WHR Risk Categories (WHO)
A 2008 WHO expert consultation, published in 2011, set the waist-to-hip ratio and waist circumference points at which the risk of metabolic complications is substantially increased in European-origin adults.
| Measure | Men | Women | Risk of metabolic complications |
|---|---|---|---|
| Waist circumference | over 94 cm (37 in) | over 80 cm (31.5 in) | Increased |
| Waist circumference | over 102 cm (40 in) | over 88 cm (34.6 in) | Substantially increased |
| Waist-to-hip ratio | 0.90 or more | 0.85 or more | Substantially increased |
The WHO report notes that suitable cut-off points differ between populations, and that several Asian populations show higher risk at a smaller waist. Treat the numbers as a guide, not a bright line.
Waist-to-height ratio bands (NICE)
| Waist-to-Height Ratio | Assessment |
|---|---|
| < 0.40 | Below the healthy band; check your BMI, low values can point to underweight |
| 0.40 - 0.49 | Healthy central adiposity, no increased health risk |
| 0.50 - 0.59 | Increased central adiposity, increased health risk |
| 0.60 or more | High central adiposity, further increased risk |
NICE says these bands can be used for adults of both sexes and all ethnicities with a BMI under 35, including people with high muscle mass. The simple rule behind them, from Margaret Ashwell's work, is "keep your waist to less than half your height".
Formulas and a worked example
WHR = waist ÷ hips
WHtR = waist ÷ height (same units for both)
Worked example. A woman 165 cm tall with an 84 cm waist and 102 cm hips. WHR = 84 ÷ 102 = 0.82, under the WHO cut-off of 0.85 for women. WHtR = 84 ÷ 165 = 0.51, just into NICE's increased band. Her waist is also over the WHO's 80 cm "increased" point. Taking her waist down to 82.5 cm, half her height, would bring the ratio to 0.50.
The example shows why it helps to look at more than one number: her hips make the WHR look fine, while her waist against her height says otherwise.
WHR vs WHtR vs BMI - Which is Best?
Research consistently shows that abdominal fat distribution predicts cardiovascular and metabolic disease better than BMI alone. A 2012 meta-analysis by Ashwell, Gunn and Gibson found waist-to-height ratio a better screening tool than waist circumference or BMI for cardiometabolic risk factors in adults.
| Metric | Looks at belly fat | Accounts for Height | Simple Rule |
|---|---|---|---|
| BMI | No | Yes | 18.5-24.9 is healthy |
| WHR | Yes | No | Under 0.9 men / under 0.85 women |
| WHtR | Yes | Yes | Under 0.5 (waist less than half height) |
Apple and pear shapes
People who store more fat around the waist are often called apple-shaped, and those who store it on the hips and thighs pear-shaped. Fat deep in the abdomen, around the organs, is the type most linked to type 2 diabetes and heart disease, which is why a high waist-to-hip ratio matters more than the number on the scale. The calculator labels you apple-shaped when your WHR reaches the WHO cut-off for your sex.