Waist-to-Hip Ratio Calculator

Use this calculator to find your waist-to-hip ratio (WHR) to assess the health risks associated with your body fat distribution. It provides insights into the location of your body fat, distinguishing between the relatively harmless subcutaneous fat found just beneath your skin and the potentially dangerous visceral fat that accumulates around your vital organs.

What Is Waist-to-Hip Ratio?

Waist-to-Hip Ratio (WHR) is a measurement that compares the circumference of your waist to that of your hips. It's calculated by dividing your waist measurement by your hip measurement. WHR is used to assess body fat distribution and is considered a reliable indicator of health risks associated with central obesity.

Taking Waist and Hip Measurements

Use a flexible measuring tape made of non-stretchable material. Remove clothing or measure over thin, form-fitting clothing to avoid adding extra bulk. For both measurements, the tape should be wrapped snugly, parallel to the floor, without compressing the skin. Stand straight with feet shoulder-width apart, relax, and breathe normally. Avoid sucking in your stomach or flexing your muscles.

For the waist measurement, locate the midpoint between the lower edge of your last rib (bottom of the rib cage) and the top of your iliac crest (the top of your hip bone). Place the tape measure around your waist at this narrowest point. Measure at the end of a normal exhalation.

For the hip, locate the widest part of your hips or buttocks. Wrap the tape measure around the broadest point, ensuring the tape is parallel to the floor and not twisted or angled up or down.

Understanding Waist-to-Hip Ratio

The waist-to-hip ratio (WHR) has emerged as an important anthropometric measure for assessing health risks associated with body fat distribution.

WHR's ability to assess the distribution of body fat, rather than its total amount, is significant because research has demonstrated that where fat is stored in the body has profound implications for health outcomes. It indicates the relative abundance of visceral fat compared to peripheral fat and muscle, particularly in the gluteal region (also known as the buttocks).

Early Recognition of Body Fat Distribution

The concept that body fat distribution matters for health emerged from observations in the 1980s that traditional measures of obesity, such as body mass index (BMI), failed to capture significant health risks. The pioneering work that established WHR as a health indicator came from two landmark Swedish studies conducted in the mid-1980s.

The findings were revolutionary because they suggested that fat distribution might be a more accurate predictor of cardiovascular disease and mortality than overall fatness. It showed significant positive associations with the incidence of heart attack, stroke, and overall mortality. Notably, the link remained significant even after adjusting for factors such as age, BMI, smoking, cholesterol levels, triglycerides, and blood pressure.

Visceral Fat: The Metabolic Threat

Research has revealed that visceral adipose tissue, the fat that accumulates around internal organs in the abdominal cavity, is metabolically more active and potentially more dangerous than subcutaneous fat. Visceral fat releases hormones, fatty acids, and inflammatory chemicals into the body, resulting in elevated levels of cholesterol, blood pressure, blood glucose, and triglycerides.

The Protective Role of Subcutaneous Fat

Interestingly, research has shown that subcutaneous fat, particularly in the hip and thigh regions, may actually provide some protective benefits. Studies have found that subcutaneous fat can be associated with lower mortality risk in normal and overweight individuals. This finding helps explain the "obesity paradox," the observation that some overweight individuals don't show increased mortality risk when measured by BMI alone.

Development of International Standards

Health risk cut-off points have been established by The World Health Organization. For men, a waist-to-hip ratio (WHR) above 0.90 is a concern. For women, a WHR above 0.85 is a cause for concern. A WHR above 1.0 for anyone indicates a significantly higher risk.

Recognition of Ethnic Variations

Research has revealed significant ethnic differences in body fat distribution and associated health risks, leading to calls for population-specific WHR cut-offs. Asian populations, in particular, tend to accumulate visceral fat at lower BMI levels and may require different WHR thresholds.

Cardiovascular Disease Risk

The Framingham Heart Study and other primary cohorts have demonstrated that WHR shows stronger associations with cardiovascular disease mortality compared to BMI or waist circumference alone.

A particularly significant finding emerged from research showing that women with higher WHR face even greater cardiovascular risks than men with similar body fat distribution. A study of nearly half a million UK participants found that women experienced a 15% higher risk of heart attacks than men with similar waist-to-hip fat distribution.

Diabetes and Metabolic Syndrome

WHR has proven to be an excellent predictor of type 2 diabetes risk. Research consistently shows that central obesity, as measured by WHR, is more strongly associated with insulin resistance and diabetes development than general obesity. The measure is particularly valuable because it can identify individuals at high risk of diabetes, even when their BMI appears normal.

Studies have demonstrated that WHR is positively correlated with fasting blood sugar levels and changes in your blood sugar (glucose) levels after eating a meal. The association between WHR and metabolic syndrome components, including hypertension, dyslipidemia, and glucose intolerance, remains significant even after adjusting for other risk factors.

Mortality Prediction

Recent large-scale research has provided compelling evidence that WHR may be a superior predictor of mortality risk compared to BMI. A 2023 study published in JAMA Network Open, analyzing data from 387,672 participants, found that genetically determined WHR had a stronger association with all-cause mortality compared to BMI.

Gender Differences

Women typically have lower WHR values due to different fat distribution patterns, with more fat stored in the hip and thigh regions. However, when women do develop central obesity (higher WHR), they may face even greater health risks than men.

Imaging Studies

Advanced imaging techniques, including CT and MRI, have provided detailed validation of WHR's significance by directly measuring the visceral and subcutaneous fat compartments. These studies have confirmed that WHR correlates well with visceral fat measurements and that the ratio of visceral to subcutaneous fat is a key determinant of metabolic risk.

Technology and Innovation

Technologies, such as 3D body scanning and advanced imaging, are developing more accurate methods for measuring body fat distribution. These tools can improve traditional waist-to-hip ratio (WHR) measurements by providing more accurate health risk assessments.

WHR is a simple but effective method for assessing health risks. Research shows it is better than body mass index (BMI) for predicting risks of heart disease, diabetes, and mortality. As researchers learn more about obesity, WHR remains an important tool for identifying individuals at risk and guiding healthcare efforts to improve health outcomes.

Reducing Abdominal Fat

There are no proven methods or diets that can specifically target the reduction of abdominal fat through spot reduction, meaning you cannot lose fat from just your abdomen by exercising a specific muscle group or following a particular diet. However, several scientifically supported approaches can help reduce overall body fat, including abdominal fat.

• Increase Soluble Fiber Intake: Foods rich in soluble fiber (such as fruits, vegetables, legumes, oats, and barley) help you feel full longer and may reduce belly fat gain over time.
• Reduce Refined Carbs and Sugars: Limiting the intake of refined carbohydrates and sugar-sweetened beverages is linked to less abdominal fat accumulation. A John Hopkins research study found that, for the same amount of calories, those who were on a low-carb diet lost more weight than those on a low-fat diet. About the same amount of desirable lean tissue (muscle mass) was lost in both cases. This means that the fat loss percentage was higher on the low-carb diet.
• Avoid Trans Fats: Trans fats, often found in processed foods, are associated with increased abdominal fat and should be avoided.
• Choose Healthy Fats: Replacing unhealthy fats with sources like avocados, nuts, seeds, and fatty fish can support overall fat loss.
• Mediterranean Diet: Evidence supports that following a Mediterranean-style diet can help reduce abdominal fat and improve health.
• Aerobic Exercise (Cardio): Regular aerobic activity, such as brisk walking, running, or cycling, is effective at reducing overall body fat, including abdominal fat.
• Resistance Training (Strength Training): Lifting weights or performing strength exercises helps build muscle, which can increase your metabolism and aid in fat loss, including abdominal fat.
• High-Intensity Interval Training (HIIT): HIIT workouts are effective for burning calories and reducing body fat.
• Increase Daily Movement: Adding more activity throughout the day, such as walking more or taking the stairs, can help burn calories and reduce fat.
• Manage Stress: High-stress levels can lead to increased abdominal fat due to the hormone cortisol. Stress management techniques may help.
• Adequate Sleep: Poor sleep is linked to weight gain and increased abdominal fat, so prioritizing good sleep hygiene is essential.

A study found that when it comes to decreasing the amount of belly fat, aerobic exercise or aerobic exercise combined with resistance exercise (weight training) resulted in a meaningful reduction in visceral fat. As for resistance exercise alone, it demonstrated little potential for reducing visceral fat.

References:

1. World Health Organization. Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation. Geneva: WHO; 2008. https://www.who.int/publications/i/item/9789241501491
2. Yusuf S, Hawken S, Ounpuu S, et al. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005;366(9497):1640-1649. https://pubmed.ncbi.nlm.nih.gov/16271645/
3. Czernichow S, Kengne AP, Stamatakis E, Hamer M, Batty GD. Body mass index, waist circumference and waist-hip ratio: which is the better discriminator of cardiovascular disease mortality risk? Eur Heart J. 2011;32(24):3055-3062. https://pubmed.ncbi.nlm.nih.gov/21844493/