Waist-to-Height Ratio Is the Best Anthropometric Index for Screening the Risk of Obesity-Related Disorders

Although waist circumference has been recommended as an index of abdominal fat distribution, it has many shortcomings. For example, various cutoff values of waist circumference have been proposed for different ethnic groups, countries, and genders. The lack of height adjustment for central fat distribution makes it difficult to persuade taller and shorter people of similar waist circumferences that they have similar metabolic risks. Studies from various countries have reported that the waist-to-height ratio (WHtR) is more related to metabolic risks, diabetes, coronary heart disease, gout, stroke, transient ischemic attacks, early carotid intima-media thickening, and chronic kidney disease than other anthropometric indices of obesity. WHtR also has the potential for application of a single index to children, adolescents, adults of different genders and countries, and people of normal weight. This is especially important in Asia because most Asians are not prominently obese, despite the prevalence of metabolic risk factors. WHtR 0.5 may provide a useful clinical tool for screening persons at risk, and an effective public health message for the prevention of obesity-related metabolic risks and diseases.