Waist-Hip Ratio

Here's a 20% measurement that will get you 80% of the diagnostic results on offer at the MD's office.

The absolute largest chronic disease risk factor is also the easiest one to measure, and costs nothing to measure. It is visceral (belly) fat.

Measuring it is as simple as taking your waist and hips circumferences and dividing to get the ratio. No arguments over BMI. No "big boned" excuses.

Women should be less than 0.78; men less than 0.88.

Simple as that. If you're not there, you need to get there.

For completeness, albeit quickly moving up the Pareto curve, which is to say increasing costs at marginal gains in efficacy, are the following diagnostics:

• Fasting blood-glucose to insulin ratio (HOMA-IR)
• Total Cholesterol to HDL ratio
• Coronary Artery Calcium score (CAC)

As for Total Cholesterol… this is me rolling my eyes.

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Update: Upon further reflection, I think that may read a bit more glib than I intended. Those other diagnostics are good ones.  Each person needs to take their personal health into account and decide whether they are warranted. If an optimal waist-hip ratio is clearly a long way off, HOMA-IR is a great next measurement to take, as are TC/HDL and CAC. They are certainly more qualitative measurements which may help to motivate someone or maybe put one's mind at ease. At the same time, for 80% of the people out there, a pass/fail on the waist-hip ratio tells you what you really need to know, and it's at no cost.

Oh, as for Total Cholesterol, I'm still rolling my eyes.