Waist-to-Height Ratio as a Measure of Heart Health

For years, body mass index (BMI) has been the go-to number for assessing health risks, but it’s not the only measure. BMI considers height and weight—it doesn’t show where body fat is stored. That’s where waist-to-height ratio (WHtR) comes in.

WHtR is simple: divide your waist measurement by your height. A ratio greater than 0.5 (your waist is more than half your height) may indicate a higher risk for heart disease, diabetes, and other metabolic conditions. PIH Health Cardiologist, Van La DO, explains that “WHtR may be a more accurate predictor of cardiovascular risk than BMI, because it reflects belly fat—which is one of the less known risk factors for heart problem”.

Why belly fat matters

Fat stored around the abdomen, known as visceral fat, surrounds vital organs and increases inflammation. This type of fat is strongly linked to higher cholesterol, high blood pressure, and insulin resistance. That’s why people with an “apple-shaped” body—who carry more weight around their middle—tend to have a naturally higher risk of heart disease compared to those with a “pear-shaped” body, where fat is stored more in the hips and thighs.

Lowering the risk

The good news? Apple-shaped individuals can take steps to protect their heart health:

• Stay active: Aim for at least 150 minutes of moderate exercise per week. Cardio activities like walking, swimming, or cycling are especially effective at reducing visceral fat.

• Build muscle: Strength training helps boost metabolism and improve insulin sensitivity

• Choose heart-healthy foods: Focus on vegetables, fruits, whole grains, lean proteins, and healthy fats. Limit added sugars and processed foods that contribute to belly fat.

• Manage stress and sleep: Poor sleep and high stress can increase abdominal fat storage

• Track your numbers: Along with WHtR, monitor blood pressure, cholesterol, and blood sugar to stay ahead of risk factors

The bottom line

BMI isn’t the whole story. Waist-to-height ratio provides a clear picture of heart health by highlighting belly fat, a key risk factor. By keeping your waist less than half your height—and adopting healthy habits—you can lower your risk and strengthen your heart.

Talk to your primary care physician and/or consult a cardiologist if you have more questions about keeping your heart healthy. To find a doctor, visit PIHHealth.org/Doctors