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Evaluating CMR
Clinical Tools
Waist-to-Hip Ratio (WHR)
- 1Key Points (1 page)
- 2WHR, Health Risk, and Intra-abdominal Fat (1 page)
- 3Measuring WHR (1 page)
- 4The Limitations of WHR (1 page)
- 5Changes in WHR (1 page)
- 6References (1 page)
Changes in WHR
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Figure 2: 
Figure 2: One of the main limitations of WHR is its ability to predict changes in body composition or health risk. Changes in WHR could be due to changes in the numerator (waist) or denominator (hip). For example, lower WHR after an exercise intervention could be due to reductions in waist circumference or increases in hip circumference because of lower body muscle gain. Similarly, large reductions in hip circumference relative to waist circumference may cause no change in or even increase WHR despite significant weight loss and improvements to metabolic risk, particularly in women (24-26) (Figure 2). The relationship between changes in WHR and intra-abdominal fat provides further illustration of this point. Unlike waist circumference, changes in WHR do not consistently lead to changes in intra-abdominal fat, especially in women (19, 21, 27). A change or lack of change in WHR is therefore difficult to interpret. As such, waist circumference alone should be used to assess obesity, related health risk, and any changes to either.
WHR is a good indicator of health risk and an index of relative abdominal fat distribution. However, WHR is not a measure of absolute abdominal fat mass. Individuals can have varying degrees of intra-abdominal fat for a given WHR. Furthermore, WHR is often unable to detect changes in intra-abdominal fat or health risk associated with weight loss. In view of this, waist circumference alone may be a better clinical tool for assessing abdominal obesity and related health risk.
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