Waist-to-height ratio

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]

Not to be confused with Waist–hip ratio.
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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] However, a 2011 study that followed 60,000 participants for up to 13 years found that waist–hip ratio (when adjusted for BMI) was a better predictor of ischemic heart disease mortality than WHtR.[3]

Conversely, WHtR was not a predictor for new-onset diabetes melitus 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] For people under 40 the critical value is 0.5, for people aged 40–50 the critical value is between 0.5 and 0.6, and for people over 50 the critical values start at 0.6.[6]

Health implications

The following table categorises the boundaries for ratios in terms of their health implications: [7][8]

Children (up to 15)MenWomenCategorisationExamples
<=0.34<=0.34<=0.34Extremely SlimMarilyn Monroe (0.3359)
0.35 to 0.45 0.35 to 0.42 0.35 to 0.41 Slim
0.46 to 0.510.43 to 0.520.42 to 0.48HealthyFemale College Swimmer (0.4240)
Male College Swimmer (0.4280)
Body Builder (0.4580)
0.52 to 0.630.53 to 0.570.49 to 0.53OverweightFemale at increased risk (0.4920)
Male at increased risk (0.5360)
0.58 to 0.620.54 to 0.57Very Overweight
0.64 => 0.63 =>0.58 =>Obese

See also

References
  1. CM Lee, Huxley RR, Wildman RP, 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.CS1 maint: uses authors parameter (link)
  2. Schneider; et al. (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. PMC 3115050. PMID 21461943.
  4. Ren-Jieh Kuo; et al. (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, et al. (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. "Waist-Height Ratio Better Than BMI for Gauging Mortality". 18 Jun 2013. Retrieved 7 April 2016.
  7. 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. S2CID 7290185.CS1 maint: uses authors parameter (link)
  8. Schneider, H.J. (2010). "The predictive value of different measures of obesity for incident cardiovascular events and mortality". The Journal of Clinical Endocrinology and Metabolism. 95 (4): 1777–85. doi:10.1210/jc.2009-1584. PMID 20130075.CS1 maint: uses authors parameter (link)
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