Medicine:Waist-to-height ratio

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Short description: Numerical index of body proportion

A person's waist-to-height ratio (WHtR), also called waist-to-stature ratio (WSR), is defined as their waist circumference divided by their height, both measured in the same units. The WHtR is a measure of the distribution of body fat. Higher values of WHtR indicate higher risk of obesity-related cardiovascular diseases; it is correlated with abdominal obesity.[1]

A 2010 study that followed 11,000 subjects for up to eight years concluded that WHtR is a much better measure of the risk of heart attack, stroke or death than the more widely used body mass index.[2] A 2011 study that followed 60,000 participants for up to 13 years found that, after adjustment for attained age, waist–hip ratio, especially if adjusted for BMI, was a better predictor of ischemic heart disease mortality than WHtR, and either is better than BMI alone.[3]

Conversely, WHtR was not a predictor for new-onset diabetes mellitus in at least one study.[4]

A WHtR of over 0.5 is critical and signifies an increased risk; a 2010 systematic review of published studies concluded that "WHtR may be advantageous because it avoids the need for age-, sex- and ethnic-specific boundary values".[5] In April 2022, the UK's National Institute for Health and Care Excellence (a government body) proposed new guidelines which suggested that all adults "ensure their waist size is less than half their height in order to help stave off serious health problems".[6] In September 2022, NICE formally adopted this guideline.[7]

See also


  1. Lee, C M; Huxley, R R; Wildman, R P; Woodward, M (July 2008). "Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis'". Journal of Clinical Epidemiology 61 (7): 646–653. doi:10.1016/j.jclinepi.2007.08.012. PMID 18359190. 
  2. Schneider (2010). "The predictive value of different measures of obesity for incident cardiovascular events and mortality.". The Journal of Clinical Endocrinology & Metabolism 95 (4): 1777–1785. doi:10.1210/jc.2009-1584. PMID 20130075. 
  3. Mørkedal, Bjørn; Romundstad, Pål R; Vatten, Lars J. (2011). "Informativeness of indices of blood pressure, obesity and serum lipids in relation to ischaemic heart disease mortality: the HUNT-II study". European Journal of Epidemiology 26 (6): 457–461. doi:10.1007/s10654-011-9572-7. ISSN 0393-2990. PMID 21461943. 
  4. Ren-Jieh, Kuo (2011). "Inability of waist-to-height ratio to predict new onset diabetes mellitus among older adults in Taiwan: A five-year observational cohort study". Archives of Gerontology and Geriatrics 53 (1): e1–e4. doi:10.1016/j.archger.2010.05.005. PMID 20627333. 
  5. Browning, Lucy M (2010). "A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value.". Nutrition Research Reviews 23 (2): 247–69. doi:10.1017/S0954422410000144. PMID 20819243. 
  6. Gregory, Andrew (8 April 2022). "Ensure waist size is less than half your height, health watchdog says". The Guardian. 
  7. "Obesity: identification, assessment and management | Clinical guideline [CG189"]. National Institute for Health and Care Excellence. 8 September 2022.  Recommendations 1.2.11 and 1.2.12

Further reading

  • Ashwell, M.; Gunn, P.; Gibson, S. (2012). "Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis.". Obesity Reviews 13 (3): 275–286. doi:10.1111/j.1467-789X.2011.00952.x. PMID 22106927. </ref>