What is the waist-hip ratio?
Meaning, thresholds and health risks explained simply
The waist-hip ratio (WHR) is a simple yet meaningful measure for assessing body fat distribution and the associated cardiovascular risk. While BMI only captures the relationship between weight and height, the WHR takes into account where fat is stored – and that is exactly what matters for health. Fat in the abdominal area (visceral fat) is metabolically active and is linked to a significantly higher risk of cardiovascular disease, type 2 diabetes and high blood pressure than fat on the hips and thighs.
Calculating the WHR is straightforward: waist circumference (cm) divided by hip circumference (cm). For a person with an 80 cm waist and a 100 cm hip, the WHR is 0.80. The WHO thresholds are 0.90 for men (increased risk from 0.91) and 0.85 for women (increased risk from 0.86). These values are based on extensive population studies and are used internationally as a standard screening tool.
Visceral abdominal fat differs from subcutaneous fat not only in its location but also in its function. It produces pro-inflammatory messenger substances (adipokines) and free fatty acids that travel directly into the portal vein and from there into the liver. This promotes insulin resistance, raises blood pressure and worsens the cholesterol profile. Studies show that people with a high WHR have up to a threefold increased risk of heart attack, independent of BMI.
Compared with waist circumference alone, the WHR has the advantage of accounting for body proportions: a large-framed person with wide hips can have a waist circumference similar to that of a smaller-framed person, yet still carry a lower relative risk. The WHR usefully complements BMI and waist circumference and is recommended by the WHO for cardiometabolic risk screening.