The Significance of Waist To Hip Ratio — Are You An Apple or A Pear?

March 8, 2017
Joseph R. Anticaglia, MD

Smoking is presently the leading cause of preventable deaths in the United States However, obesity is in position to overtake that cancer enabler and become the leading cause of preventable deaths in the U.S.

Over the last 3 decades, obesity has reached epidemic proportions. The numbers can vary, but the NIH estimates that approximately 300,000 deaths are attributable to the aftereffects of being obese. Poor eating habits, sedentary lifestyle, age, genetic predisposition are some of the factors that contribute to obesity and the unhealthy distribution of belly fat.

Body Shapes: Are you a Pear or an Apple?

Metabolic syndrome (MeS) is the result of a combination of the unhealthy lifestyle choices, such as eating too much sugar, unhealthy saturated fats and lack of exercise. As a result, one is at a greater risk to develop heart disease, type 2 diabetes, hypertension, stroke and a bulging waistline.

People who are obese-overweight often have an apple shape body — meaning they have a lot of visceral fat around the abdomen (beer belly, pot belly). This group is more at risk to die from complications of MeS.

Having a pear-shaped body means the waist is narrower and belly fat is mostly distributed around the hips. Pear-shaped bodies are less prone to metabolic syndrome and thought to be less likely to experience the complications of insulin resistance, type 2 diabetes, heart disease and other aspects of this syndrome.

Apple shape Pear Shape
More Visceral fat
Greater risk of
Metabolic Syndrome
Less Visceral fat
Lower risk of
Metabolic Syndrome

Waist to Hip Ratio (WHR)

The distribution of belly fat and its measurement are wake-up calls to avoid medical problems. The waist-to-hip ratio measures the circumference of the waist divided by that of the hips. The measurement should be taken standing up and at the end of a normal respiration.

One method places the measuring tape around the abdomen at a midpoint between the lowest rib and the top of the hip bone (iliac crest). Next, one measures the circumference of the hips. For example, if a woman’s waist measures 24 inches and her hips 32 inches; her waist-to-hip ratio is 0.75 (24 divided by32)…

Obesity is defined, according to the World Health Organization, as a waist-to-hip ratio above 0.85 for females and above 0.90 for males. These figures are important yardsticks for metabolic syndrome.

If the above is confusing or you’re not sure, here is a general guide for the average individual:
For women, a waist size of 34.6 inches or more is obese
For men, a waist size of 40 inches or more indicates obesity

Subcutaneous Fat versus Visceral Fat

Subcutaneous fat is superficial body fat stored under your skin that you can grasp with your hand (stomach, arms thighs).

Visceral fat, intra-abdominal fat, is deep body fat that wraps around internal organs such as the intestines, liver and pancreas. Research suggests that visceral fat is biologically active pumping out harmful chemicals that drive up your risk for insulin resistance, type 2 diabetes and the metabolic syndrome. Belly fat is both subcutaneous and visceral fat.

Used by permission of Mayo Foundation for Medical Education and Research. All rights reserved.

If you’re overweight or obese, one race you don’t want to win is overtaking smoking as the leading cause of preventable deaths in the U.S. That macabre “winner’s” circle is loaded with deaths from strokes, heart attacks, poorly controlled diabetes and high blood pressure. You’ll also notice former cancer and Alzheimer patients in this deadly circle.

Belly fat is dangerous — but reversible — when you implement a healthy diet, a good exercise program and cut down on stress.


References

U.S.Department of Health and Human Services Overweight and Obesity: A Major Public Health Issue; Prevention Report 2011
Flegal, Katherine M et al; Estimating Deaths Attributable to Obesity in the United States; Am. J. Public Health; September 2014
WHO Expert Consultation; Waist Circumference and Waist Hip Ratio; December, 2008
Mayo Clinic Belly Fat In Men: Why Weight Loss Matters; April 26, 2016
Mercola, Joseph; Your Waist Size Predicts Heart Disease Better Than Your Weight; May 20, 20111
Anticaglia, Joseph R’ Metabolic Syndrome and Wellness Stay Off The Farm’ HC Smart 2016

This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.

© HC Smart, Inc.