Waist-to-height ratio: Self-test shows your disease risk

Cardiovascular problems, diabetes, fatty liver: such diseases often smolder already in the body before the first symptoms appear. With a simple self-test, you can determine how big the risk is. This can enable early diagnosis and thus successful therapy.

Enrico Zessin, Physician in training for internal medicine and sports medicine, doctor in the German Athletics Association and qualified molecular biologist

The so-called body mass index is already considered obsolete by many doctors. Cause: BMI does not take into account the relationship between body fat and muscle mass, but only refers to body weight and height. When it comes to disease risk, another metric is more telling than BMI: the waist-to-height ratio. You can easily determine it yourself in the self-test.

Waist-to-height ratio (WtHR)

According to researchers, the ratio of waist to height is a good indicator to determine the risk of cardiovascular disease and metabolic diseases such as type 2 diabetes or fatty liver. Cause: The waist-to-height ratio, also known as the waist-to-height ratio (WtHR), takes into account the inner abdominal fat. Unlike other small fat pads on the thighs or buttocks, this is said to have a particular negative effect on health. Also known as visceral fat, the tissue encloses internal organs and provides them with mechanical protection. Too much of However, visceral fat can produce harmful messenger substances and thus trigger inflammatory reactions in the body, which in turn leads to diseases.

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Studies prove the importance of the WtHR value

A number of studies have already analyzed that the WtHR value is meaningful. A Brazilian research paper from 2019 looked at more than 13,500 participants. The result: The waist-to-height ratio identified more people at risk for disease than a combination of BMI and hip circumference – regardless of gender, age and weight.1

Respectively, 39.6 and 33.3 percent of adult men and women classified as low-risk based on BMI and hip circumference, respectively, showed an increased risk of disease with the WtHR value. According to the researchers, these people may not have been made aware of the need for health promotion and disease prevention measures.

In their study, the Brazilian researchers urge to use the WtHR value for risk assessment. Although BMI is recognized as an international classification, it tends to fail and leads to inaccurate assessments. This in turn results in improper treatment of the obese. The waist-to-height ratio is an “easily interpreted and inexpensive primary risk assessment tool that identifies a higher number of individuals with cardiometabolic risk.” Cardiometabolic diseases are clinical pictures that affect the cardiovascular system and / or metabolic processes.

A 2010 study also confirmed the importance of the waist-to-height ratio: Researchers at Ludwig Maximilians University in Munich had for several years observed the health development of 11,000 people and used various methods to calculate the risk of disease. They came to the following conclusion: “Whether a person has a heart attack or a stroke or dies from it, can best be shown with WHtR.” The higher the WtHR, the greater the risk.2

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Calculate waist-to-height ratio: The formula

The formula for calculating the WtHR value is:

Waist (in cm): Height (in cm)

For a 35-year-old man who is 1.74 meters tall and has a waist circumference of 84 centimeters, it gives a value of 0.48. It would still be in the ideal range from 0.4 to 0.5. Values ​​above 0.5 are already in the risk range (0.51-0.56), those below 0.4 mean underweight.3

Waist to height ratio: table

From the age of 40, age must be taken into account. Then the tolerable value is shifted upwards by 0.01 per year. This means that a person of 45 would still be in the ideal range with a value of 0.55.

Measure the waist circumference correctly

The waist is approximately level with the navel between the lower chest and the hip bone. It is best to measure the circumference in the morning before breakfast.

The waist is approximately level with the navelPhoto: Getty Images

You do not necessarily have to have a stomach to be sick

“I would not call it an ‘alternative’ to BMI, but rather a supplement,” says Uwe Schröder of the German Institute for Sports Nutrition about WtHR. Both parameters have limit values ​​that are set arbitrarily because “a limit must be set somewhere”, as he explains to FITBOOK. Schröder also recommends considering other parameters if normal values ​​are exceeded to get a realistic picture of the risk of disease.

However, he also says that WtHR is actually more informative than BMI when it comes to the risk of certain diseases (e.g. cardiovascular disease, non-alcoholic fatty liver disease, type 2 diabetes, dyslipidemia). Schröder advises consulting BMI so that “possible ‘weight optimization potential’ can be concluded”.

However, the expert also points out that BMI allows only limited conclusions about the crucial visceral fat. Today, this can only be made visible with an MRI. The ‘TOFIs’ (= thin on the outside, fat on the inside) are the result of these analyzes. These are people who apparently have almost no fat, are often of normal weight, but who have a lot of visceral fat and therefore have a very high risk of disease. . ” So one does not necessarily have to have a small stomach to be overt.sick.A self-test to determine the risk of disease is of little help in this case.

Schröder recommends a “true body fat measurement” (eg with a professional body fat scale or a skin fold measurement), which can provide more clarity.

With the waist-height ratio, you can make a certain risk assessment in the self-test. However, as there are many factors that affect the risk of illness, it is always advisable to take an individual interview with a trusted doctor about lifestyle and habits, nutrition and, if applicable, pre-existing family relationships to assess the risk.

Also interesting: Do carbs make you fat in the evening?


What will surely please many: In their study, Brazilian scientists do not classify love handles in themselves as bad. “A certain amount of love handles are acceptable,” they say – just not too much. Uwe Schröder also calls for a little more foresight: “Often ‘tangible’ values, which in reality are only compared to arbitrarily set limits, are used as an opportunity to radically change individual eating habits. We are very obedient to numbers, but we certainly do not die right away just because we exceed or fall below a standard value by a few percentage points. “


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