Objective: To provide a rationale for using waist:hip ratio (WHR) measurements in clinical practice.
Data sources: The article reviews the literature on body fat distribution back to the mid 1950s.
Study selection: Studies are reviewed which show a clear association between abdominal obesity and a range of ailments including coronary events, hypertension, blood lipid levels, cholecystectomy, diabetes and gallbladder disease.
Data extraction: Key data on the correlation of body fat distribution and health risks are summarised.
Data synthesis: Abdominal fat measured by a WHR may be a better single predictor of many diseases than other risk factors such as overall obesity, hypertension, smoking, or hypercholesterolaemia.
Conclusions: The association between WHR and risk indicators appears to be "dose" related, and independent of sex, race and age. High WHRs, however, are more characteristic of men with lower socioeconomic status, whereas weight control programs are more commonly developed for women. A reorientation of weight control initiatives based on health rather than aesthetic priorities is needed. Measurement of WHR should be a routine part of clinical assessments. The predictability of the measure can be improved by combining it with a measure of body mass.