The rule is simple: keep your waist below half your height. In large studies, waist-to-height ratio predicts heart attack risk better than BMI. It's easy to measure at home and gives you a direct signal about visceral fat.
How to measure
- Stand relaxed, feet together.
- Measure your waist at the midpoint between your lowest rib and the top of your hip bone (usually around your belly button).
- Divide waist by height (same units).
Example: if you're 70 inches tall with a 35-inch waist, your ratio is 0.50. Right at the cutoff.
What the number means
| Ratio | What it means |
|---|---|
| < 0.4 | Underweight range (may indicate too little body fat) |
| 0.4–0.5 | Healthy range |
| 0.5–0.6 | Increased risk |
| > 0.6 | High risk (substantially elevated heart disease risk) |
The 0.5 cutoff applies regardless of height, age, or sex. It's well-supported as a practical screening cut-point for cardiometabolic risk.
Why it matters more than BMI
BMI doesn't distinguish between muscle and fat, or between subcutaneous fat (under the skin) and visceral fat (around organs). Visceral fat is the dangerous kind. Waist-to-height ratio tracks visceral fat directly.
More on why visceral fat matters in our visceral fat guide.
What to do if you're above 0.5
- Cut refined carbs and added sugars.
- Add cardio and resistance training.
- Get 7–8 hours of sleep (poor sleep drives visceral fat).
- Manage stress (cortisol promotes visceral fat storage).
The good news: visceral fat responds faster to lifestyle changes than other fat. It's often the first to go when you make changes.
The bottom line
Keep your waist below half your height. If it's drifting above, consider it an early warning sign. The biology driving plaque buildup may already be active.
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