While BMI remains the gold standard for population health screening, waist-to-height ratio offers a more nuanced view of metabolic risk by focusing on central adiposity.
Key takeaways
- Waist-to-height ratio better predicts metabolic syndrome and cardiovascular risk than BMI alone.
- The measurement is simple: waist circumference divided by height, with a target ratio below 0.5.
- This metric is particularly valuable for people with high muscle mass or those in borderline BMI categories.
Why waist-to-height ratio matters
Central adiposity—fat stored around the abdomen—is more metabolically active than subcutaneous fat and strongly linked to insulin resistance and inflammation.
Waist-to-height ratio captures this risk factor that BMI often misses, especially in people with high muscle mass or those near BMI category boundaries.
- Target ratio: below 0.5 for optimal health
- Warning zone: 0.5-0.6 (increased risk)
- High risk: above 0.6 (significant metabolic risk)
How to measure accurately
Stand straight and measure your waist at the narrowest point between your ribs and hip bones, typically just above the belly button.
Ensure the tape measure is parallel to the floor and snug but not compressing the skin. Take the measurement after exhaling normally.
- Use a flexible, non-stretchy tape measure
- Measure in the morning before eating
- Take multiple measurements and use the average
When to use waist-to-height ratio
This metric is particularly useful for people with high muscle mass who may have elevated BMI but low body fat.
It also helps identify metabolic risk in people with normal BMI but high central adiposity—a condition sometimes called "normal weight obesity."
Action steps to take next
- Measure your waist and height, then calculate your ratio using our BMI calculator.
- If your ratio is above 0.5, focus on reducing central adiposity through diet and exercise.
- Track both BMI and waist-to-height ratio monthly to monitor comprehensive health changes.
Health questions answered
Is waist-to-height ratio better than BMI?
It depends on your situation. Waist-to-height ratio is better for predicting metabolic risk, while BMI remains valuable for overall weight assessment. Use both together for the best picture.
What if my BMI is normal but waist-to-height ratio is high?
This suggests you may have "normal weight obesity" with high central fat. Focus on strength training and reducing refined carbohydrates to improve body composition.