The Increasing Importance of Waist-to-Height Ratio to Assess Cardiometabolic Risk: A Plea for Consistent Terminology

We have recently performed a systematic review which collated seventy eight cross-sectional and prospective studies exploring waist-to-height ratio and waist circumference or body mass index as predictors of diabetes and cardiovascular disease published in English between 1950 and 2008. This review, which also employed specificity and sensitivity comparisons, indicated that waist-to-height ratio could be a useful global clinical screening tool, with a weighted mean boundary value of 0.5, supporting the simple public health message "keep your waist circumference to less than half your height". During the collation of evidence, we noticed inconsistency in the site of measurement of waist circumference and also the terminology and abbreviations used to describe 'waist-to-height ratio'. We encourage others to routinely use the waist circumference measurement used most often (that recommended by World Health Organizationmid way between the lower rib and the iliac crest) and the terminology 'waist-to-height ratio' abbreviated to WHtR to avoid confusion about this anthropometric index which is growing in popularity for screening for cardiometabolic risk.