What is the WHtR?
Waist-to-height ratio as a modern health indicator
The waist-to-height ratio (WHtR) is a simple body measurement index that relates waist circumference to height. The underlying rule of thumb is memorable: "Keep your waist circumference to less than half your height." For a person 180 cm tall, waist circumference should therefore stay below 90 cm – ideally below 80 cm (WHtR = 0.44). This rule applies across ages and sexes, which makes the WHtR the most universal of the three common body-fat indices (BMI, WHR, WHtR).
Research has shown that the WHtR correlates well with visceral fat (fat around the internal organs). Visceral fat is hormonally active and releases pro-inflammatory cytokines that promote insulin resistance, arteriosclerosis and metabolic syndrome. Unlike BMI, which does not distinguish between muscle and fat mass, the WHtR captures clinically relevant fat distribution. A meta-analysis of over 300,000 participants showed that the WHtR outperforms BMI and waist circumference alone in predicting cardiovascular risk factors.
Another advantage: the WHtR takes height into account. A 190 cm tall man with a 95 cm waist circumference has a WHtR of 0.50 – an elevated risk. The same waist circumference on a 160 cm tall woman results in a WHtR of 0.59 – an even more markedly elevated risk. Waist circumference alone would have rated both the same. This scaling principle makes the WHtR particularly suitable for population studies and individual risk screening.