Waist to Hip Ratio

The last double indirect method is the waist to hip ratio. It is a ratio measurement of
the circumference of the waist to that of the hip and an indicator of body fat
distribution. [a] For the instrument to measure waist to hip ratio, it just requires an
inelastic tape. While for the target group, its objective is to determine the coronary
artery disease risk factor associated with obesity. [b]

Fig. Waist to Hip Ratio measurement [c]

Procedure
Here are the procedures of the measurement of waist to hip ratio.
1. The subject stand with good posture and relax.

2. The assistant places the tape on the skin surface of subject without compressing
on his/her skin, then measures and records the subjects hip and waist
circumferences.
3. The measurements should be repeated twice and the results should be within 1cm
differences.
4. Waist to hip ratio can be calculated by dividing the waist circumference with the
hip circumference.

Fig. Calculation of Waist to Hip ratio [d]

Cautions
There are several important issues while using waist to hip ratio. The first thing is the
placement of tape. If the tape is placed on the wrong place, the resulting waist to hip
ratio will be inaccurate. Tape should be placed at the approximate midpoint between
the lower margin of the last palpable rib and the top of the iliac crest when measuring
the hip, while around the widest portion of the buttocks, with the tape parallel to the
floor when measuring the hip. [e]

Fig. Placement of Tape [f]

Next will be the tightness and type of tape. Besides depending on correct positioning,
the accuracy of waist and hip circumference measurements also relies on the tightness
of the tape. Using a stretch-resistant tape that provides a constant 100g of tension
through the use of a special indicator buckle can reduce differences in tightness so as
to increase the accuracy. [e]

As mentioned above, subject should stand with good posture. A good posture means
that subject should stand with arms at the sides, feet positioned close together, and
weight evenly distributed across the feet. Moreover, waist circumference should be

measured at the end of a normal expiration, when the lungs are at their functional
residual capacity so that the fullness of the lungs and the position of the diaphragm
will not affect the measurement. Furthermore, Subject should be relax and take a few
deep, natural breaths before the actual measurement is made which can minimize the
inward pull of the abdominal contents during the waist measurement. Last but not
least, Waist measurement should be made after the subject has fasted overnight or is
in a fasted state to prevent the error due to stomach contents. [e]

Illustrated example of calculation

WHR = Gw/Gh
where WHR = waist-to-hip ratio
Gw = Waist circumference
Gh = Hip circumference

e.g. Gw = 71 cm
Gh = 74 cm
WHR = Gw/Gh = 71/74 = 0.96

Table. Waist to Hip Ratio results [a]

From the above example, the waist to hip ratio is 0.96. According to the table, it
belongs to unacceptable, which means the subject has a high risk of suffering from
obesity, diabetes and hypertension.

Advantages and disadvantages

The advantages of waist to hip ratio are minimal equipment required, simple and fast
to set up and conduct, can be conducted almost anywhere, a non-invasive method,
good notice on risk of getting cardiovascular disease and more efficient prediction of
mortality.

While the disadvantages are assistant required to administer the test, measurement
errors due to poor technique or inexperienced assistant and no consideration on other
parts of body.

References
a. David P. Swain, 2013. ACSM's Resource Manual for Guidelines for Exercise

Testing and Prescription. Available at: https://books.google.com.hk/books?

id=HZKFm0VrmhYC&pg=PA291&lpg=PA291&dq=
%22A+ratio+measurement+of+the+circumference+of+the+waist+to+that+of+the+hip
%22&source=bl&ots=lExCU5EmtU&sig=1OgoU60aDtnt2D_yRLNOpK5omik&hl=
zh-TW&sa=X&ved=0CBwQ6AEwAGoVChMI88fipp7kyAIVQamUCh3VlQf#v=onepage&q=%22A%20ratio%20measurement%20of%20the%20circumference
%20of%20the%20waist%20to%20that%20of%20the%20hip%22&f=false [Accessed
at 15 October 2015]

b. Robert Wood, 2008. Waist to Hip Ratio (WHR) Available at:

http://www.topendsports.com/testing/tests/WHR.htm [Accessed at 15 October 2015]

c. Mensurations, 2008. Waist to Hip Ratio Measurement. [Image] Available at:

http://mensurations.com/wp-content/uploads/2014/12/benefits-of-waist-hip-ratioWHR.jpg [Accessed at 15 October 2015]

d. Women-info, 2014. Calculation of waist to hip ratio [Image] Available at:

http://www.women-info.com/en/wp-content/uploads/2014/06/waist-hips-ratio.jpg
[Accessed at 15 October 2015]

e. World Health Organization, 2008. Waist Circumference and Waist-Hip Ratio Report
of a WHO Expert Consultation. Available at:
http://apps.who.int/iris/bitstream/10665/44583/1/9789241501491_eng.pdf [Accessed
at 15 October 2015]

f. Wikipedia, 2000. Placement of tape. [Image] Available at:

https://upload.wikimedia.org/wikipedia/commons/thumb/d/dd/Waisthip_ratio.svg/2000px-Waist-hip_ratio.svg.png [Accessed at 15 October 2015]