Waist-to-Hip Ratio

Aka: Waist-to-Hip Ratio, Waist Circumference, Anthropometry, Android Obesity, Apple Obesity, Beer Belly, Gynoid Obesity, Pear Obesity

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II. Technique

  1. General
    1. Use non-stretchable measuring tape
    2. Tape should touch skin, but not compress soft tissue
    3. Avoid twists in the tape
  2. Waist Circumference
    1. Do not measure within 1 hour of large meal
    2. Measure patient while supine
      1. Measuring tape may fall in standing position
      2. Panniculus shifts downward in standing position
      3. Williamson (1993) Am J Hum Biol 15:159-67 [PubMed]
    3. Measure at natural waist, midway between:
      1. Palpated iliac crest
      2. Palpated lowest rib margin at mid axillary line
  3. Hip Circumference
    1. Patient stands erect
      1. Arms at side
      2. Feet together
    2. Measure hips at maximum circumference over buttocks

III. Interpretation of Higher Obesity Risk

  1. Waist-to-Hip Ratio
    1. Measures fat distribution
      1. Pear Obesity (Gynoid Obesity)
      2. Apple Obesity (Android Obesity, Beer Belly)
        1. Higher cardiovascular disease risk
        2. Higher risk of Insulin Resistance
    2. Values suggestive of Apple Obesity
      1. Males > 1.0 confers increased risk
      2. Females > 0.9 confers increased risk
  2. Waist Circumference
    1. Males >= 40 inches (102 cm) confers increased risk (>=35 inches in asian descent)
    2. Females >= 35 inches (88 cm) confers increased risk (>=31 inches in asian descent)

IV. References

  1. Flier in Wilson (1998) Williams Endocrinology, p. 1063
  2. (1998) Treatment of Adult Obesity, AOA, p. 63-4
    1. http://www.shapeup.org

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