The waist-to-hip ratio (WHR) is a quick measure of fat distribution that may help indicate a person's overall health. People who carry more weight around their middle than their hips may be at a higher risk of developing certain health conditions.
This article explains how to calculate WHR and includes a chart to help people understand their results. It also looks at how WHR ratio affects health, how a person can improve their ratio, and what else they should consider.
How to calculate waist-to-hip ratio
Waist circumference should be measured just above the belly button.
To find out their WHR, a person needs to measure both the circumference of their waist and their hips. Circumference means the distance around something.
To measure the circumference of their waist, a person should stand up straight and breathe out, then measure their waist just above the belly button with a tape measure. This should be where the waist is smallest.
Be careful not to pull the tape measure too tight, and remember to record the waist measurement before moving on to the hips.
To measure the circumference of their hips, stand up straight and wrap a tape measure around the widest part of the hips. Take the measurement where the ends of the tape measure overlap, again do not pull it too tight.
To calculate the WHR, divide the first measurement (waist circumference) by the second measurement (hip circumference). Measurements can be recorded in either centimeters (cm) or inches (in) without affecting the ratio.
For example, if a person's waist circumference is 80 cm (31.5 in) and their hip circumference is 90 cm (35.5 in) then their WHR ratio is:
80 ÷ 90 = 0.89 cm (31.5 ÷ 35.5 = 0.89 in)
What is a healthy waist-to-hip ratio?
The hips should be measured at the widest part of the hips.
According to the World Health Organization (WHO), having a WHR of over 1.0 may increase the risk of developing conditions that relate to being overweight, including heart disease and type 2 diabetes.
This may be the case even if other measures of being overweight, such as body mass index (BMI) are in normal range.
The WHO advise that a healthy WHR is:
- 0.85 or less for women
- 0.9 or less for men
The following chart shows how the WHO classify the risk of being affected by weight related health conditions according to WHR:
|Low||0.95 or lower||0.80 or lower|
|High||1.0 or higher||0.86 or higher|
How does waist-to-hip ratio affect health?
Those with a high WHR carry weight around their middle, so their body shape may be described as an "apple."
Research shows people who are "apple-shaped" are at a greater risk of certain health conditions than those who are "pear-shaped" (when the hips are wider than the upper body).
These health conditions include:
- Cardiovascular disease: One study found that abdominal obesity increased the risk of cardiovascular disease and . Another study found the WHR predicted cardiovascular disease more effectively than BMI or waist circumference. A third study found that WHR is a better indicator of risk of mortality from cardiovascular disease than waist circumference alone.
- Type 2 diabetes: A 2016 study found that an increased waist circumference was linked to an increased risk of type 2 diabetes.
- Fertility: A 2002 study found that women with a WHR of over 0.80 have a lower pregnancy rate than those with a lower WHR, regardless of their BMI.
As well as using WHR to indicate how likely someone is to develop certain health conditions; it may also be used to indicate obesity. According to WHO:
- a WHR of over 0.85 indicates obesity in women
- a WHR of over 0.90 indicates obesity in men
How to improve waist-to-hip ratio
Reducing portion size and exercising regularly are recommended to improve waist-to-hip ratio.
If a person has a high WHR and is carrying excess weight around their waist, they may be concerned about the related health risks. To reduce these risks, it is a good idea to try to lose weight.
The best way to lose weight is to consume fewer calories than are burned, usually by eating less and exercising more. Eating a healthful diet, reducing portion size, and exercising several times a week is a good place to start.
A 2011 study found that a diet high in fruit and dairy and low in white bread, processed meat, margarine, and soft drinks may help reduce abdominal fat. A doctor or nutritionist can provide further advice on how to lose weight.
While a person's WHR is a useful measure for some health conditions, it is important to remember that it is not foolproof.
People may take inaccurate measurements or make a mistake when doing the calculation. In addition, if someone has a high BMI or is less than 5 feet tall, their WHR may be less meaningful.
It is important to note that a WHR is not designed to measure the health of children and should only be used for adults.
Measuring a person's WHR is a quick way to get an indication of:
- overall health
- obesity levels
- risk of weight-related health conditions
However, as a WHR can be measured inaccurately, it should not be relied on as a sole measure of obesity or health risk.
Talking to the doctor about weight and any associated health risks is always the best way to get a more complete picture.
Waist-to-Hip Ratio Calculator
1. World Health Organization Fact sheet: obesity and overweight. Available online: http://www.who.int/mediacentre/factsheets/fs311/en/ (accessed on 5 October 2009).
2. Gill T. Epidemiology and health impact of obesity: an Asia Pacific perspective. Asia Pacific J. Clin. Nutr. 2006;15:3–14.[PubMed]
3. Low S, Chin MC, Deurenberg-Yap M. Review on epidemic of obesity. Ann. Acad. Med., Singapore. 2009;38:57–59.[PubMed]
4. Asia Pacific Cohort Studies Collaboration The burden of overweight and obesity in the Asia-Pacific region. Obes. Rev. 2007;8:191–196.[PubMed]
5. Brown WV, Fujioka K, Wilson PW, Woodworth KA. Obesity: why be concerned? Am. J. Med. 2009;122:S4–11.[PubMed]
6. Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88.[PMC free article][PubMed]
7. Yach D, Stuckler D, Brownell KD. Epidemiologic and economic consequences of the global epidemics of obesity and diabetes. Nature Med. 2006;12:62–66.[PubMed]
8. Muller-Riemenschneider F, Reinhold T, Berghofer A, Willich SN. Health-economic burden of obesity in Europe. Eur. J. Epidemiol. 2008;23:499–509.[PubMed]
9. Zhao W, Zhai Y, Hu J, Wang J, Yang Z, Kong L, Chen C. Economic burden of obesity-related chronic diseases in Mainland China. Obes. Rev. 2008;9:62–67.[PubMed]
10. Anis AH, Zhang W, Bansback N, Guh DP, Amarsi Z, Birmingham CL. Obesity and overweight in Canada: an updated cost-of-illness study Obes Rev 2009. doi: 10.1111/j.1467-789X.2009.00579.x. [PubMed]
11. WHO Technical Report Series 894 Obesity: Preventing and Managing The Global Epidemic. World Health Organization; Geneva, Switzerland: 2000. [PubMed]
12. Garrow JS. Treat Obesity Seriously—a Clinical Manual. Churchill Livingstone; Edinburgh, Scotland, UK: 1981.
13. Klein S, Allison DB, Heymsfield SB, Kelley DE, Leibel RL, Nonas C, Kahn R. Waist circumference and cardiometabolic risk: a consensus statement from Shaping America's Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Am. J. Clin. Nutr. 2007;85:1197–1202.[PubMed]
14. Wang JW, Hu DY, Sun YH, Wang JH, Wang GL, Xie J, Zhou ZQ. Obesity criteria for identifying metabolic risks. Asia Pac. J. Clin. Nutr. 2009;18:105–113.[PubMed]
15. Hsieh SD, Muto T. Metabolic syndrome in Japanese men and women with special reference to the anthropometric criteria for the assessment of obesity: Proposal to use the waist-to-height ratio. Prev. Med. 2006;42:135–139.[PubMed]
16. Vazquez G, Duval S, Jacobs DR, Jr, Silventoinen K. Comparison of body mass index, waist circumference, and waist/hip ratio in predicting incident diabetes: a meta-analysis. Epidemiologic Rev. 2007;29:115–128.[PubMed]
17. Welborn TA, Dhaliwal SS. Preferred clinical measures of central obesity for predicting mortality. Eur. J. Clin. Nutr. 2007;61:1373–1379.[PubMed]
18. Bjorntorp P. The associations between obesity, adipose tissue distribution and disease. Acta Med. Scand. Supplementum. 1988;723:121–134.[PubMed]
19. Han TS, Seidell JC, Currall JE, Morrison CE, Deurenberg P, Lean ME. The influences of height and age on waist circumference as an index of adiposity in adults. Int. J. Obes. Related Metab. Disord.: J. Int. Assoc. Study Obes. 1997;21:83–89.[PubMed]
20. Ashwell M. Obesity risk: importance of the waist-to-height ratio Nurs Stand 20092349–54.quiz 55. [PubMed]
21. Han TS, Bijnen FC, Lean ME, Seidell JC. Separate associations of waist and hip circumference with lifestyle factors. Int. J. Epidemiol. 1998;27:422–430.[PubMed]
22. Despres JP, Moorjani S, Lupien PJ, Tremblay A, Nadeau A, Bouchard C. Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease. Arteriosclerosis. 1990;10:497–511.[PubMed]
23. Despres JP. Health consequences of visceral obesity. Ann. Med. 2001;33:534–541.[PubMed]
24. Han TS, van Leer EM, Seidell JC, Lean ME. Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ. 1995;311:1401–1405.[PMC free article][PubMed]
25. James WP. Assessing obesity: are ethnic differences in body mass index and waist classification criteria justified? Obes. Rev. 2005;6:179–181.[PubMed]
26. Zhu S, Heymsfield SB, Toyoshima H, Wang Z, Pietrobelli A, Heshka S. Race-ethnicity-specific waist circumference cutoffs for identifying cardiovascular disease risk factors. Am. J. Clin. Nutr. 2005;81:409–415.[PubMed]
27. Ashwell M, Hsieh SD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int. J. Food Sci. Nutr. 2005;56:303–307.[PubMed]
28. Lee CM, Huxley RR, Wildman RP, Woodward M. Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J. Clin. Epidemiol. 2008;61:646–653.[PubMed]
29. Misra A, Wasir JS, Vikram NK. Waist circumference criteria for the diagnosis of abdominal obesity are not applicable uniformly to all populations and ethnic groups. Nutrition. 2005;21:969–976.[PubMed]
30. Obesity in Asia Collaboration. Huxley R, Barzi F, Lee CM, Lear S, Shaw J, Lam TH, Caterson I, Azizi F, Patel J, Suriyawongpaisal P, Oh SW, Kang JH, Gill T, Zimmet P, James PT, Woodward M. Waist circumference thresholds provide an accurate and widely applicable method for the discrimination of diabetes. Diabetes Care. 2007;30:3116–3118.[PubMed]
31. Huxley R, James WP, Barzi F, Patel JV, Lear SA, Suriyawongpaisal P, Janus E, Caterson I, Zimmet P, Prabhakaran D, Reddy S, Woodward M, Obesity in Asia Collaboration Ethnic comparisons of the cross-sectional relationships between measures of body size with diabetes and hypertension. Obes. Rev. 2008;9:53–61.[PubMed]
32. Deurenberg P, Deurenberg-Yap M, Guricci S. Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes. Rev. 2002;3:141–146.[PubMed]
33. WHO Expert Consultation Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–163.[PubMed]
34. Huang HM, Chan GP. Assessing obesity in children and adolescents. Hu Li Tsa Chih - J. Nurs. 2009;56:78–82.[PubMed]
35. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–1243.[PMC free article][PubMed]
36. Wang Y. Epidemiology of childhood obesity—methodological aspects and guidelines: what is new. Int J Obes Related Metab Disord: J Int Assoc Study Obes. 2004;8(Suppl 3):S21–28.[PubMed]
37. World Health Organization The WHO Child Growth Standards. Available online: http://www.who.int/childgrowth/standards/en/ (accessed on 20 October 2009).
38. World Health Organization Growth reference data for 5−19 years. Available online: http://www.who.int/growthref/en/ (accessed on 20 October 2009).
39. Garza C, De Onis M. Symposium: A New 21st-Century International Growth Standard for Infants and Young Children—Introduction. J. Nutr. 2007;137:142–143.
40. World Health Organization WHO Child Growth Standards: Growth velocity based on weight, length and head circumference: Methods and development. Available online: http://www.who.int/childgrowth/standards/velocity/tr3_velocity_report.pdf (accessed on 10 January 2010).
41. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull. World Health Organization. 2007;85:660–667.[PMC free article][PubMed]
42. Cole TJ, Flegal KM, Nicholls D, Jackson AA. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ. 2007;335:194.[PMC free article][PubMed]
43. Snijder MB, van Dam RM, Visser M, Seidell JC. What aspects of body fat are particularly hazardous and how do we measure them? Int. J. Epidemiol. 2006;35:83–92.[PubMed]
44. McTigue KM, Hess R, Ziouras J. Obesity in older adults: a systematic review of the evidence for diagnosis and treatment. Obesity. 2006;14:1485–1497.[PubMed]
45. Inelmen EM, Sergi G, Coin A, Miotto F, Peruzza S, Enzi G. Can obesity be a risk factor in elderly people? Obes. Rev. 2003;4:147–155.[PubMed]