthropometric measure rather than waist-to-hip ratio 2

Hip Circumference

No specific "normal" hip circumference values are established in isolation for Asia-Pacific populations. Hip circumference is measured as part of calculating waist-to-hip ratio but is not used independently as a risk marker 2, 4

Critical Context for Asia-Pacific Populations

Why Lower Thresholds Matter

Asian populations have several unique characteristics that necessitate lower cut-points:

• Higher body fat percentage at any given BMI compared to Caucasians, with 2-3 kg/m² lower BMI for the same body fat percentage 3
• Preferential visceral fat accumulation rather than subcutaneous fat deposition 3
• Insulin resistance evident even in lean individuals, particularly in South Asians 3
• Development of metabolic syndrome and type 2 diabetes at lower BMI and waist circumference values than other ethnicities 1, 3

Clinical Application Algorithm

1. Measure waist circumference in all patients with BMI <35 kg/m² 4
2. Use Asia-Pacific thresholds (≥90 cm men, ≥80 cm women) to identify elevated risk 1
3. Screen for metabolic complications (fasting glucose, lipid panel, blood pressure) even when measurements are below traditional "obese" ranges 3
4. Consider waist-to-hip ratio as supplementary information, particularly when waist circumference is borderline 1, 2
5. Assess for obesity-related complications in combination with anthropometric findings rather than relying on measurements alone 1, 3

Common Pitfall to Avoid

Do not apply Caucasian/Western cut-off points to Asian patients 2, 3. Using standard Western thresholds (≥102 cm for men, ≥88 cm for women) will miss a substantial proportion of Asian individuals at high cardiometabolic risk who fall below these values but above Asia-Pacific thresholds 1, 3