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Height and weight are now widely used as components of the body shape measure, body mass index (BMI, weight\/height<jats:sup>2<\/jats:sup>), with the height power referred to as the scaling factor, \u03b1. At present, WC is usually not adjusted for height or is expressed as WC\/height in which \u03b1 = 1. Although other \u03b1 values have been proposed, a critical review of these shape measures is lacking. Here, we examine classical pathways by which the scaling exponent for height used in BMI was developed and then apply this strategy to identify the optimum WC index characteristic of adult shape. Our analyses explored anthropometric, body composition and clinically\u2010relevant data from US and Korean National Health and Nutrition Surveys. Our findings provide further support for the WC index of WC\/height<jats:sup>0.5<\/jats:sup> as having the strongest associations with adiposity while having the weakest correlations with height across non\u2010Hispanic white and black, Mexican American and Korean men and women. The WC index, defined as WC\/height<jats:sup>0.5<\/jats:sup>, when combined with BMI, can play an important role when phenotyping adults for excess adiposity and associated health risks in research and clinical settings.<\/jats:p>","DOI":"10.1111\/obr.12947","type":"journal-article","created":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T05:48:27Z","timestamp":1568180907000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Optimum waist circumference\u2010height indices for evaluating adult adiposity: An analytic review"],"prefix":"10.1111","volume":"21","author":[{"given":"Phoenix","family":"Hwaung","sequence":"first","affiliation":[{"name":"Pennington Biomedical Research Center, LSU System  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moonseong","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Clemson University  Clemson South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Pennington Biomedical Research Center, LSU System  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangmo","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hallym University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana M.","family":"Thomas","sequence":"additional","affiliation":[{"name":"United States Military Academy  West Point New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Shepherd","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology University of Hawaii Cancer Center  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1127-9425","authenticated-orcid":false,"given":"Steven B.","family":"Heymsfield","sequence":"additional","affiliation":[{"name":"Pennington Biomedical Research Center, LSU System  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1514009"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437739.71477.ee"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.5551\/jat.18473"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.5551\/jat.12.295"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30084-1"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3345\/kjp.2016.59.11.425"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijpo.12491"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12780"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2012.201"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/86.1.82"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.110.007161"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12358"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2017.0460"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajhb.22653"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.088831"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9781139864909"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfm517"},{"issue":"4","key":"e_1_2_11_19_1","first-page":"183","article-title":"Indices of adiposity","volume":"16","author":"Billewicz WZ","year":"1962","journal-title":"Br J Prev Soc Med."},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(72)90027-6"},{"issue":"3","key":"e_1_2_11_21_1","first-page":"122","article-title":"Indices of obesity derived from body weight and height","volume":"21","author":"Khosla T","year":"1967","journal-title":"Br J Prev Soc Med."},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/03014460701732962"},{"key":"e_1_2_11_23_1","volume-title":"Human body size and the laws of scaling: Physiological, performance, growth, longevity and ecological ramifications","author":"Samaras T","year":"2007"},{"key":"e_1_2_11_24_1","unstructured":"TrefethenLN.BMI (body mass index). 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