Waist-to-height ratio as a tool for predicting metabolic risk

The National Institute for Health and Care Excellence (NICE) recommends that people should keep their waist measurement to less than half their height to reduce their risk of potential health problems. This is called the waist-to-height ratio. It can be used, alongside body mass index (BMI), to estimate how much fat a person is carrying around their middle. Knowing this can help with assessing and predicting health risks for type 2 diabetes, hypertension or cardiovascular disease.

NICE recommends using waist-to-height ratio alongside BMI to assess and predict weight-related conditions. However, we don’t know enough about how waist-to-height ratio changes throughout a person’s life to fully understand whether it could be used as an alternative to BMI when trying to predict future health conditions.

Project aims

During this study we want to explore whether using waist-to-height ratio in childhood could be used together with BMI to:

• predict the risk of diseases related to central body fat in later life
• explore if central body fat in childhood contributes to liver disease and high blood pressure in adulthood

To do this, we will use data from the Avon Longitudinal Study of Parents and Children (ALSPAC). We will look through ages seven, 15 and 24 to:

• chart changes in waist-to-height ratio compared to BMI
• examine the link between waist-to-height ratio or BMI and blood pressure
• examine the link between waist-to-height ratio or BMI and liver steatosis (a buildup of fat in the liver)
• explore if waist-to-height ratio could be used as an alternative measure to predict risk for blood pressure and liver health

What we hope to achieve

We hope our findings will demonstrate that waist-to-height ratio can successfully be used in children and young people as an alternative clinical measure to BMI. Demonstrating this could mean is begins to be used more widely in paediatric weight management.

In turn, a wider rollout of NICE recommendations could make assessing whether a child or young person needs help with their weight easier. This would be particularly useful in community settings and countries with poorer access to resources.

This project is being led by Dr Sumona Mandal with Dr Kushala Abeysekera, Dr Sam Leary, Professor Nic Timpson and Professor Julian Hamilton-Shield providing supervision.