Waist-to-height ratio

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A person's waist-to-height ratio – occasionally written WHtR[a] – or called waist-to-stature ratio (WSR), is defined as their waist circumference divided by their height, both measured in the same units. This dimensionless quantity is used as a predictor of obesity-related cardiovascular disease and 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]

More than twenty-five years ago, WHtR was first suggested as a simple health risk assessment tool because it is a proxy for harmful central adiposity[2] and a boundary value of 0.5 was proposed to indicate increased risk.[3][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] In April 2022, the UK's National Institute for Health and Care Excellence (a government body) proposed new guidelines which suggested that all adults "ensure their waist size is less than half their height in order to help stave off serious health problems".[6] In September 2022, NICE formally adopted this guideline.[7]

According to World Health Organization guidance, the waist circumference is usually measured midway between the lower rib and the iliac crest.[8]


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  1. ^ Lee CM, 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.
  2. ^ Cite error: The named reference Vague-1956 was invoked but never defined (see the help page).
  3. ^ Cite error: The named reference Hsieh-1995 was invoked but never defined (see the help page).
  4. ^ Cite error: The named reference Ashwell-1996 was invoked but never defined (see the help page).
  5. ^ Browning LM, Hsieh SD, Ashwell M (December 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): 247–269. doi:10.1017/S0954422410000144. PMID 20819243.
  6. ^ Gregory A (8 April 2022). "Ensure waist size is less than half your height, health watchdog says". The Guardian. Retrieved 8 April 2022.
  7. ^ "Obesity: identification, assessment and management | Clinical guideline [CG189]". National Institute for Health and Care Excellence. 8 September 2022. Recommendations 1.2.11 and 1.2.12
  8. ^ Cite error: The named reference WHO-2011 was invoked but never defined (see the help page).