How do you calculate waist-to-hip ratio and why is it important for cardiometabolic risk?

• A. WHR = waist circumference divided by hip circumference; higher WHR indicates central adiposity and higher cardiometabolic risk.
• B. WHR = hip circumference divided by waist circumference
• C. WHR = waist circumference minus hip circumference
• D. WHR = body mass / height

Answer: (A)

Waist-to-hip ratio measures how fat is distributed on the body, focusing on central or abdominal fat relative to hip fat. It’s calculated by dividing the waist circumference by the hip circumference, using consistent units (both in cm or inches). For measurement, place the waist at the natural waistline (just above the navel) and measure the hips at the widest part of the buttocks, then compute WHR = waist ÷ hip.

This measure matters because abdominal or central adiposity is more closely linked to cardiometabolic problems—such as insulin resistance, higher triglycerides and lower HDL, hypertension, inflammation, and an overall increased risk of type 2 diabetes and cardiovascular disease—than overall body weight alone. A higher WHR indicates more fat around the abdomen relative to the hips, signaling greater cardiometabolic risk. Thresholds commonly cited are about 0.90 or higher for men and 0.85 or higher for women, though exact cutoffs can vary by population.

The other kinds of calculations don’t capture fat distribution: reversing the ratio swaps the numerator and denominator, subtracting creates a difference rather than a ratio, and using body mass divided by height aligns with BMI, which reflects overall weight status rather than where fat is distributed.