Waist-to-height ratio

Last updated on 16-5-2025 by Laïla Boulbayem
Why do we study the waist-to-height ratio?
  • The accumulation of fat around the abdomen (known as abdominal obesity) has been strongly linked to cardiovascular disease, Alzheimer’s disease, and other conditions.
  • The waist-to-height ratio provides a simple screening for health risks associated with the build-up of extra fat around the abdomen.

 How do we study it?

  • We measured participants’ waist circumference and height, using standardised procedures and devices.
  • The waist-to-height ratio was calculated as waist circumference divided by height.
  • A waist-to-height ratio of 0.5 or higher indicates increased health risks.

Key results

Six in ten individuals in the Belgian population aged three years and above have a health risk related to abdominal obesity.
Nine in ten older adults (65 years and above) have a health risk related to abdominal obesity.
Adult men have a higher health risk associated with abdominal obesity than women.
The health risk related to abdominal obesity decreases with the level of education.
At the regional level, the health risk associated with abdominal obesity increased in Brussels, decreased in Wallonia and did not change in Flanders between 2014-2015 and 2022-2023.
 

Age and sex

Proportion of the Belgian population aged three years and above with a health risk related to abdominal obesity (waist-to-height ratio ≥ 0.50), by age and sex, Belgium: 2022-2023

  • Crude = results weighted for season, age, sex and socioeconomic status
  • Although the cut-off value of 0.50 has been widely applied in children to predict cardiometabolic risk, the optimal cut-off value is still under discussion, potentially requiring specific cut-offs for different populations.
  • Older adults (65 years and above) do not include institutionalised (including those in care homes) or hospitalised individuals, or those who could not be interviewed without assistance (e.g., individuals with dementia).
  • The health risk decreases between childhood (29%) and adolescence (18%), and progressively increases during young (48%), middle-aged (73%), and older adulthood (89%).
  • In children and adolescents there are no differences by sex, but differences do appear in adulthood.
  • Adult men have a higher health risk associated with abdominal obesity than women. In older adults, 96% of men have a health risk, compared to 84% of women.

Educational level

Proportion of the Belgian population aged three years and above with a health risk related to abdominal obesity (waist-to-height ratio ≥ 0.50), by level of education, Belgium: 2022-2023

  • Crude = results weighted for season, age, sex and socioeconomic status.
  • Although the cut-off value of 0.50 has been widely applied in children to predict cardiometabolic risk, the optimal cut-off value is still under discussion, potentially requiring specific cut-offs for different populations.
  • The educational level is calculated at the household level by considering the highest diploma obtained by: (i) the respondents or their partner for adults (aged 18 years and above), or (ii) the father and mother (or carer, if applicable) for children and adolescents (aged 3 to 17 years). However, for simplicity, we refer to the education level of individuals rather than the education level of their households.
  • The health risk related to abdominal obesity is lower for those with a higher level of education: 67% are at risk among the low-educated, compared to 57% among the mid-educated and 45% among the highly educated.

     

Region and year

Proportion of the Belgian population aged 3 to 64 years with a health risk related to abdominal obesity (waist-to-height ratio ≥ 0.50), by year and region, Belgium: 2022-2023

  • Adjusted = results weighted for season, age, sex and socioeconomic status, and adjusted according to age and sex  based on linear regression model (using the Belgian population of 2022-2023 as reference).
  • Although the cut-off value of 0.50 has been widely applied in children to predict cardiometabolic risk, the optimal cut-off value is still under discussion, potentially requiring specific cut-offs for different populations.
  • The health risk related to abdominal obesity in the population aged 3 to 64 years old is higher in Brussels than in Flanders.
  • Overall, the health risk did not change in the Belgian population aged 3 to 64 years between 2014-2015 and 2022-2023.
  • At the regional level in the Belgian population aged 3 to 64 years, the risk increased in Brussels, decreased in Wallonia and did not change in Flanders between 2014-2015 and 2022-2023.

Please cite this page as: Sciensano. Weight status and eating disorders: Waist-to-height ratio, Food Consumption Survey 2022-2023, June 2024, Brussels, Belgium, https://www.sciensano.be/en/results-food-consumption-survey-2022-2023/weight-status-and-eating-disorders/waist-height-ratio

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