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.


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.

Are you ready to make Heart Healthy Changes into Lifelong Habits to achieve a heart healthy weight? Use this assessment to get yourself on the right path -- http://hearthealthmadeeasy.com.