How to measure your waist: Health and waistline size

Share on Pinterest

By following simple instructions, taking a waistline measurement with a tape measure is easy.

1. Remove or wear thin clothing around the abdomen and hips.
2. Hold the tape measure between the top of the hipbone and the bottom of the ribs.
3. Breathe out normally.
4. Bring the tape around the waist.
5. Do not hold the tape too tight and ensure the tape measure is straight around the back.
6. Record the measurement.

According to the Heart Foundation, a healthy waistline size is:

• 37 inches or less for men
• 31.5 inches or less for women

A person’s health may be at risk if their waist circumference is bigger.

While the waistline is a key measure of a person’s overall health risk, a person should also consider their waist-to-height ratio (WHtR) and body mass index (BMI).

Waist-to-height ratio

A person’s WHtR measures the distribution of body fat.

A 2018 observational study indicated that waist circumference and WHtR could be good indicators of high blood pressure (hypertension) risk.

Another study in 2016 concluded that WHtR is more effective than BMI and waist circumference at identifying those at ‘early health risk’ of central obesity-related illnesses when using a boundary value of WHtR of 0.5, or 50%.

A person is at higher risk of developing central obesity-related illness if they have a WHtR of over 50%.

To calculate WHtR, measure the waist circumference and height in inches. Then, divide the waist circumference by height, and multiply by 100.

Individuals who have either overweight or obesity are at higher risk of developing conditions such as heart disease and type 2 diabetes. People of moderate weight are also at greater risk of developing these conditions if they have an increased waist circumference, according to the National Heart, Lung and Blood Institute NHLBI).

BMI is another useful measurement when it comes to bodyweight and health.

To calculate BMI, measure weight in kilograms and height in meters squared (this is your height in meters times itself). Then, take these numbers and divide weight by square height. Using an online calculator tool is an easy way to determine BMI.

The NHLBI indicate that BMI ranges for most adults aged 18–65 are as follows:

• under 18.5 — underweight
• 18.5–24.9 — healthy
• 25–29.9 — overweight
• 30 or more — obese

BMI does not distinguish between weight carried as fat or muscle or the distribution of fat on the body. It may not, therefore, provide an accurate assessment of a person’s health in some instances.

For example, athletes may have a high BMI but may not be at higher risk of certain health conditions. Older adults may have a lower BMI due to low muscle mass, yet they may be at higher risk of heart disease and other illnesses.

Having a larger waistline indicates that a person has excess abdominal fat. Abdominal fat of the visceral fat type is different from fat that accumulates on the thighs, as visceral fat is located inside your abdominal cavity.

When fat cells in visceral fat break down, they release free fatty acids and other substances into the portal vein. The portal vein brings blood from the intestines to the liver.

These substances cause a state of toxicity that affects the pancreas and reduces its ability to produce the hormone insulin. Insulin is needed for cells to be able to take up glucose in the body.

This toxicity also contributes to insulin resistance, where the body’s cells do not respond properly to insulin. Both of these factors mean that the body’s blood sugar levels increase.

Excessive visceral fat increases inflammation in the body.

A person’s waistline may predict a number of things about their health:

Type 2 diabetes mellitus

A study in 2015 concluded that waist circumference and WHtR are better predictors of the risk of type 2 diabetes than BMI in both sexes, but particularly for women.

Heart disease

The American Heart Association suggest that waistline size (especially in relation to hip size) predicts heart attacks better than BMI. This is especially true for apple-shaped women, who face a higher heart attack risk than apple-shaped men.

Cancer

A 2018 population-based cohort study notes that waist circumference is an important predictor of several types of cancers in men, including colorectal cancer and gastroesophageal cancer.

Stroke

A study in Strokenotes that indicators of abdominal fat distribution, especially WHtR, have a greater association with stroke risk in both men and women than BMI.

Mortality

A 2015 review of studies reported that people with a larger waistline might have a shorter life expectancy than people with a normal-sized waist. The researchers accounted for other factors, such as age, use of tobacco, and alcohol, and found that they did not significantly influence the results.

Inflammation

According to a 2017 study, larger waist circumference increases inflammation in the body in some people. In turn, a 2015 article in Circulation indicated that inflammation is a contributing factor and increases the risk of several health conditions, including:

• cardiovascular disease
• cancer
• arthritis
• Alzheimer’s disease
• depression

Several factors influence a person’s waist size. These include:

Genetics

A 2019 meta-analysis indicated that genes play a role in determining body-fat distribution, in particular waist-to-hip ratio. Consequently, some individuals are, therefore, more likely to store fat around their middle than on their thighs.

Genetics may help explain why some families are more likely to be “apple-shaped,” while others are more likely to be “pear-shaped.”

While individuals may not be able to change their basic body shape, it is still possible to reduce the amount of fat stored on the waistline.

Ethnicity and sex

According to Harvard Health, visceral abdominal fat is less common among those in Mediterranean countries. In contrast, Native Americans, Pima Indians, Hispanics, and those living in India and South Asia are more likely to have abdominal obesity.

Black men and white women typically have less visceral abdominal fat than white men and black women.

Activity levels

Sedentary people tend to have more abdominal fat than those who are more active throughout the day.

The Centers for Disease Prevention and Control (CDC) cite activities such as watching television and playing video games as having positive associations with increased abdominal fat and obesity among both men and women.

Food intake

Certain types of foods may increase the risk of obesity and abdominal fat, including:

• sugary foods and drinks
• processed foods
• trans fats
• alcohol

Eating too many calories, regardless of the type of food, may cause weight gain. For those that are apple-shaped, this extra weight will accumulate on the abdomen.

Having a low-protein or low-fiber diet may also affect a person’s waistline.

Other influences

Other factors also play a role in increased abdominal fat, including:

• stress
• hormonal changes, such as going through menopause
• lack of sleep
• imbalance in gut bacteria

Although it is not possible to reduce fat in specific areas, any weight loss in people who carry excess fat can help. The NHLBI suggest that losing just 5–10% of body weight can reduce health risks in someone with overweight or obesity.

Some tips for reducing weight and waist size include:

• aiming to do at least 150 minutes of moderate activity weekly (or 75 minutes of vigorous activity)
• strength training at least 2 days per week.
• eating a balanced diet, filled with fruits and vegetables, whole grains, lean proteins, and beneficial fats
• avoiding sugary and processed foods and foods made with refined flour
• limiting or avoiding alcohol
• practicing portion control
• drinking enough water to stay hydrated
• trying to get 7–9 hours of good-quality sleep nightly
• using stress-management techniques, including meditation and yoga

Individuals with type 2 diabetes, a heart condition, or another health issue should speak to a doctor or dietitian who can then advise on the appropriate diet and exercises to reduce belly fat.

Having excess abdominal fat can increase the risk of several health conditions, including heart disease and diabetes. To reduce this risk, individuals should aim to achieve or maintain a healthy waist circumference and WHtR.

While waistline measurements and BMI can give some indication as to a person’s health and risk of health problems, they do not paint the whole picture. It is important to discuss individual risk and management techniques with a doctor.