Waist-to-hip ratio: What is it and what does it tell you about your health?

Whether it’s a curvy hourglass figure or slim and straight model physiques, the waist and hips of women have been used for decades to highlight an ideal body shape.

While we are strongly against unrealistic body expectations, we know from more recent evidence that the waist-to-hip ratio can be a powerful tool for your health.

This has nothing to do with the pursuit of someone else’s perfection. It’s all about finding the best version of yourself and working to meet it.

So, let’s get into your waist, hips, and everything in between. Here’s how to measure your waist-to-hip ratio, why it matters, and how it compares to the world’s most popular body measure — the BMI. 

What is the waist-to-hip ratio?

The waist-to-hip ratio is a number that can be used to measure the amount of fat in your abdominal region. It can be calculated by dividing your waist circumference by your hip circumference [1][5].

There are a few different body measurements that can be used to understand how much fat is in your mid-section. Other options include your waist-to-height ratio and your waist circumference alone.

The links between belly fat and health

You might be wondering why your doctor or another health professional is so focused on your waist size. Well, the reason is — too much belly fat is known to put you at risk of certain diseases [4].

It’s not just any fat they’re worried about though; it’s a specific type known as visceral fat. This fat is found deep within your body and typically surrounds the organs.

Research tells us that visceral fat can release chemicals and hormones that are toxic to your body, leading to an increased risk of disease.

Sedentary lifestyles are known to be one of the biggest causes of visceral fat. This kind of lifestyle is super common in the modern world as we rely heavily on screens — both at work and in our leisure time [6]. 

There are also some factors outside your control, like your genetics and hormonal changes during menopause. These factors can also increase the likelihood of developing visceral fat. 

Waist-to-hip ratio vs BMI

We may have had waists and hips forever, but measuring the waist-to-hip ratio is a somewhat new idea. For over 100 years, it was BMI that ruled supreme. 

So, what’s the difference between these measurements? And why are health experts making the switch? Here’s what you need to know.

The basics of BMI

Body mass index, or BMI, is an internationally recognised system used to assess a person’s weight category and the associated health risks.

 There are 4 categories in the system [1][5]:

1. Less than 18.5 is considered underweight
2. Anything from 18.5 to 24.9 is considered a healthy weight
3. Above 25 is considered overweight
4. Above 30 is considered obese 

To calculate your BMI, the only details you need are your height and weight. You can do this with the help of your doctor or by using an online calculator.

The problems with using BMI for your health

Where do we even begin with this one? The more you unpack the BMI, the more you realise it is far from the best way to understand your health.

The history

Let’s start with its history. Originally known as the Quetelet Index, the equation was designed in 1832 to chart the average European man [5].

It was renamed the BMI in 1972 and has been used for over 50 years to categorise people’s health by weight. Despite its popularity, the BMI was never meant to be used as a medical assessment tool.

Diversity

Then there’s the fact it doesn’t fit well with diverse populations. As we said earlier, the BMI was originally designed for European men.

Recent research has found that different ethnic groups can have a higher or lower percentage of body fat than their BMI implies [1].

An emerging area of research is trying to find the right categories for diverse groups; including Asians, Africans, Australian Aboriginals, Hispanics, Pacific Islanders, and many more.

Measuring body mass

Probably the biggest problem with the BMI is that it doesn’t differentiate between different types of body mass. Your body is made up of bone, muscle and fat — all of which carry weight.

But, the BMI can’t tell the difference between these groups. So, even if your body is made from more muscle than fat — your BMI could place you in an unhealthy weight category [2]. 

The BMI also can’t tell where your body fat is distributed. This is an issue because we know that fat in certain areas, like the stomach, is more dangerous to your health than other areas [2]. 

And this is the key reason that health experts are turning toward waist measurements, like the waist-to-hip ratio. They are considered a better indicator of your body fat distribution and therefore a better predictor of its impact on your health.

How to calculate your waist-to-hip ratio

The basic steps for calculating your waist-to-hip ratio are very simple:

1. First, take your waist measurement
2. Next, take your hip measurement
3. Finally, divide your first number (waist) by your second number (hips)

The steps may be easy, but getting an accurate measurement requires a bit of finesse. Mostly, this is because experts have a debate going about where to measure your waist.

Some say it is the narrowest point of your mid-section, others suggest using your belly button as a guide.

To keep things uniform, the World Health Organization (WHO) has officially defined the waist as the midpoint between the lowest rib which you can feel and the top of the iliac crest [1].

The iliac crest is the top bone point of your hips which you can feel jutting out beneath the skin. It’s typically located a little beneath your stomach, on both sides of the body. 

Thankfully, the hips have an agreed measuring point. This is to measure around the widest part of your buttocks [1]. 

Tips for an accurate waist-to-hip ratio

The WHO also have a few tips to help you find an accurate measure of your waist-to-hip ratio. These include [1]:

• Tape measure: This should be snug around the body, but not constricting. Avoid tape measures with stretch as this can skew your results.
• Good posture: Stand with your hands by your sides and feet close together. It helps to have someone else take your measurements; such as your doctor, trusted family or friends.
• Take a deep breath: Holding your breath pushes out the stomach. Instead, take your measurements at the end of a long, deep exhale.
• Measure in the morning: Food, water, and gas can push out the stomach. The best time to measure is after fasting, such as first thing in the morning when you wake up.
• Don't suck in: It’s natural to want to suck in your stomach, but this can skew your results. Try to relax and let your stomach soften.

What is a healthy waist-to-hip ratio for women?

We’ve talked a lot about what the waist-to-hip ratio means for your health, but we haven’t yet shared the magic number to aim for.

According to the WHO, a healthy waist-to-hip ratio for women is equal to or less than 0.85. For men, this increases slightly to 0.90 [1].

It’s a good idea to keep an eye on your waist-to-hip ratio over time. Even small increases can have serious impacts on your health.

In a review of multiple studies, researchers found that for every 0.1 unit increase in the waist-to-hip ratio, your risk of serious disease went up by 20% [2]. 

How to lower your waist-to-hip ratio

If your waist-to-hip ratio is less than desirable, we want you to know it’s not the end of the world. There are lots of ways you can lose weight, plus reduce your waist and hip size.

Get more exercise

We bet you’re not surprised to know that exercise is one of the most effective methods for trimming your waist and hips.

In general, aiming for 30 minutes of aerobic exercise per day is great for your health [3][4]. You can try anything from walking to swimming, cycling, dancing, hiking, or even gardening and house chores.

Strength training is also important and experts suggest 2-3 sessions per week [3]. While most people think of weight training first, there are plenty of different strength workouts to try — such as Pilates. 

Enjoy a healthy diet 

Along with a refreshed exercise routine, you probably want to take a close look at your diet.

Avoiding excess sugars from food or beverages is a good start [4]. Next, you can replace unhealthy fats (like butter, cheese, and bacon) with healthier substitutes (like olive oil, salmon, or tofu).

As for what you should be eating, a diet high in protein and fibre has been linked to lower stomach fat [6].

Try a holistic weight loss programme

Working out and eating well may be great advice, but for many people — it’s just words. If you’re finding it hard to get started, you might benefit from a holistic weight loss programme. 

Juniper’s Weight Reset Programme is designed to motivate and guide you on a long-term weight loss journey. It combines weight loss medications (Wegovy or Mounjaro) with the tools you need for lasting change. 

Once in the programme, you’ll also gain access to a members-only app to help track your progress, unlock exclusive health education, and get informed support when you need it.

More sleep, less stress

The sweet spot for sleep and a healthy weight is the recommended 7-9 hours per night. Any more or less than this, and you’re at higher risk of developing belly fat [3].

Make sure to practice techniques to lower stress too. Not only does cortisol, the stress hormone, contribute to stomach fat — it can also lead to sleepless nights.

Cut out unhealthy habits

While there’s nothing wrong with a glass of wine at dinner or a few drinks on the weekend, too much alcohol is known to be bad for your health [4]. Keeping an eye on your drinking habits can be helpful to cut down on your stomach fat.

Another habit that it’s best to ditch is smoking. Research has found that the waist-to-hip ratio of a current smoker was around 2 units higher than people who never smoke [6].

And while smoking has been linked to a lower BMI, this is likely because of losing muscle mass — not fat.

Image credit: Pexels/Andres Ayrton