With so many ways to measure your health, it can be downright confusing to figure out which method is the best. From BMI to waist circumference and everything in between, which measurement will really help you learn if you need to make a few healthy changes?
While each measurement tool may be useful in its own way, it’s not really a secret anymore that body mass index (BMI) isn’t the best at deciding your overall health (even though it’s been seen as the tried-and-true method for decades). This may leave you and your healthcare providers wondering what to use instead. Enter waist to height ratio.
This article will review waist to height ratio while comparing it to other tools, like BMI. It will also dive into the research and relay the most important findings from recent studies on waist to height ratio, plus tips for what you can do to maintain a healthy one.
What is waist to height ratio?
Waist to height ratio (WHtR) is an anthropometric measurement of central adiposity (or abdominal fat). Essentially, WHtR is an assessment of your waist circumference in relation to your height.
Like other anthropometric measurements, including BMI and Body Shape Index (ABSI), WHtR can be used to evaluate your overall health. It can even be used to predict your potential risk for certain health problems.1
But unlike BMI and ABSI, WHtR is thought to be easier to use. And while Dual-energy X-ray Absorptiometry (DXA) is the gold standard when it comes to measuring body composition, it’s simply too expensive for everyday use.2
Several studies have found WHtR to be more reliable than the ever-popular BMI. But, unlike WHtR, BMI doesn’t take fat distribution into account. This often leads to people with high muscle mass being categorized as obese, despite being otherwise healthy.1
And although ABSI is a better measure of body shape and overall health than BMI, the calculation is more complex. The calculation for WHtR is much more straightforward.
What does waist to height ratio say about your health?
Your waist to height ratio can tell you a lot about your health.
It should be noted, though, that WHtR alone shouldn’t be the only determinant of your health status. Your healthcare provider should use other assessments in addition to WHtR.
Researchers have found WHtR to be a better predictor of hypertension than BMI and waist circumference alone in all genders. According to one such study, the higher your WHtR, the greater your risk of hypertension.3 This relationship between WHtR and hypertension risk has also been found in people with type 2 diabetes.4
Aside from predicting hypertension, a high WHtR has also been found to be a better predictor of general health and cardiometabolic risks compared to BMI and other anthropometric measurements. One study found that those with a WHtR greater than 0.5 had higher levels of total cholesterol, triglycerides, and LDL cholesterol than those with a WHtR less than 0.5.5
Interestingly, WHtR has also been found to be a better indicator of lifespan than BMI. Researchers from England were able to correlate a higher WHtR value (greater than 0.5) to years of life lost. Basically, the study found WHtR to be a better predictor of mortality than BMI.6
How to calculate waist to height ratio
It’s fairly simple to calculate your waist to height ratio. You’ll just need a measuring tape and a calculator. To measure your waist circumference, place a flexible tape measure around your belly just above the hip bones. The tape should be snug but not compressing, and you should take the measurement after breathing out.7
Your waist to height ratio is found by dividing your waist circumference in centimeters (cm) by your height in centimeters (waist circumference (cm) / height (cm)).
If you don’t have a measuring tape in centimeters, multiply your measurements in inches (in.) by 2.54. For example, 2 in. is equal to 5.08 cm. This is found by multiplying 2 by 2.54.
Or, you can simply input your height and waist circumference in the calculator below to see your WHtR.
It is recommended to keep your waist circumference to less than half your height. A WHtR between 0.4 and 0.49 is thought to be best for reducing your risk of various health issues.1
Tips for maintaining a healthy WHtR
Obviously, you can’t change your height. But you may be able to change your waist circumference (and WHtR) if necessary.
To maintain a healthy WHtR, you’ll need to pay attention to your waist circumference and make healthy lifestyle changes as needed. Here are some tips for maintaining a healthy WHtR:
- Eat plenty of nutrient-dense foods, like lean protein, healthy fats, fruits, vegetables, whole grains, and legumes.
- Eat balanced meals and snacks throughout the day—fad diets are never the answer!
- Limit ultra-processed foods, but don’t forget to eat fun foods once in a while.
- Find an exercise routine that you enjoy and can maintain.
- Drink lots of water.
- Get enough sleep.
- Reduce stress in your life as much as possible.
- Practice mindfulness, both in general and when it comes to eating.
If you feel stuck and need help maintaining or improving your waist to height ratio, a registered dietitian or another qualified healthcare provider should have the skill set to guide you. They will combine your WHtR with other health assessments to create a plan that’s right for you.
About Brittany Lubeck
Brittany Lubeck is a registered dietitian and nutrition writer. She has a Bachelor of Science in Dietetics, a Master of Science in Clinical Nutrition, and began her career as a clinical dietitian. Brittany has always enjoyed research and loves that she can help people learn more about nutrition through her writing.
Sources:
1. Yoo, E. G. “Waist-to height ratio as a screening tool for obesity and cardiometabolic risk.” Korean Journal of Pediatrics 11, no. 59 (2016): 425-431.
2. Parente, E. B., S. Mutter, et al. “Waist-height ratio and waist are the best estimators of visceral fat in type 1 diabetes.” Scientific Reports 10 (2020): 18575.
3. Choi, J. R., S. B. Koh, & E., Choi. “Waist-to-height ratio index for predicting incidences of hypertension: the ARIRANG study.” BMC Public Health 1, no. 18 (2018): 767.
4. Moosaie, F., S. M. F. Abhari, et al. “Waist-To-Height Ratio Is a More Accurate Tool for Predicting Hypertension Than Waist-To-Hip Circumference and BMI in Patients With Type 2 Diabetes: A Prospective Study.” Frontiers in Public Health 9 (2021): 726288.
5. Ashwell, M., & S. Gibson. “Waist-to-height ratio as an indicator of ‘early health risk’: simpler and more predictive than using a ‘matrix’ based on BMI and waist circumference.” BMJ Open 3, no. 6 (2016): e010159.
6. Ashwell, M., L. Mayhew, et al. “Waist-to-Height Ratio Is More Predictive of Years of Life Lost than Body Mass Index.” PLoS One 9, no. 9 (2014): e103482.
7. “Assessing Your Weight.” U.S. Department of Health and Human Services. CDC.gov.
