Why the simple waist-to-height ratio is a powerful health measurement

April 17 2017 by in Dr. Ted Naiman, Insulin

The waist-to-height ratio is a great predictor of a person’s level of insulin resistance. The test can predict your risk for developing diseases linked to excessive insulin, like type 2 diabetes and heart disease.

Above is a great infographic by Dr. Ted Naiman explaining the concept.

The test is also basically free and anyone can do it at home. Not sure how to measure? Check out the picture below:

How to measure

So now you’ve calculated the results – and want to know what the results mean. Dr. Naiman has got you covered. Ideally, aim for a waist-to-height ratio of less than 0.5:

Recommendations and examples

Personally I’m at a ratio of 0.44 today – though some may consider it unfair as I’m 6’7″…

Do you want to share your result? Feel free to do so in the comments below.

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32 comments

1
Kate
April 17 2017
Waist measurement in cm, divided by Height in cm, equals Ratio.
2
J. Lance De Foa, MD
April 17 2017
I first read about this on Dr. Jason Fung's blog and started using it with my patients and myself in October 2016. When I saw I had 7 cm excess circumference I stopped buying donuts "for the clinic". From the patient's height I calculate the target waist. For women with a waist narrowing I measure the narrowest spot. For those without, and for most men I measure the widest, around the "love handles" and often crossing the umbilicus. That way it is easier to measure improvement. Most have waists above 1/2 their height. Most also have elevated fasting insulin & elevated glucose or A1c. I give out a sheet with the DietDoctor.com visual guides. Every day in clinic SOMEONE is narrowing and losing weight.
3
John
April 17 2017
I belive it should consider the measurement not only of the belly as it does but also the hip, some people just have thicker bones and structures. I know people that are short without any belly at all but with strong structure.
This is a good general rule, but with lots of room for improving.

Reply: #34
4
Popi
April 18 2017
There's different body shapes and bone structures! A simple ratio tells only a small part of the story

Reply: #24
5
Rebecca
April 19 2017
I am 5ft 3 and waist measures 31 inches. I have been doing the low carb diet for 3-4 months..(very diligently) and my waist has not changed I did drop 5 pounds though. I am in ketosis (I measure every morning). And now when I do the math.. seems I am at risk. Any comments, suggestions?
Thanks.

Rebecca
6
Lora
April 19 2017
Quick calculator for waist to height
https://www.health-calc.com/body-composition/waist-to-height-ratio
7
Markus
April 19 2017
Cant be right this. Accordning to this im apparently obese!?
Im a bit over weight but not that fat! Hahaha...not buyin it...
8
Lori Hope
April 19 2017
When I was first diagnosed a rather overweight Nurse told me that I had 'Truncal Obesity'
9
Peggy Holloway
June 9 2017
.44 so I'm OK. 64 years old and 17+ years on LCHF seems to be working.
10
Geoff
June 9 2017
I don't know exactly what 'Truncal Obesity' is but I do see a lot of people wearing wide untucked tops to cover their trunks. If this test is true than our USA Obesity may be higher than published standards.
11
Claire
June 9 2017
.42 so that's equivalent to a female swimmer. (I'm female and 42 years old) Is that ok? Where's the info that tells you what's ok and what's not?

Reply: #27
1 comment removed
13
Kathleen
June 9 2017
Actually, the ratio is the same whether you measure in cm or inches.
14
Ann
June 9 2017
0.39 - not bad for a 53 year old mum!
1 comment removed
16
NancyJ
June 10 2017
Diana, this is a ratio. If you measure waist in inches then measure height in inches. If you measure waist in cm then measure height in cm. The ratio will be the same.
17
Cathy
June 11 2017
Diana you mention 0.8 and 0.9 - that is Waist to Hip ratio recommendations. This article refers to Waist to Height ratio. 5'5" (65") tall person with a waist of 32.5" has a ratio of 0.5. In cm that would be 165cm tall with 82.5cm waist - also 0.5 ratio.
18
Anneleen
July 24 2018
I have very wide hips, I can feel the bone if I press lightly, I think I am not so far away from my ideal weight as a 35 year old woman with my bone structure. But this test shows I am at risk. A person with small hips and a big belly could have a better result because of narrow hips, so for me, this test is incomplete.
19
Ian
December 18 2018
A pity you refer to "waist measurement" when you mean "circumference at iliac crest level". I'm guessing those are the actual measurements in your reference table. It would help if you edited the article to make this much clearer. One's waist is higher than the iliac crest level, in both men and women. And if "waist x 2" was an ideal rule of thumb, a very healthy woman with a 24" waist would be only 4 ft tall!

Reply: #28
20
Dee
January 6 2019
So I find the instructions quite confusing. I actually am apple shaped and short- 5'1.5 inches. I have diabetes - my blood sugar is fairly regulated without medication. But I've always had a larger waist measurement and my hips are narrower. Currently I am about 10 pounds overweight after losing a lot, but even at my "goal" weight at 67 years old, my waist measurement would put me at risk between 53-54 % or so. That probably was true even when I was 20 years old! (well, maybe not then, I don't know-I was so skinny then!). Also, I have extra skin (not actual fat that can be reduced by much at this point, but skin) from losing weight which makes it harder to get an accurate measurement as the skin takes up space. I find myself worried and confused. Currently I weight 137 and I find it is difficult to get lower than 128 and even then it is very hard to maintain.
21
Dee
January 6 2019
Oh, and my waist measurement is around 33.5 ish but that is at my natural waist-I don't understand the instructions - if i moved the tape down to hip bone it would be even higher!
22
Kell
February 25 2019
Says I'm obese, not even on your chart! And I'm not! Rubbish!
23
Rebecca
March 30 2019
I think this is limited in utility, especially for women. I have a VERY short waist--less than 2 inches from top of hip bone to lowest rib, and both rib cage and hips are large. All those internal organs have to fit somewhere. I found Teresa Tapp's analysis of body types super helpful here. I will never have a tiny waist because of body structure. (Although I have long, long legs.) But long waisted women can get tiny waists... And their fat tends to settle on their thighs. Would love to see this take bone structure into account. It's just nonsensical that someone with my body structure would be compared to a long waisted person.
24
Reply to comment #4 by Popi
Anneleen
June 5 2019
I feel the same way.
I'm 162cm, SW 65,5kg, CW 57kg, waist 90cm so ratio is 5,5. I do have wide hips but I'm still concerned...
25
jenny
July 11 2019
Interesting such measuring can give idea of insulin resistance, wonderful.

MAY I ENQUIRE MY OWN STATUS....

I am 166cm HEIGHT WAIST 81cm still able to get finger under the tape measure so about 80cm in reality... so I guess I would be around 0.4.9????? saved by the bell, just within the limits yes or no?
26
Chris
August 1 2019
Down from 0.8 to 0.61 over the past eight months and a half. I still need to lose at least 12 cms (+/- 12kgs) to reach an almost healthy level.
I am 165 cm tall and current weight is 86 kgs (coming from 116!). Not a bad result for a post-menopausal 54 years young, very motivated DD-fan :-) I wish you all the best, and thanks for this enlightening article.
27
Reply to comment #11 by Claire
Ol' Will
December 31 2019
Claire, At the end of the article is the sentence: "Ideally, aim for a waist-to-height ratio of less than 0.5". This is followed by a chart under the heading: "Recommendations and examples". It has several examples.
28
Reply to comment #19 by Ian
Ol'Will
December 31 2019
Ian, Almost at the end of the article is the statement: "Ideally, aim for a waist-to-height ratio of less than 0.5". It doesn't say that 0.5 is the ideal ratio. Basically, it's saying the currently recognized cut off between "healthy" and "not healthy" is 0.5. Within reason, lower is good, meaning a smaller waist. Your theoretical babe with the 24" waist is in the "good" zone if she's 48" tall or taller. :-)
29
Sam
January 4 2020
Measure your height. Divide by two. That's your number. If you can comfortably get that number out of a measuring tape wrapped horizontally anywhere around your midsection, you're in good shape. Otherwise, head for a keto diet to get rid of some visceral fat.
30
aleezah2000
August 12 2020
0.47 at 6'1, still fasting.
54th day of consecutive 25hrs fasts, with one 48hrs and three 36hrs in this time since 19 Jun. Me n my wife both r doing the same together.
31
George P
September 4 2020
Used to be known as the 'Ashwell Ratio'
32
Elizabeth Link
January 28 2021
Mine is 3.8
33
earthtojai
February 13 2021
Your 'where to measure' info is different than a piece of research about this in 2017. They measured halfway between the iliac crest and the bottom of the rib cage. As a woman I get a waist circumference that varies from 31 inches at narrowest part, and 37 inches at the navel. Using the between iliac crest and bottom of rib cage measurement it is 33 inches which is under 0.5.

I noticed doing the measurement on my husband, (due to non-childbearing hips) his iliac crest is higher up. All of this makes it tricky to know if the result your getting is the true one doesn't it? - link below

https://www.researchgate.net/publication/316515880_Prediction_of_whol...
34
Reply to comment #3 by John
Bruce
November 20 2022

I belive it should consider the measurement not only of the belly as it does but also the hip, some people just have thicker bones and structures. I know people that are short without any belly at all but with strong structure.
This is a good general rule, but with lots of room for improving.

There is a calculation of height to hip ratio also. But it's not as accurate as this for predicting insulin resistance. This measurement is backed by numerous studies.

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