Written by Peta Cullis

11 Nov 2021

Waist circumference is a valid measure of fat distribution and disease risk. Taking waist circumference is a simple way to measure health risk for chronic disease in addition to other factors.

Fat in the abdominal area is largely visceral fat, deep within the abdominal cavity. Research excess body fat, especially abdominal fat, disrupts the normal balance and functioning of certain hormones in the body affecting overall health. Visceral fat pumps out immune system chemicals called cytokines that can increase the risk of cardiovascular disease. These and other biochemicals are thought to have adverse effects on our cells sensitivity to insulin, blood pressure, and blood clotting.

Visceral fat is also directly linked with higher total cholesterol and LDL (bad) cholesterol, lower HDL (good) cholesterol, and insulin resistance, meaning that your body’s muscle and liver cells don’t respond adequately to normal levels of insulin, increasing the risk of Type 2 diabetes.

Waist measurement is not valid however in the following cases:

  • Pregnant women
  • Children
  • In a person with a BMI is over 35kg/m2or in
  • In those with diseases that cause abdominal distension such as: congestive cardiac failure; cirrhosis; nephrotic syndrome; peritoneal carcinomatosis; peritoneal tuberculosis; Lymphadenopath and high volumes of gas such as irritable bowel syndrome.
  • Certain people from non-European backgrounds with different body shapes.

How to Take an Accurate Waist measurement

  1. Use a soft, flexible measuring tape ~700mm wide, such as a seamstress would use. If you do not have a tape, use a piece of string or ribbon and measure this.
  2. Removing clothing is best, otherwise take off any bulky clothing, loosen your belt and empty your pockets.
  3. Stand up straight with your feet shoulder width apart, arms hanging loosely at your sides.
  4. Feel for the very top of your hip bone and the bottom of your last rib- your waist is mid-way between these two points, this should be in line with directly above your navel.

5. Exhale a normal breath out, do not hold your breath or suck your stomach in.

6. Wrap your tape measure around your waist so it is parallel with your belly button. Check that the tape is not twisted. Don’t pull too tight or let the tape fall too loosely, the tape should not compress your soft tissues but should be firm.

7. Record your measurement, for highest accuracy take the measurement twice and use the average of these two measurements.

Waist Circumference Ranges for Chronic Illness Risk

European BackgroundMen (cm)Women (cm)
Increased Risk of chronic illness≥94cm≥80cm
Greatly increased risk of chronic illness≥102cm≥88cm
South Asians
Increased Risk of chronic illness≥90cm≥80cm
Māori & Pacific Islanders  ≥102cm≥88cm

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