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New draft guidance on waist-to-height ratio

Friday April 8th 2022

People's waist measurements should be less than half of their height, an updated official draft guideline published today says.

The update encourages adults with a body mass index (BMI) below 35 kg/m² (obesity class 2) to measure their own waist-to-height ratio.

NICE, the National Institute for Health and Care Excellence, says using the waist-to-height ratio with BMI measurement can provide an estimate of central adiposity. This could help assess and predict health risks such as type 2 diabetes, hypertension or cardiovascular disease.

It has added the waist-to-height ratio to its draft guideline after examining evidence from several studies that showed alongside BMI, it could be used to assess and predict weight-related conditions in all ethnicities and sexes.

The guideline also recommends, in line with international guidance, using lower BMI thresholds for overweight and obesity for people from South Asian, Chinese, other Asian, Middle Eastern, Black African, or African-Caribbean family compared to the general population.

This follows research that showed people from some Black, Asian and minority ethnic groups are more prone to central adiposity and have an increased cardiometabolic health risk at lower BMI thresholds.

Dr Paul Chrisp, director for centre for guidelines at NICE, said: “Our updated draft guideline offers people a simple and effective way of measuring their weight so they can understand the factors that could impact on their health and take action to address them.

“Our committee found that a clear benefit of using the waist-to-height ratio is that people can easily measure it themselves, interpret the results, and seek medical advice if they are at increased health risk.

“The evidence shows that people from some Black, Asian and minority ethnic groups have a greater propensity to develop central adiposity and have an increased cardiometabolic health risk so we have lowered the BMI thresholds for those communities, in line with international guidance, to ensure people from those family backgrounds can get support from weight management services if required.

“We are now looking for views from the healthcare professionals and the public on the proposed recommendations in the guideline before final publication.”

Guideline committee member Professor Rachel Batterham, consultant in obesity, diabetes and endocrinology, added: “Increased fat in the abdomen increases a person’s risk of developing several life-limiting diseases including type 2 diabetes and heart disease.

“Waist-to-height ratio is a simple, easy to use measure that identifies people who are at increased health risk and would benefit from weight management support to improve their health.”

The guideline has a number of further recommendations for research, including gathering additional information to assess health risks in adults and children and young people.

A consultation on the draft recommendations is open until Wednesday, 11 May 2022 at

Tags: Diabetes | Diet & Food | Fitness | Heart Health | NHS | UK News

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