Waist-to-Height Ratio and Longevity: What Two Major Studies Reveal About Your Waistline and Health Risk
- Alastair Hunt
- Jun 10
- 3 min read
Updated: 6 days ago
When it comes to assessing health risk, weight alone doesn’t tell the full story. Body Mass Index (BMI), though widely used, fails to show where fat is stored. Increasingly, researchers are focusing on a more revealing measure - waist-to-height ratio (WHtR). This simple calculation offers insight into visceral fat levels and shows a strong connection to cardiovascular risk and overall mortality.
As ever, please talk to your doctor or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise or lifestyle, especially if you are under treatment. Links to all studies at bottom of page.
What the Studies Show
A 2023 study in the International Journal of Obesity analysed 20 cohort studies and found that people with the highest WHtR had a 23% greater risk of dying from any cause than those with the lowest. Each standard deviation increase in WHtR raised mortality risk by 16%. Cardiovascular death risk rose even more - by 39% in the highest WHtR group and 19% per standard deviation increase.
A broader review, published in The BMJ in 2020, included data from over 2.5 million people across 72 studies. It found that a 0.1 unit increase in WHtR was linked to a 24% increase in all-cause mortality, even after adjusting for BMI. The pattern followed a J-shape: risk was lowest at a WHtR of about 0.50, but rose steeply beyond that point.
Unlike BMI, WHtR directly reflects abdominal fat - especially the visceral kind linked to heart disease and diabetes. Because it adjusts for height, WHtR offers a more precise measure of central fatness than waist circumference alone. Its single, universal threshold - keeping your waist less than half your height - makes it straightforward for both clinical and public health use.
Measuring WHtR
Measuring WHtR is quick and easy. Waist should be measured midway between the bottom of the ribs and the top of the hip bone, after a relaxed exhale, with the tape snug but not tight and held horizontally. Height should be measured without shoes, standing upright. Divide the waist measurement by the height, using the same units. A result below 0.50 indicates low health risk.
Unlike BMI, which can remain unchanged even as fat shifts or muscle mass changes, WHtR is more sensitive to visceral fat. It provides a practical way for people to track central obesity over time, especially during lifestyle changes. It also identifies risk in people who might appear “normal weight” by BMI but carry excess abdominal fat.
Final Thoughts
Waist-to-height ratio offers a stronger, more practical way to gauge health risks than BMI alone. Backed by extensive research, its simplicity and accuracy make it a valuable tool for both personal monitoring and public health strategy. If you haven’t measured yours yet, it may be one of the most important numbers to know. Another measurement that can be taken at home is the waist-to-hip ratio, learn more here.
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Alastair
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Related Studies and Resources
Abdi Dezfouli R, Mohammadian Khonsari N, Hosseinpour A, Asadi S, Ejtahed HS, Qorbani M. Waist to height ratio as a simple tool for predicting mortality: a systematic review and meta-analysis. Int J Obes (Lond). 2023 Dec;47(12):1286-1301. doi: 10.1038/s41366-023-01388-0. Epub 2023 Sep 28. PMID: 37770574.
Jayedi A, Soltani S, Zargar MS, Khan TA, Shab-Bidar S. Central fatness and risk of all cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies. BMJ. 2020 Sep 23;370:m3324. doi: 10.1136/bmj.m3324. PMID: 32967840; PMCID: PMC7509947.
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