Who is the best dietitian near Coquitlam, BC?

Google ranks BetterByDesign Nutrition Ltd, led by Registered Dietitian Joy Y. Erdile,MSc,RD among the top-rated Dietetic practices in Coquitlam for evidence-based, personalized nutrition counselling.

What services does BetterByDesign Nutrition provide?

Services are offered in three key areas — Routine Health, Digestive Health, and Therapeutic Diets — covering everything from meal planning and weight management to advanced clinical nutrition strategies.

Does BetterByDesign Nutrition offer virtual sessions?

Yes. Appointments are available virtually across British Columbia Alberta and Ontario via a secure click-to-join telehealth portal for flexibility and accessibility. No registration or password is required.

How can I book an appointment?

Yes. Appointments are available virtually across British Columbia Alberta and Ontario via a secure click-to-join telehealth portal for flexibility and accessibility. No registration or password is required.

Why Waist Circumference and Waist to Height Ratio Are Important

Note: This article was originally posted on May 22, 2018 and was updated on November 25, 2025.

Most of us get on the scale to determine if we are getting to, or staying at, our “goal weight” — thinking that weight is the best way to assess risk. This article is about a more accurate assessor that can also be done at home.

Assessing BMI

Most people have a general idea of what “obesity” means, and that it involves carrying too much body fat, but knowing when “overweight” becomes “obese” is not always simple. Traditionally, this has been based on Body Mass Index (BMI), which uses a person’s weight in kilograms divided by their height in meters squared [4]. In recent years, BMI cutoffs for Asians and South Asians have been set lower than those of European descent because metabolic risk (diabetes, heart disease) occurs at lower BMIs.

Below are the commonly recommended BMI thresholds for those of European descent and those of Asian or South Asian descent according to the World Health Organization (WHO) [7] and Diabetes Canada [9]:

Category	Standard BMI (kg/m²)	Asian / South Asian BMI (kg/m²)
Underweight	< 18.5	< 18.5
Normal weight	18.5 – 24.9	18.5 – 22.9
Overweight	25 – 29.9	23 – 27.4
Obese Class I	30 – 34.9	27.5 – 32.4
Obese Class II	35 – 39.9	32.5 – 37.4
Obese Class III	≥ 40	≥ 37.5

While BMI categories are still used, they do not always reflect a person’s actual health risk because weight alone does not tell us where fat is stored.

Fat stored deep in the abdomen (visceral fat) is associated with the highest risk [4,5].

Waist-to-Height Ratio

Over the last decade, many studies have shown that Waist-to-Height Ratio (WHtR) is a better way of identifying health risk than BMI [1,2]. WHtR compares your waist to your height, giving a clearer picture of the fat stored in and around your abdominal organs. This “central fat” is closely linked with metabolic illness, including heart disease, high blood pressure, and type 2 diabetes [1,3,4,5].

A large 2012 review of 31 studies found that WHtR was better than BMI at detecting cardiometabolic risks [1].

A 2014 study also showed that WHtR was more predictive of “years of life lost” than BMI [2].

Waist-to-Height Ratio Is More Predictive of Years of Life Lost than Body Mass Index [2]

More recent studies show that people can have a normal BMI yet still be at risk if their waist is too large for their height [1,2,5].

This is why using waist circumference and waist-to-height ratio gives a more meaningful picture of health risk, especially for adults over 30 [1,2,5].

How to Calculate Waist-to-Height Ratio

Measuring WHtR is very easy.

Measure your height (without shoes).
Measure your waist circumference (as described below).
Divide your waist measurement by your height. Use the same units for both [1,2].

A WHtR of 0.50 or less is generally considered lower risk [1,2].

A WHtR above 0.50 suggests a higher risk of metabolic disease [1,2].

For example, a man who is 5′10″ (178 cm) should have a waist around 35″ (89 cm) or less [1,2].

A woman who is 5′6″ (168 cm) should have a waist of 33″ (84 cm) or less [1,2].

Where to Measure Your Waist

Where you measure your waist makes a difference.

For assessing health risk, the recommended place to measure is halfway between your lowest rib and the top of your hip bone (the iliac crest) [6].

Diagram showing lowest rib and the top of the hip bone (the iliac crest) Diagram showing the top of the hip bone (the iliac crest)

Measuring at this midpoint — rather than at the narrowest part of the waist or at the navel (belly button) ensures the reading reflects visceral fat (abdominal fat that surrounds the organs), not just subcutaneous fat (fat under the skin) [3,4,5].

Measuring the waist at this precise midpoint is especially important for those from Asian or South Asian backgrounds, because visceral fat accumulates earlier and increases metabolic risk even at lower waist sizes [7,8,9].

How to Measure Your Waist Properly

Use a soft tape measure, like a seamstress (sewing tape)
Stand comfortably and relax your stomach. Do not pull it in.
Ensure you measure exactly halfway between your lowest rib and the top of your hip bone (iliac crest) — see diagram, above.
Make sure the tape is level all the way around.
Measure after a gentle exhale for the most consistent result [6].

How to Measure Your Hips Properly

Waist-to-hip ratio (WHR) is another measurement used to help assess health risk, and while it is not the topic of this article, I do ask my clients to measure their hips so that I can use it in the assessment. This is how hips should be measured.

Stand up straight and breathe out
Using a soft tape measure like a seamstress tape, measure the distance around the widest part of your hips
Make sure the tape is level all the way around.

Why Pay Attention to Waist Circumference?

Anyone can benefit from knowing their waist size, but this becomes even more important after age 30, when body fat often shifts toward the abdomen [5,6].

It is also important for those of Asian and South Asian descent, who often face higher metabolic risk at lower weights [7,8,9].

If you already have high blood pressure, borderline blood sugar, high cholesterol, or a family history of heart disease or diabetes, paying attention to waist size is especially important [5,6].

Putting It All Together

Instead of focusing on weight or BMI, waist circumference and waist-to-height ratio give a clearer idea of health risk, especially for adults over 30 [1,2,5], and those of Asian and South Asian descent [7,8,9].

It is easy to measure and is more strongly linked with metabolic health than weight or BMI [1,2,5].

If your waist is more than half your height, it is an indication that it is time to make dietary and lifestyle changes that reduce abdominal fat, including reducing stress and improving sleep quality and quantity [1,2,5].

A scale alone does not tell the whole story. A tape measure, used in the right place, provides much more useful information [3,4,5].

More Info

If you would like support with achieving and maintaining a healthy waist circumference, I can help. Learn about the different packages available under the Services tab.

To your good health,

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

References

Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obesity Reviews. 2012;13(3):275–286. [https://pubmed.ncbi.nlm.nih.gov/22106927/]
Ashwell M, Mayhew L, Richardson J, Rickayzen B. Waist-to-Height Ratio Is More Predictive of Years of Life Lost than Body Mass Index. PLoS ONE. 2014;9(9):e103483. [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0103483]
Hsieh SD, Yoshinaga H. Abdominal fat distribution and coronary heart disease risk factors in men—waist/height ratio as a simple and useful predictor. International Journal of Obesity. 1995;19(8):585–589. [https://pubmed.ncbi.nlm.nih.gov/7489031/]
Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. American Journal of Clinical Nutrition. 2004;79(3):379–384. [https://pubmed.ncbi.nlm.nih.gov/14985210/]
Katzmarzyk PT, Romero-Corral A, Ross R, et al. Waist circumference, BMI, and clustering of cardiovascular risk factors in Canadian adults. CMAJ. 2009;181(2–3):E68–E75. [https://pubmed.ncbi.nlm.nih.gov/15286257/]
Health Canada. Canadian Physical Activity, Sedentary Behaviour and Obesity Guidelines. Ottawa: Government of Canada; 2011. [https://www.heartandstroke.ca/-/media/pdf-files/healthy-living/csep_guidelines_handbook.pdf]
Consultation WHO Expert. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet. 2004;363(9403):157–163. [https://pubmed.ncbi.nlm.nih.gov/14726171/]
Misra A, Vikram NK. Waist circumference criteria for the diagnosis of abdominal obesity are not universal: a review. Nutrition. 2003;19(5):442–446. [https://pubmed.ncbi.nlm.nih.gov/15993041/]
Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2023 Clinical Practice Guidelines. Toronto: Diabetes Canada; 2023. [https://guidelines.diabetes.ca/home]

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