Biomarker
Waist-to-hip ratio and waist circumference
Waist-to-hip ratio divides your waist measurement by your hip measurement. Together with waist circumference, it is the cheapest proxy available for visceral fat — the fat around your organs that drives insulin resistance and cardiovascular risk.
What it measures
Where fat sits matters as much as how much there is. Fat stored around the abdomen is metabolically active, releasing free fatty acids and inflammatory signals straight into the portal circulation. Fat on hips and thighs largely is not.
Reported in: ratio (waist ÷ hip), plus waist in cm
Reference ranges
WHO thresholds for substantially increased metabolic risk.
Waist-to-hip ratio — men
0.90 or below
Above 0.90 indicates abdominal obesity and raised metabolic risk.
Waist-to-hip ratio — women
0.85 or below
Above 0.85 indicates abdominal obesity and raised metabolic risk.
Waist circumference — men
Below 94 cm
94–101 cm increased risk; 102 cm and above substantially increased.
Waist circumference — women
Below 80 cm
80–87 cm increased risk; 88 cm and above substantially increased.
Metabolic syndrome criterion
Ethnicity-specific waist
One of five criteria, alongside raised triglycerides, low HDL, raised blood pressure and raised fasting glucose.
Laboratory reference ranges vary between analysers and populations. Always read the range printed on your own report.
What moves the number
- Visceral fat responds quickly to reduced refined carbohydrate and alcohol
- Aerobic exercise reduces waist circumference even without weight loss
- Sleep debt and chronic cortisol elevation favour abdominal storage
- Menopause shifts fat distribution from hips towards the waist
- Measurement technique — half of all variation is a badly placed tape
How Vitals uses this measurement
Vitals stores waist, hip and the derived ratio, uses waist circumference as a metabolic syndrome criterion alongside blood pressure and triglycerides, and shows the trend so you can see visceral fat move before the scale does.
Frequently asked questions
Where exactly do I put the tape?
Waist: midway between the lowest rib and the top of the hip bone, at the end of a normal breath out, tape snug but not compressing. Hips: at the widest point of the buttocks. Measure standing, without clothing over the tape.
Which is better, waist-to-hip ratio or waist alone?
Waist circumference alone is simpler and predicts cardiometabolic risk about as well. The ratio adds value when body sizes differ widely, and it is the measure the WHO thresholds above are built on.
Can it improve without weight loss?
Yes, and often does. Visceral fat is mobilised early in a lifestyle change, so the tape frequently moves before the scale.
Related biomarkers
Sources
- World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation, 2008
- Alberti KGMM et al. Harmonizing the metabolic syndrome, Circulation 2009
Educational information only, not medical advice. Discuss your own results with a qualified healthcare professional.
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