Waist-to-height ratio should be used as a screening tool for early health risks

March 16, 2016
Credit: kurhan / Shutterstock.com

Waist-to-height ratio is a simpler and more predictive indicator of the 'early heath risks' associated with central obesity than the complex 'matrix', based on BMI and waist circumference (WC), currently used by Public Health England (PHE).

Research published today in BMJ Open found that 35% of adults judged to be OK using the current PHE 'matrix' were found to have higher levels of some cardio metabolic risk factors when using the waist-to-height ratio (WHtR). These risk factors can be early indicators of health problems including diabetes, heart disease or stroke.

Dr Margaret Ashwell, Senior Visiting Fellow at Cass Business School and her colleague Sigrid Gibson, analysed data from the UK National Diet and Nutrition Survey (NDNS) between the years 2008 to 2012. 

They found that using a simple boundary value for WHtR of 0.5 identifies more people at 'early health risk' than the more complex 'matrix' favoured by Public Health England which uses boundary values for Body Mass Index (BMI) and waist circumference (WC).

The PHE 'matrix' only considers people to be at increased risk if they have both a BMI>25 and a high waist circumference. However people of a normal weight with a high can still be at risk.

The research showed that adults with a high WHtR (>0.5) had higher levels of some cardio metabolic , even after adjusting for BMI. In fact 35% of adults judged to be OK by the 'matrix' were at higher risk.

Ashwell and Gibson argue that WHtR may be a simpler and more predictive indicator of the 'early heath risks' associated with central obesity. Dr Ashwell commented:

"WHtR is a simple primary screening risk assessment tool that identifies more people at 'early health risk' than a 'matrix', which uses a combination of BMI and WC. We recommend that the 'matrix' be amended to show that having a high WC even in the 'healthy' range of BMI, carries 'increased' risk. Indeed, we believe that serious consideration should be given to the use of WHtR to replace the '' completely."
Measuring WHtR offers a simple approach as only a piece of string is required. The adult's or child's height is measured by the string, the string is then folded in half and if it doesn't fit around their waist, that person's health should be monitored.

A 2014 study by researchers at Cass Business School showed that the years of life that people lose through being obese can be better predicted by measuring waist-to-height ratio (WHtR) than by using the conventional Body Mass Index (BMI).

Based on their research, Professors Ben Rickayzen and Les Mayhew urged policymakers to adopt the measurement - waist divided by height - to replace BMI in primary screening.

Commenting on the latest research, they said: "This study provides new evidence that official advice on obesity is fostering complacency when people should be taking more action to watch their waistline".

Explore further: The secret to a longer life keeping your waist to less half you height, study suggests

More information: Margaret Ashwell et al. Waist-to-height ratio as an indicator of 'early health risk': simpler and more predictive than using a 'matrix' based on BMI and waist circumference, BMJ Open (2016). DOI: 10.1136/bmjopen-2015-010159

Related Stories

The secret to a longer life keeping your waist to less half you height, study suggests

September 10, 2014
(Medical Xpress)—Keep your waist trimmer than half your height and you could significantly boost your life expectancy.

Study examines use of waist measures among overweight and obese adolescents

April 2, 2012
Waist measures (waist circumference, waist to height ratio) in conjunction with body mass index appear to be associated with lipid and blood pressure assessments among overweight and obese adolescents, according to a report ...

Waist circumference linked to diabetes risk, independently of body mass index

June 5, 2012
A collaborative re-analysis of data from the InterAct case-control study conducted by Claudia Langenberg and colleagues has established that waist circumference is associated with risk of type 2 diabetes, independently of ...

BMI and waist circumference are frequently discordant

January 19, 2015
(HealthDay)—Body mass index (BMI) and waist circumference (WC) are frequently discordant, generally because of variability in visceral adiposity (VAT) within BMI categories, according to a study published in the Feb. 1 ...

How much weight do you really need to lose?

July 21, 2015
Most people are aware that being overweight and sedentary is commonly associated with being unhealthy. This has spurred a growth in the sales of fitness trackers with 25 million being sold globally last year. Fitness trackers ...

Large waist linked to poor health, even among those in healthy body mass index ranges

March 12, 2014
Having a big belly has consequences beyond trouble squeezing into your pants. It's detrimental to your health, even if you have a healthy body mass index (BMI), a new international collaborative study led by a Mayo Clinic ...

Recommended for you

Kids with weight issues at high risk of emotional and behavioural problems

August 10, 2017
A new, in-depth study of New Zealand children and teenagers seeking help with weight issues has found their emotional health and wellbeing is, on average, markedly worse than that of children without weight issues.

Study finds 90 percent of American men overfat

July 24, 2017
Does your waist measure more than half your height?

Are sugary drink interventions changing people's behaviour?

July 19, 2017
An evaluation of efforts designed to reduce how many sugary drinks we consume shows some success in changing younger people's habits but warns they cannot be the only way to cut consumption.

Young adult obesity: A neglected, yet essential focus to reverse the obesity epidemic

July 18, 2017
The overall burden of the U.S. obesity epidemic continues to require new thinking. Prevention of obesity in young adults, while largely ignored as a target for prevention and study, will be critical to reversing the epidemic, ...

Weight gain from early to middle adulthood may increase risk of major chronic diseases

July 18, 2017
Cumulative weight gain over the course of early and middle adulthood may increase health risks later in life, according to a new study led by researchers from Harvard T.H. Chan School of Public Health. They found that, compared ...

Study finds children carry implicit bias towards peers who are overweight

June 23, 2017
Even children as young as 9 years old can carry a prejudice against their peers who are overweight, according to a new study led by Duke Health researchers. They might not even realize they feel this way.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.