Many experts agree that weight and body mass index (BMI) are insufficient to assess our health. This is because exercise, which is clearly healthy, builds muscle mass. Muscle is significantly more dense than fat, so it is possible to gain weight and actually be thinner and healthier than you were at a lower weight. BMI is worth looking at, but there is so much more!
Here’s a handy BMI calculator: https://calculator-converter.com/bmi-calculator.htm I like this one as it accepts decimals for height and weight.
Even though we normally think of a healthy BMI as being 18-25, this is not the best range for those over 65. I was informed of this when I saw a bariatrician at The Mayo Clinic (although I’m not quite at that age yet). Numerous studies show that for older people, a BMI of 25-27 is healthier (1). Of course there are different standards for children and teens as well.
Where your body stores fat is also crucial to heart health and diabetes risk. According to the American Heart Association, “Women with a waist size greater than 35 inches and men with a waist larger than 40 inches are at higher risk for heart disease and Type 2 diabetes, according to the National Heart, Lung, and Blood Institute” (2).
In addition, a very large and long term study found that waist circumference was found to have a high correlation with risks of many types of cancer (3). Given that this simple measure is so valuable in determining our health, and the risk for most causes of death, it’s an important consideration.
But there is a flaw with using waist measurement alone. It does not account for differences in height. Someone who is just 5 feet tall with a waist circumference of 35 inches is not in the same shape as someone who is 6 feet tall with that 35 inch waist circumference. There are the overall proportions of the body to consider.
The waist-to-hip ratio puts the waist measurement in a better perspective. According to WebMD, this ratio gives a clearer picture of your health than weight or BMI (4). It’s also an easy calculation. Simply measure your waist at its smallest point, likely around your belly button. Then measure your hips at their widest point. Finally, use an ordinary calculator to divide your waist measurement by your hip measurement.
There are slightly different ideas on what waist-to-hip ratios are healthy. The World Health Organization’s standard is 0.90 or less for men and 0.85 or less for women. Anything over 1.0 is considered to be dangerous for your health (3). The University of Alabama suggests looser standards of 0.99 or lower for men and 0.90 for women (5). However, if you read more about the study that gives this guidance, you will see that it was done on people aged 75 and older (6). So unless you are 75 or older, the lower numbers would apply to you.
There are other factors that make this ratio less than ideal for some individuals (7). These include height, general body size, and thigh circumference, but information was not given on how to include them.
Here’s a waist-to-hip calculator to try: https://www.healthcalculators.org/calculators/waist_hip.asp
As you may have seen, there is likely no perfect single measure that works for all of us. A body fat percentage could be helpful, but most of us don’t have the proper equipment for this. Perhaps we can consider using a variety of measurements. But, that can become burdensome.
An accurate assessment is more complex than these numbers or even looking at the standards which medical best practices recommend. Although they are the baselines for good health, there can be other considerations. Do you feel like you’re at your best? Do you have the energy to do your work or enjoy your hobbies? When you look in a mirror, do you feel confident? And if your answers are no, do you feel that you can move in the right direction? Some things to think about as we move forward to maintain our healthy weight!
(1). https://www.verywellhealth.com/healthy-weight-and-bmi-range-for-older-adults-2223592
(3). https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-020-01877-3
(4). https://www.webmd.com/fitness-exercise/what-is-waist-to-hip-ratio
(5). https://www.uab.edu/shp/nutritiontrends/nutrition-know-how/weight-control/waist-to-hip-ratio
(6). https://pubmed.ncbi.nlm.nih.gov/16895897/
(7). https://www.tandfonline.com/doi/abs/10.1080/03014460.2020.1820079
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