Waist to Hip Ratio Gets it Right

February 27, 2022

Waist to Hip Ratio Gets it Right


If it isn't one humiliation after another? But as we get older, we get saggy in all the wrong places and start to put on tummy fat. It's a very expensive test to do a body fat measurement with a DEXA scan. And the BMI (Body Mass Index) that has been our time-honored method of measurement just plain has flaws. Too many folks with good muscle mass look like they are obese on BMI. (Method to calculate BMI: (Wt in lbs)/(Height in inches*(Height in inches) all times 703. Under 25 is considered goal. Over 30 is obese. Under 19 is too skinny. Sweet spot, supposedly 22). That leads to some general skepticism.


Belly fat is dangerous stuff. We now know that you release a whole slew of inflammatory cytokines from that fat which makes your belt size bigger. Whether it be from the effect of the inflammatory foods we eat and therefore react to, or from the nature of fat cells in your belly fat, we aren't too sure. We do know that metabolic syndrome is partially defined by that too. Men should have a waist size under 40 inches, women 35 by those criteria.

Well, now we have proof that there is a better method that is just as easy to do. In fact, easier. All you need is a tape measure and a private bathroom. Measure your tummy around your waist at the level of your belly button just after breathing out, completely relaxed. Then, measure your hips at their widest place. Divide tummy circumference by hip circumference. Your goal is to have Men at < 0.9 and Women at < 0.85. 

The proof comes from the American Heart Association Journal publishing the results of the MONICA Risk, Genetics, Archiving, and Monograph (MORGAM) Project. It combined the data from 30 populations in 11 countries; 90,487 men and women, aged 30 to 74 years, predominantly white, with no history of cardiovascular disease. They were recruited from 1986 to 2010 and then followed up for up to 24 years. Pretty good numbers. Over that time period of observation, there were 9,105 deaths. Mortality is something easy to define. That's hard data and what you are most interested in.


What they found was revealing. For all hip sizes, having a smaller waist was strongly correlated with reduced mortality. (Except for the very smallest hip sizes.) For those with smaller waists, larger hip sizes were strongly associated with reduced mortality. Simple.

The net effect here is that this ratio predicts problematic body shape more accurately than the BMI go the tune of 20% more people are identified as being at risk with Waist/Hip ratios above goal versus BMI above goal. And that correlates with what we see in real life. This becomes the method of choice to determine risk for poor health outcomes and goals for optimal health. It should be one of our vital signs. If only it wasn't so humiliating.


www.What will Work for me? Look at the bright side. We now have a more sure method of monitoring our personal health. All it takes is a measuring tape and you have your work cut out for you. I have worn the same pant size for some 20 years. 38 inches. I must be ok. The horrifying realization came to me when I actually measured myself and realized that I had gotten used to squeezing myself into the same old pant size and then pulling like crazy on the belt. Leave it to your own imagination, but I'm not ideal. I have some personal work to do. Bummer. I just hate data. Especially when there is no one else to blame. I suspect my monthly fast mimicking diet needs to be extended. Join me. Misery loves company.


References: JAHA, Nutrition Today, Cedars-Sinai, Nature, JNM,


Pop Quiz  


1. What is now the most accurate health measure to assess your global risk of mortality? Answer: Waist to hip ratio


2. And the desirable ratio should be what for women?                  Answer: < 0.85      ( 0.9 for men)


3. If you pull on your pants and then have to stretch to get the zipper closed, you might be in what condition?                                   Answer: Cleopatra syndrome. "Queen of De-Nile"


4. Compared to BMI, how many more people are in trouble for excess mortality if their waist to hip ratio is above goal?                          Answer: 20% more


5. Big hips and skinny waist is horrible for you? T or F?                       Answer: False. It's good news. You may not be happy with your shape but God Bless You, you are going to live longer than many of us.   And you can be happy with that.


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