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The waist-hip ratio: a flawed index.

Richard Francis Burton1

  • 1School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.

Annals of Human Biology
|September 7, 2020
PubMed
Summary

The waist-hip ratio may be less effective than analyzing waist circumference (WC) and hip circumference (HC) separately. Treating WC and HC as distinct variables improves health predictions and data fits.

Area of Science:

  • Anthropometry
  • Public Health
  • Biostatistics

Background:

  • The waist-hip ratio (WHR) is widely used to predict health risks like cardiovascular disease and diabetes.
  • Previous research suggests WHR may be an inappropriate metric, yet individual components (waist circumference [WC] and hip circumference [HC]) have opposing health associations.
  • WC correlates positively with adverse health outcomes, while HC shows a negative correlation.

Purpose of the Study:

  • To evaluate the efficacy of using waist circumference (WC) and hip circumference (HC) as separate independent variables versus their ratio in health-related regression analyses.
  • To determine if separate analysis of WC and HC provides a more accurate prediction of health outcomes.
  • To highlight the underappreciated role of hip circumference (HC) in health assessments.
Keywords:
Waist-hip ratiohip circumferencewaist circumference

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Main Methods:

  • Utilized multiple regression analyses with health-related measures as dependent variables.
  • Compared the predictive power of WC and HC as separate independent variables against their combined ratio.
  • Included general body size measures, such as height, in the regression models.

Main Results:

  • Treating waist circumference (WC) and hip circumference (HC) as separate independent variables resulted in significantly closer fits to the data compared to using their ratio.
  • This novel approach enhances the accuracy of predicting health-related measures.
  • Including general body size, like height, further refines the regression models.

Conclusions:

  • Waist circumference (WC) and hip circumference (HC) should be analyzed as distinct predictors rather than combined into a waist-hip ratio (WHR) for improved health outcome prediction.
  • This approach offers a more nuanced understanding of body composition's impact on health.
  • Further research could explore alternative anthropometric measures, like thigh circumference, to potentially replace hip circumference (HC).