 By Geoffrey Harris, MD
Well, there is a new vital sign. In addition to the typical weight, height, pulse, and blood pressure assessments at the beginning of your typical doctor’s visit, your physician may take out a measuring tape! Specifically, the important numbers are the circumference of your waist and hips. The ratio of your waist to your hips, or Waist to Hip Ratio (WHR) has been shown to give a better correlation to dangerous atherosclerosis than weight, waist circumference, or even BMI (Body Mass Index). Typically, when we think about atherosclerosis, we think of the plaques and cholesterol that become deposited on the walls of our arteries. This atherosclerosis, or hardening of the arteries, leads to heart disease, stroke, and peripheral vascular disease. Atherosclerosis can also worsen high blood pressure and damage the kidneys.
A recent study published in the Journal of the American College of Cardiology explored WHR and its relationship to health. The study sought to correlate various body measurements with degrees of hardening of the arteries. We know that obesity is a risk for developing heart disease; the difficulty is in trying to identify people who are at high risk. Previous measurements of obesity like weight and BMI are not always an accurate predictor of risk. Since muscle is denser than fat, muscle weighs more than an equivalent volume of fat. Consequently, weight charts and BMI measurements may categorize athletic and muscular individuals as obese, putting them in a higher risk category.
The study looked at WHR, obesity, and atherosclerosis in a group of over 3,000 individuals. The researchers from the Division of Cardiology at the University of Texas Southwestern Medical Center in Dallas, Texas, found an association between higher WHR’s and elevated degrees of hardening of the arteries. These results were the same for men and women. Basically, individuals who have more fat on their abdomen have more hardening of the arteries. This information serves to strengthen recent evidence that fat deposited on the abdomen tends to be unhealthy fat that increases the risk of developing high blood pressure, heart disease, and diabetes. People with an “apple” shape and high WHR’s are at a higher risk for cardiovascular disease than people with a “pear” shape and lower WHR’s.
As the number of obese people increases, understanding how obesity leads to heart disease, high blood pressure, and diabetes becomes increasingly important. Monitoring and tracking WHR’s in my patients will give me better information and ensures that I’m keeping tabs on my patients’ health. The good news is that the WHR is easy to calculate yourself. Here is how to do it:
1) While standing up, use a tape measure to measure your waist at its smallest point. You should measure in inches. Don’t suck in your stomach or hold your breath. Write down this measurement as your “waist.”
2) Then, while still standing, measure your hips at the widest point. This measurement should also be in inches. Write down this measurement as your “hip.”
3) Divide your “waist” measurement by your hip measurement. This number is your Waist-to-hip ratio (WHR).
Now, what does this number mean? The WHR recommendations are different for men and women.
Women:
Low Cardiovascular Risk = 0.8 or below
Moderate Cardiovascular Risk = 0.81 to 0.85
High Cardiovascular Risk = Greater than 0.85
Men:
Low Cardiovascular Risk = 0.95 or below
Moderate Cardiovascular Risk = 0.96 to 1.0
High Cardiovascular Risk = Greater than 1.0
So, don’t be surprised at your next doctor’s visit when someone pulls out the measuring tape! |
Nutrition 
