Waist-to-height is a simple, accurate tool to predict your heart disease risk

Health Professional

The waist-to-height ratio is used to measure body fat distribution. A higher ratio is related to increased risk of heart disease due to abdominal obesity.

Both waist-to-height ratio and BMI are popular screening tools for health risks connected to obesity. Both methods are quick and cost efficient to use.

Researchers presenting a study with more than 2900 individuals at the 2015 European Congress on Obesity have determined waist-to-height ratio measurements to be more accurate and more efficient for identifying heart disease risk when compared to using BMI alone.

When using BMI measurements, 41% of men and 29% of women in the study were classified as “normal”, but had waist-to-height ratios above normal. Researchers determine this would equal 12% of the population being misclassified as normal if only BMI measurements were utilized to assess risk.

Participants in this study were segmented into four groups.

  1. BMI above 25 and waist-to-height ratio above 0.5
  2. BMI below 25 and waist-to-height ratio above 0.5
  3. BMI above 25 and waist-to-height ratio below 0.5
  4. BMI below 25 and waist-to-height ratio below 0.5

Individuals with low or normal BMI, but with a high waist-to-height ratio (group #2 above) had higher total cholesterol and hemoglobin A1c levels when compared to individuals with a high BMI, but lower waist-to-height ratios (group #3 above).

These findings match what researchers found in a previous 2012 meta-analysis of 300,000 adults showing waist-to-height ratio provided better risk assessment. This lead researchers to conclude waist-to-height ratio is a superior screening tool over BMI.

Average total cholesterol levels were lowest for group #4 above (BMI below 25 and waist-to-height ratio below 0.5) and average total cholesterol was highest in group #1 above (BMI above 25 and waist-to-height ratio above 0.5).

How to calculate your waist-to-height ratio

Please note that waist-to-height ratio is not the same as waist-to-hip ratio. Waist-to-hip ratio is another tool for measuring body fat distribution. The studies we’ve discussed above are in regards to waist-to-height ratio.

To find your ratio, it is important to accurately measure your waist circumference.

  • Take a measuring tape and place it directly on your skin. Do not measure your waist circumference over clothing.
  • Measure your waist horizontally halfway between your lowest rib and the top of your hipbone.
  • When you take the measurement, breathe out normally. Do not “suck it in”.

Obtaining an accurate height is best down at your doctor’s office where they have a wall-mounted measuring board. Measure your height when standing in a straight/erect position without shoes or any head gear. Do not tilt your head up.

Once you have your two measurements, divide waist circumference by height.

Example:

Waist: 36 inches

Height: 65 inches

36 divided by 65 = 0.55

While ideal ratios can vary for men versus women, the study above suggests that the healthiest ratio is less than 0.50 for both men and women.

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