According to the World Health Organization's data gathering protocol,[3] the waist circumference should be measured at the midpoint between the lower margin of the last palpable ribs and the top of the iliac crest, using a stretch-resistant tape that provides constant 100 g (3.53 oz) tension.
[4] For both measurements, the individual should stand with feet close together, arms at the side and body weight evenly distributed, and should wear little clothing.
[4] The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) states that "total cholesterol levels are usually higher in persons with predominant abdominal obesity, defined as a waist-to-hip circumference ratio of ≥ 0.8 for women and ≥ 1.0 for men.
[7] WHR has been found to be a more efficient predictor of mortality in older people (>75 years of age) than waist circumference or BMI.
[10] If obesity is redefined using WHR instead of BMI, the proportion of people categorized as at risk of heart attack worldwide increases threefold.
It is more likely that a complex set of biological and neuroendocrine pathways related to cortisol secretion contribute to central adiposity, such as leptin, neuropeptide y, corticotropin releasing factor and the sympathetic nervous system.
[28] In an ancestral environment where food was scarce, a female with high levels of gynoid fat would be signalling to males that she in an optimal state for reproduction and nurturing of offspring.
This can be seen in the fact that a female's waist–hip ratio is at its optimal minimum during times of peak fertility—late adolescence and early adulthood, before increasing later in life.
[30][31] Evidence suggests that WHR is an accurate somatic indicator of reproductive endocrinological status and long-term health risk.
A Dutch prospective study on outcome in an artificial insemination program provides evidence for the role of WHR and fecundity.
[33][34] Menopause, the natural or surgical cessation of the menstrual cycle, is due to an overall decrease in ovarian production of the hormones estradiol and progesterone.
[35] Significantly, studies find that large premenopausal WHRs are associated with lower estradiol levels and variation in age of menopause onset.
[38] In contrast, aging males gradually accumulate abdominal fat, and hence increased WHR, in parallel with declining androgen levels.
[22] Using data from the U.S. National Center for Health Statistics, William Lassek at the University of Pittsburgh in Pennsylvania and Steven Gaulin of the University of California, Santa Barbara found a child's performance in cognitive tests correlated to their mother's waist–hip ratio, a proxy for how much fat she stores on her hips.
[42] The concept and significance of WHR as an indicator of attractiveness was first theorized by evolutionary psychologist Devendra Singh at the University of Texas at Austin in 1993.
[43][44] Singh argued that the WHR was a more consistent estrogen marker than the bust–waist ratio (BWR) studied at King's College, London by Glenn Wilson in the 1970s.
These variables change across cultures, suggesting that: Thus, a WHR that indicates pubertal onset, sex, fertility, hormonal irregularities, and/or differentiates male from female in one population may not do so in another.
Drawings with normal weight and a low WHR were associated with the most positive traits (i.e. attractive, sexy, intelligent and healthy).
[58] Through this study, Singh suggests that males and females may have developed innate mechanisms which detect and make use of the WHR to assess how healthy an individual is and (particularly for men), infer possible mate value.
This shows that BMI, not WHR, modulates reward mechanisms in the brain and that this may have important implications for judgements of ideal body size in eating-disordered individuals.
Their educational and socio-economic backgrounds (nearly all middle class) were fairly homogenous, and none had previously participated in any studies involving female body shape or attractiveness.
[65] When ratings of the figures' attractiveness were made, generally it appeared that bust size, WHR, and their weight were all important contributory elements.
This is a particularly interesting finding, as most previous studies report that young women idealize female bodies solely on the basis of thinness.
[67] A number of studies have been carried out with focus on food composition of diets in relation to changes in waist circumference adjusted for body mass index.
[69] A 2011 study suggests that a dietary pattern high in fruit and dairy and low in white bread, processed meat, margarine, and soft drinks may help to prevent abdominal fat accumulation.