Metabolic Syndrome Criteria Calculator: Which Published Definitions Your Figures Meet, and What Changes When the Waist Threshold Is 90 cm Instead of 102 cm

Counts how many of the five published criteria your measurements meet, and reports which of four published definitions of the metabolic syndrome that satisfies — the 2001 NCEP ATP III criteria, the 2005 AHA/NHLBI criteria, the 2009 harmonised criteria and the 2005 IDF criteria — side by side, with no one of them substituted for another. This is a count of criteria, not a risk score. It does not estimate a probability of anything, because the criteria themselves do not. The thing on this page worth the most to most of its readers is the waist threshold: abdominal obesity is defined at over 102 cm in men by the American criteria and at 90 cm or more by the Indian national consensus, so a man with a 95 cm waist is not centrally obese on one figure and is on the other. Under the IDF criteria the waist is the one criterion that is compulsory, so that single choice can turn the whole answer over. Both figures are on the page, always, and neither is swapped in for the other.

Last updated 5 Oct 2026

This sorts a measurement into a published category. It is not a diagnosis, and one reading taken once is rarely enough to act on. If a result here worries you, take it to a doctor rather than to the internet.

Five criteria counted four ways, with both published waist thresholds

waist, triglycerides, HDL, fasting glucose and blood pressure -> how many of the five criteria are met, and which of four published definitions that satisfies under each of the two waist thresholds

Units for the waist and for the blood resultsIndian and United States laboratories report lipids and glucose in mg/dL; the United Kingdom and most of Europe report them in mmol/L. Both are accepted and the page converts with the molar factors printed in the formula block below — triglycerides at 88.5432 mg/dL per mmol/L, cholesterol at 38.665 and glucose at 18.0156, each of which is simply the analyte’s molecular weight divided by ten. Read the conversion table further down before trusting a borderline result in mmol/L. The published criteria were written in mg/dL with mmol/L figures printed beside them, and the two sets of figures are not exact equivalents: entering exactly 6.1 mmol/L of glucose does not meet the ATP III criterion of 110 mg/dL, because 6.1 mmol/L is 109.90 mg/dL. The same analyte converters in the medical set do these conversions on their own: triglycerides, HDL cholesterol and glucose.

Which set of sex-specific thresholds to useThree of the five criteria are published with sex-specific figures and two are not. This control selects the waist figures (102 cm and 90 cm for men, 88 cm and 80 cm for women) and the HDL cholesterol figure (below 40 mg/dL for men, below 50 mg/dL for women). The triglyceride, blood pressure and fasting glucose criteria are the same for both. Nothing else on the page changes.

Waist circumferenceIn the unit chosen above, taken at the end of a normal breath out, tape horizontal and snug against the skin without compressing it, read to the nearest 0.1 cm. Where the tape goes is the largest single source of error on this page. The United States national survey protocol marks a line just above the uppermost lateral border of the right ilium; other protocols use the midpoint between the lowest rib and the iliac crest, the narrowest point of the torso, or the umbilicus, and a published comparison of sites in the same people found differences between pairs of sites of up to 6.9 cm in men and 10.1 cm in women. That is larger than the eight centimetres that separate the two published thresholds for women. The page refuses a waist outside 40 to 200 cm (15.7 to 78.7 inches). The waist-to-hip page sets out the measurement problem at length.

Fasting triglyceridesIn the unit chosen above, from a fasting sample. All four definitions use the same figure: 150 mg/dL or above, which is 1.6941 mmol/L exactly, printed in the source documents as 1.7. The page refuses a value outside 20 to 5000 mg/dL (0.23 to 56.4 mmol/L). If you are taking a fibrate, nicotinic acid or high-dose omega-3 for raised triglycerides, say so below: three of the four definitions count drug treatment as meeting this criterion whatever the number is. A very high triglyceride has its own separate meaning that has nothing to do with this page — the hypertriglyceridaemia severity page in the medical set covers it.

HDL cholesterolIn the unit chosen above. The criterion is below 40 mg/dL in men and below 50 mg/dL in women, which are 1.0345 and 1.2932 mmol/L exactly, printed in the source documents as 1.03 and 1.29 and in the 2009 harmonised statement as 1.0 and 1.3. This is the one criterion on the page where a lower number counts towards the syndrome rather than a higher one, which is easy to read the wrong way round. The page refuses a value outside 5 to 150 mg/dL (0.13 to 3.87 mmol/L). It does not take total or LDL cholesterol, because no definition of the metabolic syndrome uses either — the non-HDL cholesterol page and the apolipoprotein B converter are where those belong.

Fasting plasma glucoseIn the unit chosen above, after at least eight hours without food. This is the criterion the four definitions disagree about most simply: the 2001 ATP III figure is 110 mg/dL and the 2005, 2009 and IDF figure is 100 mg/dL, so a fasting glucose of 104 meets one criterion and not the other. The page refuses a value outside 30 to 900 mg/dL (1.67 to 49.9 mmol/L). A fasting glucose of 126 mg/dL (7.0 mmol/L) or more is in the diabetes range and means something quite different from a metabolic syndrome criterion; the band notes say so when it happens. The glucose converter handles the units on its own.

Systolic blood pressure, the top number (mmHg)Always in mmHg; the unit control above does not apply to blood pressure. The criterion is met when the systolic is 130 mmHg or more OR the diastolic is 85 mmHg or more — either limb on its own is enough, which is how all four definitions are applied. Note that 130/85 is not the same as the threshold for hypertension in any country: the blood pressure category page shows where a reading falls on three national sets of criteria, which is a different question from this one. The page refuses a systolic outside 50 to 300, or any pair whose systolic is less than 5 mmHg above the diastolic.

Diastolic blood pressure, the bottom number (mmHg)Always in mmHg. This number meets the criterion on its own at 85 mmHg or more, independently of the systolic, which is the half of the rule most often dropped. The page refuses a diastolic outside 20 to 200. One reading taken once is not a blood pressure; the criterion was written against properly taken office readings and the measurement advice on the blood pressure category page applies here unchanged.

On drug treatment for raised triglycerides or low HDLAnswering yes makes BOTH the triglyceride and the HDL criterion count as met under the 2005 AHA/NHLBI criteria, the 2009 harmonised criteria and the 2005 IDF criteria, whatever the two numbers are. That is what those documents say, and the reason is obvious once stated: a treated number is not an untreated number, and a definition that read the treated value would score somebody as healthier for being on treatment. The drugs named are the ones the 2009 statement names for these two criteria. A statin is NOT one of them, because statins are given for LDL cholesterol, which is not a criterion here. The 2001 ATP III criteria contain no treatment allowance at all, so answering yes does not change that column — which is one of the ways the four definitions part company.

On drug treatment for blood pressureAnswering yes makes the blood pressure criterion count as met under the 2005, 2009 and IDF criteria regardless of the reading. Again that is the published rule, not this page’s addition: the 2005 AHA/NHLBI criteria name antihypertensive drug treatment as an alternate indicator, and the IDF criteria name treatment of previously diagnosed hypertension. And again the 2001 ATP III column is unaffected, because the criteria as published in 2001 look only at the measured reading.

On drug treatment for glucose, or diagnosed type 2 diabetesAnswering yes makes the fasting glucose criterion count as met under the 2005, 2009 and IDF criteria. The two documents word this differently and this page combines them into one question, which is a judgement call stated rather than hidden: the 2005 AHA/NHLBI criteria say drug treatment for elevated glucose, and the IDF criteria say previously diagnosed type 2 diabetes. Somebody with diagnosed type 2 diabetes on diet alone therefore meets the criterion on the IDF wording and arguably not on the 2005 wording, and this page treats them as meeting it. The 2001 ATP III column is unaffected. If you have diagnosed diabetes, the metabolic syndrome criteria are of very little use to you anyway, and the body text says why.

2of 6Example

A man, waist 95 cm, triglycerides 168 mg/dL, HDL 43 mg/dL, fasting glucose 104 mg/dL, blood pressure 128/82, on no treatment

Five criteria, counted four ways, and the one definition that asks permission before it counts

Count-any-three definitions (ATP III 2001, AHA/NHLBI 2005, harmonised 2009): met when waist + triglycerides + HDL + blood pressure + glucose ≥ 3, each term 1 or 0 · IDF 2005: met when waist = 1 and triglycerides + HDL + blood pressure + glucose ≥ 2 · waist: > 102 / 88 cm (2001), ≥ 102 / 88 cm (2005), ≥ 90 / 80 cm (Indian consensus) · triglycerides ≥ 150 mg/dL · HDL < 40 (men) or < 50 (women) mg/dL · systolic ≥ 130 or diastolic ≥ 85 mmHg · fasting glucose ≥ 110 mg/dL (2001) or ≥ 100 mg/dL (2005 onwards) · from 2005, drug treatment for a criterion counts as meeting it · mmol/L → mg/dL: triglycerides × 88.5432, cholesterol × 38.665, glucose × 18.0156

1 or 0: every criterion is a yes or a no. There is no weighting, no partial credit and no dose-response inside a criterion: a triglyceride of 151 mg/dL and one of 1510 mg/dL both contribute exactly 1, and a waist 1 mm over threshold contributes the same as one 30 cm over. That is a property of the published definitions, not of this page, and it is the single biggest thing a count throws away
≥ 3: three of five, which is what the 2001 ATP III criteria, the 2005 AHA/NHLBI criteria and the 2009 harmonised criteria all require. Which three does not matter to any of them
waist = 1 and: the structural difference, and the most interesting thing on this page. The 2005 IDF criteria make central obesity a precondition: without it the definition cannot be met however many of the other four are. The 2009 harmonised statement specifically reversed that, concluding that abdominal obesity should not be a prerequisite and should instead be one of five criteria of which any three qualify. Both documents are still in use and both are cited here
102 / 88 vs 90 / 80: two published waist thresholds for the same criterion, twelve centimetres apart in men and eight in women. The larger pair is from the 1998 United States national guideline and is carried into the ATP III and AHA/NHLBI criteria; the smaller pair is the Indian national consensus figure, and the IDF also gives 90 / 80 for South Asians. This page applies each where its own document applies it, prints both distances, and never substitutes one for the other
> vs ≥: the 2001 criteria word the waist as a strict inequality (above 102 cm) and the 2005 criteria word it as 102 cm or above. A waist of exactly 102.0 cm therefore meets one and not the other, and the page implements each as its own document words it rather than smoothing the difference away
or: the blood pressure criterion is satisfied by either limb on its own. The 2001 table writes it as 130/85 or above, which is ambiguous between and and or; the 2005 statement resolves it explicitly as systolic 130 or above OR diastolic 85 or above, and that is how all four are universally applied and how this page implements all four
× 88.5432: the molar conversions, each of which is the analyte’s molecular weight divided by ten: triglyceride as triolein at 885.43 g/mol, cholesterol at 386.65 g/mol and glucose at 180.16 g/mol. Going the other way the same constants are 0.0112939, 0.0258632 and 0.0555074 mmol/L per mg/dL, which are the factors the analyte converters in the medical set use. The page tests the mg/dL figures because that is the unit the definitions were written in; the conversion table below gives every threshold in both units and names the three where the published mmol/L figure and the converted mg/dL figure disagree
no probability: nothing here is a risk model and nothing on the page outputs one. The five criteria contain no age, no sex as a risk factor, no smoking, no LDL cholesterol and no family history, which is most of what determines cardiovascular risk, and the 2009 harmonised statement says in terms that the syndrome is not an absolute risk indicator for exactly that reason

Worked example

A man, waist 95 cm, triglycerides 168 mg/dL, HDL 43 mg/dL, fasting glucose 104 mg/dL, blood pressure 128/82, on no treatment
Test the five criteria one at a time, before counting anything. Waist 95 cm: above 102 cm? No. At or above 102 cm? No. At or above the Indian consensus figure of 90 cm? Yes. Triglycerides 168 mg/dL: at or above 150? Yes, by 18 mg/dL, which is 0.203 mmol/L. HDL 43 mg/dL: below 40 for a man? No, it is 3 mg/dL (0.078 mmol/L) above the figure. Blood pressure 128/82: systolic at or above 130? No, 2 mmHg short. Diastolic at or above 85? No, 3 mmHg short. Fasting glucose 104 mg/dL: at or above 100? Yes. At or above 110? No, 6 mg/dL short. So of the four criteria other than the waist, exactly two are met.
Now count, four times, under four published rules. ATP III 2001: waist does not count (95 is not above 102), triglycerides count, HDL does not, blood pressure does not, and glucose does not either because the 2001 figure is 110 mg/dL. One criterion of five. Not met. AHA/NHLBI 2005: waist still does not count (95 is not at or above 102), but glucose now does because the figure is 100. Two of five. Not met. 2009 harmonised, with the Indian waist figure: the waist counts, so triglycerides, glucose and waist make three of five. Met. IDF 2005: central obesity is present on the South Asian figure of 90 cm, which is the precondition, and two of the other four are met, which is what it asks for. Met.
Two of four definitions met, and the difference is one centimetre figure. That is position 2 of the 6 on this page. Hold everything else and move only the threshold: on 102 cm this man has two criteria out of five and no definition is met; on 90 cm he has three out of five and two definitions are met, including the one the global diabetes literature uses most. His waist did not change. His triglycerides did not change. The published figure that his waist was compared against changed, and that is the whole of it. For women the same window is 80 to 88 cm, eight centimetres wide rather than twelve.
How large is that window against the measurement itself? This is the uncomfortable part. A published comparison of waist measurement sites in the same people found differences between pairs of sites of up to 6.9 cm in men and 10.1 cm in women. Twelve centimetres separate the two men's thresholds, and 6.9 cm of that is reachable by moving the tape from the iliac crest to the umbilicus. For women the entire eight-centimetre window is smaller than the 10.1 cm the same study found. So the choice of threshold and the choice of tape position are of comparable size, and anybody treating either as exact is mistaken about both.
What one unit of anything does to the answer. Raise the glucose from 104 to 110 mg/dL and the ATP III count goes from one to two, still not met, while nothing else changes. Lower the HDL from 43 to 39 and the count rises by one everywhere: the harmonised count with the Indian waist becomes four of five, the 2005 count becomes three of five and is met, and the position moves from 2 to 4. Say yes to a fibrate instead and the same thing happens twice over, because drug treatment for raised triglycerides or low HDL satisfies both of those criteria under the 2005, 2009 and IDF rules — and changes nothing at all in the 2001 column, which has no treatment allowance. One answer to one question, worth two criteria out of five on three definitions and zero on the fourth.
And what this page refuses to do with the answer. It does not turn two of four definitions into a percentage, a risk, a score or a grade. It cannot: the five criteria contain nothing about age, smoking, LDL cholesterol or family history, and the 2009 harmonised statement says plainly that the syndrome is not an absolute risk indicator for that reason. Nor does the position at the top of this page order the six rows by severity — positions 3 and 2 are not comparable with each other at all, because one is a reader who fails the IDF waist precondition and the other is a reader who passes it, and no published rule says which of those is worse. The rows above are the output. The number is how the page got to the words beside it.

The six joint positions, with a worked example of each (men’s thresholds)

Triglycerides, HDL and glucose in mg/dL, blood pressure as systolic and diastolic in mmHg. Six positions, not sixteen: sweeping the whole decision-relevant grid for this page — both sexes, thirteen waist values spanning every side of both thresholds, nine triglyceride values, ten HDL values, fourteen glucose values, seven blood pressure pairs and all eight combinations of the three treatment answers, which is 1,834,560 combinations — produces exactly six distinct patterns of the four verdicts and no others. The three count-any-three definitions turn out to be strictly nested: anything meeting the 2001 criteria meets the 2005 criteria, and anything meeting the 2005 criteria meets the 2009 criteria applied with the Indian waist figure, always. **The IDF 2005 definition is the one that does not nest.** Compare rows 2 and 5: in row 2 the IDF definition is met and the 2001 criteria are not; in row 5 the 2001 criteria are met and the IDF definition is not. Those two positions cannot be put in an order, which is why the number at the top of this page is a position in a list and not a grade. It is also the whole consequence of making one criterion compulsory. For women the same six positions arise at 74 to 92 cm instead of 84 to 106, with the HDL figure at 50 rather than 40: a woman with an 84 cm waist, triglycerides of 168, HDL of 56 and glucose of 104 is in position 2 exactly as the man in row 2 is.
Position	Waist	TG / HDL / glucose / BP	ATP III 2001	AHA/NHLBI 2005	Harmonised 2009, Indian waist	IDF 2005
1	84 cm	120 / 48 / 92 / 118-76	1 of 5, no	0 of 5, no	0 of 5, no	no
2	95 cm	168 / 43 / 104 / 128-82	1 of 5, no	2 of 5, no	3 of 5, yes	yes
3	84 cm	168 / 35 / 104 / 128-82	2 of 5, no	3 of 5, yes	3 of 5, yes	no
4	95 cm	168 / 35 / 104 / 128-82	2 of 5, no	3 of 5, yes	4 of 5, yes	yes
5	84 cm	168 / 35 / 115 / 128-82	3 of 5, yes	3 of 5, yes	3 of 5, yes	no
6	106 cm	168 / 35 / 115 / 128-82	4 of 5, yes	4 of 5, yes	4 of 5, yes	yes

Where the four definitions actually differ. A comparison assembled for this page

This is a comparison built for this page, not a reproduction of anybody’s table — none of the four documents publishes a column for the other three. Only the 2001 criteria are reproduced as criteria, and only because NIH Publication No. 01-3670 is a United States Government work carrying no copyright notice. Every figure in the other three columns is cited as a figure to the reference that states it, and no table, criteria list or passage of text from the 2005 statement, the 2009 statement or the IDF consensus appears anywhere on this page. In particular the 2009 statement’s ethnicity-by-ethnicity waist table is NOT reproduced here: the two waist figures on this page are the 1998 United States figure, which is itself a Government work, and the Indian national consensus figure of 90 and 80 cm from Misra and colleagues — which is also, as it happens, the figure the IDF gives for South Asians, a coincidence of two bodies reading the same South Asian data rather than one copying the other. Three rows carry the differences that change answers: the compulsory-waist row, the waist-figure rows, and the two rows on glucose and on drug treatment.
	ATP III 2001	AHA/NHLBI 2005	Harmonised 2009	IDF 2005
How many criteria are needed	any 3 of 5	any 3 of 5	any 3 of 5	central obesity, plus any 2 of the other 4
Is central obesity compulsory	No	No	No, and the statement says so explicitly	Yes
Waist, men	above 102 cm (40 in)	102 cm (40 in) or above	population- and country-specific; 90 cm or above for Asian Indians on the national consensus figure	90 cm or above for South Asians
Waist, women	above 88 cm (35 in)	88 cm (35 in) or above	80 cm or above on the same Indian figure	80 cm or above for South Asians and Europids alike
Triglycerides	150 mg/dL or above	150 mg/dL or above, or on drug treatment	same	same
HDL cholesterol	below 40 (men) / 50 (women) mg/dL	same, or on drug treatment	same	same
Blood pressure	130/85 mmHg or above	systolic 130 or above or diastolic 85 or above, or on an antihypertensive	same	same, or treated previously diagnosed hypertension
Fasting glucose	110 mg/dL or above	100 mg/dL or above, or on drug treatment	100 mg/dL or above, or on drug treatment	100 mg/dL or above, or diagnosed type 2 diabetes
Does drug treatment count as meeting a criterion	No. Nothing in the 2001 table mentions treatment	Yes	Yes	Yes
Licence position for this site	US Government work, no copyright notice, criteria may be reproduced	AHA journal article: figures cited, table not reproduced	Copyrighted: figures cited, table not reproduced	Copyrighted: figures cited, table not reproduced

Every threshold in both units, and the three places where the two roads disagree

The factors are molar and exact: a triglyceride at 885.43 g/mol, cholesterol at 386.65 g/mol and glucose at 180.16 g/mol, so mmol/L times 88.5432, 38.665 and 18.0156 gives mg/dL, and the reciprocals 0.0112939, 0.0258632 and 0.0555074 go the other way — the same constants the analyte converters in the medical set use. This page converts mmol/L input to mg/dL and tests the mg/dL figures, because mg/dL is the unit all four definitions are written in, with the mmol/L values printed beside them as rounded equivalents. Round-tripping every value on a 0.1 mg/dL grid across the whole range this page accepts — 20 to 5000 for triglycerides, 5 to 150 for HDL and 30 to 900 for glucose — the worst error from converting to mmol/L and back is under 5 parts in 10,000,000,000,000, which is floating-point dust and nowhere near any threshold. The real hazard is the one in the last column: the published rounding, not the arithmetic. Three of the five printed mmol/L figures put a reader on the other side of their own criterion.
Criterion	As published, mg/dL	Exact equivalent, mmol/L	mmol/L figure usually printed	What happens if you enter that printed figure exactly
Triglycerides	150 or above	1.6941	1.7	1.7 mmol/L is 150.52 mg/dL, so the criterion is met. The two roads agree, with 0.52 mg/dL to spare
HDL cholesterol, men	below 40	1.0345	1.03	1.03 mmol/L is 39.83 mg/dL, so this page counts the criterion as met — while the published wording, below 1.03 mmol/L, does not. They disagree, over a window of 39.83 to 40.00 mg/dL
HDL cholesterol, women	below 50	1.2932	1.29 (IDF 2005), 1.3 (2009)	1.29 mmol/L is 49.88 mg/dL, counted as met here and not met on the wording below 1.29. They disagree. And the two documents disagree with each other: 1.3 mmol/L is 50.26 mg/dL, so a woman between 49.88 and 50.26 meets the criterion on the 2009 figure and not on the IDF one
Fasting glucose, 2005 onwards	100 or above	5.5507	5.6	5.6 mmol/L is 100.89 mg/dL, so the criterion is met. The two roads agree
Fasting glucose, ATP III 2001	110 or above	6.1058	6.1	6.1 mmol/L is 109.90 mg/dL, which does not reach 110. They disagree, in the opposite direction from HDL: the figure the criterion is usually printed as fails the criterion the document actually states

Where each figure comes from, what licence it carries, and what was rejected

The recurring rule on this site: a threshold is a fact and is used freely, and a body’s table of criteria laid out as they laid it out is their expression and is left alone. One set of criteria on this page is reproduced in full, and it is the one published by a United States Government agency with no copyright notice. Two departures from a source are recorded above rather than buried: the IDF’s permission to assume central obesity from a BMI above 30 is not implemented, and the parenthetical inch figures are reported but not used as thresholds. And one thing could not be established at any price: which of the two waist thresholds is correct for an individual reader. That is not a gap in the research. It is the finding, and it is why both are on the page.
Figure	Source used	What was rejected, or could not be established
The 2001 criteria in full: waist above 102 cm in men and above 88 cm in women, triglycerides 150 mg/dL or above, HDL below 40 in men and below 50 in women, blood pressure 130/85 or above, fasting glucose 110 mg/dL or above, and the diagnosis at three or more	Executive Summary of the Third Report of the NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), NIH Publication No. 01-3670, May 2001, Table 8. Verified against the document itself rather than against a secondary source. A United States Government work carrying no copyright notice, so these criteria are the one set on this page that may be, and are, reproduced as criteria.	Nothing was rejected here, but two things in the brief for this page had to be corrected against the document. The brief said treated blood pressure, lipids and glucose count as meeting their criteria because the published definitions say so: the 2001 document says no such thing, and its Table 8 contains no treatment allowance of any kind. The treatment rule enters with the 2005 statement. The brief also gave the 2005 update as having lowered the glucose figure, which it did, but it also changed the waist inequality from above 102 cm to 102 cm or above and added the treatment alternates, neither of which the brief mentioned.
The move of the fasting glucose figure from 110 to 100 mg/dL, the waist inequality becoming inclusive, and drug treatment counting as an alternate indicator for triglycerides, HDL, blood pressure and glucose	Grundy SM and colleagues, the 2005 AHA/NHLBI scientific statement, Circulation 2005;112:2735–2752. Cited as figures and as a description of how it differs from 2001. The figure 100 mg/dL stands on its own in any case: it is the bottom of the impaired fasting glucose range, and the Centers for Disease Control and Prevention — a United States Government work — prints a fasting result of 100 to 125 mg/dL as prediabetes and 126 mg/dL or above as diabetes.	Reproducing the statement’s criteria table, or any passage of its text. It is an American Heart Association journal article and this site carries advertising, so its numbers are used as numbers and its expression is left alone.
Central obesity as a compulsory criterion, and the South Asian waist figure of 90 cm in men and 80 cm in women	The IDF consensus worldwide definition of the metabolic syndrome (2005, published 2006), cited by figure: central obesity required, plus any two of raised triglycerides, reduced HDL, raised blood pressure and raised fasting glucose, with treatment alternates for each and the waist threshold ethnicity-specific.	Reproducing the IDF table, and reproducing its full list of ethnic groups. One further IDF provision is deliberately NOT implemented: that central obesity may be assumed without measuring the waist when BMI is above 30 kg/m². This page has no BMI input, and inferring a waist from a BMI is exactly the substitution the page exists to avoid. It is recorded here rather than silently dropped. The BMI page is where that figure belongs.
Any three of five, with the waist threshold population- and country-specific	Alberti KGMM, Eckel RH, Grundy SM and colleagues, Harmonizing the Metabolic Syndrome, a joint interim statement of the IDF Task Force on Epidemiology and Prevention, the NHLBI, the AHA, the World Heart Federation, the International Atherosclerosis Society and the International Association for the Study of Obesity. Circulation 2009;120:1640–1645. Cited by figure, plus one short sentence quoted because it is the page’s own warrant for printing no probability.	The ethnicity-by-ethnicity waist table, which is not reproduced anywhere on this page. The statement instructs that the waist threshold be population-specific; this page supplies the Asian Indian figure from the Indian national consensus instead of from the statement’s table, which gives the same numbers for this population by a route that is cleanly citable as two figures.
The Indian waist figures of 90 cm in men and 80 cm in women	Misra A, Chowbey P, Makkar BM and colleagues, Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management, J Assoc Physicians India 2009;57:163–70, carried forward unchanged in the 2025 revised definition by Misra, Vikram, Ghosh, Ranjan, Gulati and the India Obesity Commission, Diabetes Metab Syndr 2025;19:102989. The same two figures are already used on the waist-to-hip page in this set. Cited as two figures with their provenance; no criteria table is reproduced.	Taking the South Asian cut-offs from the international health body’s expert consultation, which is where most sites get them. Its publications carry a NonCommercial licence term that a site carrying advertising cannot satisfy, and the prohibition is not laundered by taking the figures from a third party that has reprinted them. The same body’s own 1998 definition of the metabolic syndrome, which required insulin resistance, is not used on this page for the same reason and is not described here.
The waist figures of 102 cm and 88 cm, and the fact that they were derived in a largely white North American population	National Heart, Lung, and Blood Institute, Obesity Education Initiative Expert Panel, Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, NIH Publication No. 98-4083, 1998. A United States Government work in the public domain, and the origin of the figures the 2001 and 2005 criteria carry.	The parenthetical inch figures as thresholds. The 2001 table prints 40 inches beside 102 cm and 35 inches beside 88 cm, and those are roundings rather than conversions: 40 inches is 101.6 cm and 35 inches is 88.9 cm. The two roundings go in opposite directions, so an inch-based test is marginally stricter than the metric one for men and marginally looser for women. This page tests the centimetre figure and reports the inch distance separately rather than choosing.
The protocol differences of up to 6.9 cm in men and 10.1 cm in women between waist measurement sites	The 2023 comparison of waist circumference measurement sites and their association with visceral and subcutaneous fat and cardiometabolic abnormalities already cited on the waist-to-hip page: differences between pairs of sites in the same individuals ranged from 0.2 to 6.9 cm in men and from 0.1 to 10.1 cm in women.	Nothing. It is the most important number on this page after the thresholds themselves, because 6.9 cm is more than half the twelve-centimetre gap between the two men’s thresholds and 10.1 cm is larger than the whole eight-centimetre gap for women.
A probability, a risk percentage or a score	Not offered, and not offered deliberately. The headline is a position in a list of six and the figures beside it are counts of criteria.	Every route to a number. The five criteria contain no age, no smoking, no LDL cholesterol and no family history, and the 2009 statement says the syndrome is not an absolute risk indicator because it lacks exactly those. The published associations — roughly a doubling of cardiovascular events over five to ten years and about a five-fold increase in the risk of type 2 diabetes, and a meta-analysis of 87 studies and 951,083 patients giving relative risks near 2.35 for cardiovascular events — are population relative risks and are reported as such in the body text. Turning any of them into a personal percentage would be an invention.
Whether the clustering predicts more than its components	Reported as contested, with both sides cited: the Mottillo meta-analysis on one side, and on the other the joint statement of the American Diabetes Association and the European Association for the Study of Diabetes, which concluded that the syndrome has been imprecisely defined, that there is considerable doubt about its value as a cardiovascular risk marker, and that clinicians should treat every risk factor without regard to whether the criteria are met.	Presenting either side as settled. It is not settled, and a page that resolved it in either direction would be stating a position rather than reporting one. The confidence intervals of the meta-analysis figures were not verified against the primary article for this page and are therefore not printed; only the point estimates are.
Paediatric criteria	Not on this page at all. All four definitions are adult definitions.	Applying adult criteria to anyone under 18. The paediatric definitions use different thresholds and age- and sex-specific waist percentiles, and an adult count applied to a 14-year-old is the wrong instrument rather than an approximation.

Why four committees counted the same five things and got different answers, and why the waist figure matters most here

The metabolic syndrome is not a disease. It is a counting rule, and there are four of them in use. Five things get measured — waist, triglycerides, HDL cholesterol, blood pressure and fasting glucose — and a published definition says how many have to be over a line before the phrase applies. The 2001 NCEP ATP III criteria asked for three of five. The 2005 AHA/NHLBI statement kept three of five and moved two of the lines. The 2005 IDF definition asked for central obesity plus two of the other four. The 2009 harmonised statement, signed by both the IDF and the American bodies, went back to any three of five and said the waist threshold should depend on the population. All four remain in the literature and in use, so the honest thing a calculator can do is count four times and show the four answers, which is what this page does.

The disagreement that matters most for this site’s readers is one centimetre figure. Abdominal obesity in the 2001 and 2005 American criteria means a waist above 102 cm in a man and above 88 cm in a woman. Those numbers come from a 1998 United States guideline and were derived in a largely white North American population. The Indian national consensus, led by Misra and colleagues in 2009 and carried forward in its 2025 revision, sets abdominal obesity at 90 cm in men and 80 cm in women, on evidence that body fat, insulin resistance and their metabolic consequences arrive at a smaller waist in South Asian populations. Twelve centimetres apart for men, eight for women. A man with a 95 cm waist is not centrally obese on one published figure and is on the other, and nothing about him differs between the two statements. Under the IDF definition the waist is the one criterion that is compulsory, so for that man the choice of figure is not a nuance that shifts a count by one — it is the difference between meeting the definition and being unable to meet it at all. This page prints both distances and swaps neither in for the other, exactly as the BMI page prints both sets of BMI cut-offs and the waist-to-hip page prints both waist figures.

The compulsory-waist rule is a structural difference, not a threshold difference, and it is the most interesting thing about the comparison. A threshold difference moves a boundary; everybody stays on the same scale. A structural difference changes what kind of test it is. Because the IDF requires central obesity first, a person with raised triglycerides, low HDL and a raised blood pressure — three criteria out of five — meets the 2001, 2005 and 2009 definitions and cannot meet the IDF one if the waist is under the threshold, no matter what else is true. And a person just over the Indian waist figure with only two other criteria meets the IDF definition while failing the 2001 and 2005 counts. Those two readers cannot be put in an order: one is a definite yes on the oldest and strictest counting rule and a definite no on the IDF rule, the other is the reverse. Sweeping the whole decision space for this page — 1,834,560 combinations across both sexes, every side of every threshold and all eight combinations of the three treatment answers — produces exactly six distinct patterns of the four verdicts, and they do not form a single order. The three count-any-three definitions are strictly nested, so those three do order; the IDF definition cuts across all three. That is why the number at the top of this page is a position in a list of six and not a grade, and why the words in the chip beside it are the actual output.

The other two disagreements are smaller and still change answers. The fasting glucose line was 110 mg/dL in 2001 and became 100 mg/dL in 2005, so every reader between 100 and 109 mg/dL meets one criterion and not the other. The figure 100 is not a committee’s invention: it is the bottom of the impaired fasting glucose range, and the United States Centers for Disease Control and Prevention prints 100 to 125 mg/dL as prediabetes. And from 2005 onwards, being on drug treatment for a criterion counts as meeting it — an antihypertensive satisfies the blood pressure criterion whatever the reading, a fibrate or nicotinic acid satisfies both lipid criteria, and glucose-lowering treatment or diagnosed type 2 diabetes satisfies the glucose criterion. The reasoning is that a treated number is not an untreated number, and a definition that read the treated value would score somebody as having fewer criteria for being on treatment. The 2001 criteria contain no treatment allowance whatever, which is worth stating because it is widely assumed they do. So for anybody on treatment the 2001 column on this page reads low by construction and should not be compared with the others as though it were the same test.

Units are the quiet hazard, and the quiet hazard has a direction. Lipids and glucose are reported in mg/dL in India and the United States and in mmol/L in the United Kingdom and most of Europe. The definitions were all written in mg/dL, with mmol/L figures printed beside them as rounded equivalents, and the rounding is not neutral. 150 mg/dL of triglyceride is 1.6941 mmol/L and is printed as 1.7. Forty mg/dL of HDL is 1.0345 mmol/L and is printed as 1.03. One hundred mg/dL of glucose is 5.5507 mmol/L and the IDF prints it as 5.6; 110 mg/dL is 6.1058 and is usually quoted as 6.1. Enter those printed figures exactly and three of the five disagree with the criterion the document actually states — a man entering 1.03 mmol/L of HDL has 39.83 mg/dL and meets a criterion the words below 1.03 would not give him, and a reader entering 6.1 mmol/L of glucose has 109.90 mg/dL and does not meet the 2001 criterion of 110 that 6.1 is the usual print of. This page converts to mg/dL at the molar factors and tests the mg/dL figures, and the conversion table above names every one of those windows. The analyte converters in the medical set do the same arithmetic one analyte at a time: triglycerides, HDL, LDL and glucose.

What a count cannot see, which is most of what matters. Every criterion is a one or a zero. A triglyceride of 151 mg/dL and one of 1510 mg/dL are the same criterion, although the second has a risk of acute pancreatitis attached to it that the first does not and that no definition of the metabolic syndrome mentions — the hypertriglyceridaemia severity page handles that. A blood pressure of 130/85 and one of 230/130 are the same criterion, although one is a conversation next month and the other is a conversation today. A fasting glucose of 100 and one of 300 are the same criterion, although the second is diabetes. And the five criteria between them contain no age, no sex as a risk factor, no smoking, no LDL cholesterol, no family history and no kidney function, which is most of what determines cardiovascular risk. They also see nothing of the things that routinely travel with this cluster and are not in it: a raised ferritin, for one, which is common enough alongside these five that it has its own name and its own page, the high ferritin interpreter, and a waist-to-height ratio, which the 2025 Indian revision prefers to the waist alone and which the waist-to-height page computes. The 2009 harmonised statement says this about its own creation in terms: the syndrome "is not an absolute risk indicator, because it does not contain many of the factors that determine absolute risk". That sentence is the reason this page prints no percentage and never will.

And whether the clustering means anything beyond its parts is genuinely unsettled, twenty years into the argument. On one side, the clustering is real and is associated with outcomes: a meta-analysis of 87 studies and 951,083 patients reported relative risks of about 2.35 for cardiovascular events, 1.99 for myocardial infarction, 2.27 for stroke and 1.58 for all-cause mortality, with the association persisting in people without diabetes, and the 2009 statement puts the figures at roughly double the risk of a cardiovascular event over five to ten years and about a five-fold increase in the risk of type 2 diabetes. On the other side, a joint statement from the American Diabetes Association and the European Association for the Study of Diabetes examined the construct in 2005 and concluded that it has been imprecisely defined, that its pathogenesis is uncertain, that there is considerable doubt about its value as a cardiovascular risk marker, and that too much is missing to warrant calling it a syndrome at all — recommending instead that every cardiovascular risk factor be evaluated and treated without regard to whether a patient meets the criteria. Both positions are held by serious people reading the same data. This page reports both and resolves neither, because resolving it is not a calculator’s job.

What this page deliberately does not do. It does not diagnose anything: these are screening criteria and a count of them from figures typed into a web page is not a clinical assessment. It does not estimate risk, in any units, for the reasons above. It does not take a BMI, and it does not implement the IDF’s own provision that central obesity may be assumed when BMI is above 30 kg/m², because inferring a waist from a weight-to-height ratio is precisely the substitution this page exists to refuse — measure the waist. It does not apply to anyone under 18, where the criteria are different. It does not use the international health body’s 1998 definition, which required demonstrated insulin resistance, and it does not use that body’s waist cut-offs either, both for a licensing reason stated in the sources table rather than because of anything about the content. It does not tell you what to do. The useful next step from any position on this page is the same: take the five actual numbers, and both waist thresholds, to a doctor who can see the things these five numbers cannot.

Frequently asked questions

My waist is 95 cm. Do I have central obesity or not?

Both, depending on which published figure you compare it against, and that is a real answer rather than a dodge. On the 2001 ATP III and 2005 AHA/NHLBI criteria, abdominal obesity in a man means a waist above 102 cm, so 95 cm is not it. On the Indian national consensus figure of 90 cm, which the IDF also uses for South Asians, 95 cm is abdominal obesity. Twelve centimetres separate the two figures and nothing about your body sits between them. The reason there are two is that the larger pair was derived in a largely white North American population and the smaller pair was derived on evidence that body fat, insulin resistance and their metabolic consequences appear at a smaller waist in South Asian populations. Which figure applies to you is a question about ancestry and about which population’s data you think describes you, and this page will not answer it for you — it prints your distance from both. What makes it matter more than a shifted boundary usually would: the IDF definition makes central obesity compulsory, so the same 95 cm is the difference between meeting that definition and being unable to meet it at all. For women the equivalent window is 80 to 88 cm.

Why do the four definitions give different answers for the same five numbers?

Because they are four different tests, not four wordings of one test, and they differ in three ways. First, structurally: the 2005 IDF definition makes central obesity a precondition and then asks for two of the other four, while the 2001, 2005 and 2009 definitions ask for any three of five and do not care which three. Second, in the waist figure: 102 and 88 cm in the American criteria, population-specific in the 2009 statement, and 90 and 80 cm for South Asians in the IDF criteria and in the Indian consensus. Third, in two details that look minor and are not — the fasting glucose line moved from 110 mg/dL in 2001 to 100 mg/dL in 2005, and from 2005 onwards being on drug treatment for a criterion counts as meeting it, where the 2001 criteria allowed nothing of the kind. Sweeping the whole space of possibilities produces six distinct patterns of the four verdicts. Four of those six are patterns in which at least one definition says yes and at least one says no on identical figures.

Is this a risk score? What is my risk?

It is not a risk score, this page will not give you a risk, and no honest page could from these five numbers. The metabolic syndrome criteria contain no age, no smoking status, no LDL cholesterol, no family history and no kidney function — which is to say they leave out most of what determines cardiovascular risk. The 2009 harmonised statement says so about its own definition, describing the syndrome as not an absolute risk indicator precisely because it does not contain those factors. What does exist is population-level association: that statement puts it at roughly double the risk of a cardiovascular event over five to ten years and about a five-fold increase in the risk of type 2 diabetes, and a meta-analysis of 87 studies and 951,083 patients reported relative risks near 2.35 for cardiovascular events, 1.99 for myocardial infarction, 2.27 for stroke and 1.58 for all-cause mortality. Those are relative risks in populations, against people without the syndrome. They are not your probability of anything, and multiplying one of them by a baseline this page does not have would be inventing a number.

Does the metabolic syndrome actually tell a doctor anything the individual numbers do not?

That is contested, and it has been contested since the definitions were written. The case for it is that the components cluster for reasons that are probably shared, that the clustering is associated with outcomes in large meta-analyses, and that a single label gets a clinician to look at all five things rather than the one that prompted the test. The case against it was put at length in 2005 in a joint statement from the American Diabetes Association and the European Association for the Study of Diabetes, which concluded that the syndrome has been imprecisely defined, that its pathogenesis is uncertain, that there is considerable doubt about its value as a cardiovascular risk marker, and that too much critical information is missing to warrant calling it a syndrome at all; its recommendation was that clinicians evaluate and treat every cardiovascular risk factor without regard to whether the criteria are met. Twenty years on, the argument is not settled. This page reports both sides and the sources for both, and declines to pick, because picking would be stating an opinion in the voice of a calculator.

I take a blood pressure tablet and my reading is normal. Which criteria does that meet?

Under the 2005 AHA/NHLBI criteria, the 2009 harmonised criteria and the 2005 IDF criteria, you meet the blood pressure criterion whatever the reading is, because antihypertensive drug treatment is named as an alternate indicator in its own right. Under the 2001 ATP III criteria you do not, because that document looks only at the measured figure and contains no treatment allowance at all — a point widely assumed to be otherwise, and one that was checked against NIH Publication No. 01-3670 itself for this page. The same asymmetry applies to a fibrate or nicotinic acid, which satisfies both lipid criteria from 2005 onwards and neither in 2001, and to glucose-lowering treatment. The practical consequence is that if you are on treatment, the 2001 column on this page reads low by construction, and comparing it with the other three as though they were measuring the same thing will mislead you. The counts under each rule are printed separately for exactly that reason.

My results are in mmol/L. Is it safe to convert them myself?

It is safe if you use the molar factors and treat the published mmol/L figures with suspicion, and that second half is the part that catches people. The factors are triglycerides at 88.5432 mg/dL per mmol/L, cholesterol at 38.665 and glucose at 18.0156, each being the molecular weight over ten. The problem is that the mmol/L figures printed in the definitions are rounded: 150 mg/dL of triglyceride is 1.6941 mmol/L and is printed as 1.7; 40 mg/dL of HDL is 1.0345 and is printed as 1.03; 100 mg/dL of glucose is 5.5507 and is printed as 5.6; 110 mg/dL is 6.1058 and is printed as 6.1. Enter the printed figure exactly and three of those five land on the opposite side of the criterion from where the printed figure suggests. The sharpest case is glucose: 6.1 mmol/L is 109.90 mg/dL, which does not reach the 110 mg/dL the 2001 criteria state, so the number that criterion is usually quoted as fails it. This page converts to mg/dL and tests the mg/dL figures, and the conversion table on the page lists every one of those windows.

Why does the page say position 2 of 6, and is 4 worse than 2?

No, and that is the point of printing the words beside the number. The six positions are the six distinct patterns of the four verdicts that actually arise, found by sweeping 1,834,560 combinations of the inputs across both sexes and every side of every threshold. They are listed in a presentation order, and they do not form a severity scale, because two of them cannot be compared at all. Position 2 is a reader who meets the IDF definition and fails the oldest counting rule; position 3 is a reader who meets two counting rules and cannot meet the IDF definition because the waist criterion is not satisfied. No published rule says which of those is worse, and inventing an order would be inventing a judgement. What does order is the three count-any-three definitions, which turn out to be strictly nested: anything meeting the 2001 criteria meets the 2005 criteria, and anything meeting those meets the 2009 criteria applied with the Indian waist figure. The IDF definition is the one that cuts across them, which is exactly what making one criterion compulsory does.

Can I use this if I already have diabetes, or if I am under 18?

Under 18, no, and the page says so rather than producing a number quietly: all four definitions here are adult definitions, and the paediatric criteria use different thresholds together with age- and sex-specific waist percentiles, so an adult count applied to a teenager is the wrong instrument rather than an approximate one. With diagnosed type 2 diabetes the arithmetic still works and the answer is of much less use to you. The main published value of the metabolic syndrome criteria is as a marker of future type 2 diabetes risk in people who do not yet have it, and the IDF criteria count diagnosed type 2 diabetes as satisfying the glucose criterion outright, so a diabetic reader scores a criterion for the diagnosis itself. What remains worth doing is looking at the individual figures: the waist, the triglycerides, the HDL and the blood pressure each mean something on their own, and the insulin-resistance measures in the medical set ask a more quantitative question than a count does.

The thresholds are a few millimetres and a few mg/dL away from my numbers. How much should I trust that?

Rather less than the page’s arithmetic might suggest, and the waist is the worst of it. A published comparison of waist measurement sites in the same people found differences between pairs of sites of 0.2 to 6.9 cm in men and 0.1 to 10.1 cm in women, which means the tape placement alone can be worth more than half the gap between the two published men’s thresholds and more than the whole gap between the two women’s. The blood results move too: a single fasting lipid panel carries real biological and analytical variation, and a fasting glucose depends on how genuinely fasted the sample was. The criteria themselves are steps and nothing in a body steps, so a reader one unit either side of a line is in substantially the same position as a reader one unit the other side. The signed distances in the rows above are printed so that this is visible rather than hidden: read the distance, compare it with the measurement error, and treat a criterion that is within the error as undetermined rather than as met or not met.

Related calculators

References

National Cholesterol Education Program. Executive Summary of the Third Report of the NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). National Heart, Lung, and Blood Institute, NIH Publication No. 01-3670, May 2001. VERIFIED AGAINST THE DOCUMENT ITSELF, which carries no copyright notice and is a United States Government work: Table 8, Clinical Identification of the Metabolic Syndrome, gives abdominal obesity as a waist circumference of more than 102 cm (more than 40 in) in men and more than 88 cm (more than 35 in) in women, triglycerides of 150 mg/dL or above, HDL cholesterol below 40 mg/dL in men and below 50 mg/dL in women, blood pressure of 130/85 mmHg or above, and fasting glucose of 110 mg/dL or above; and the text states that for purposes of ATP III the diagnosis of the metabolic syndrome is made when three or more of the risk determinants shown in Table 8 are present. VERIFIED ALSO, and contrary to the brief for this page: the 2001 criteria contain NO allowance for drug treatment of any criterion. Table 8 carries two footnotes, one noting that abdominal obesity is more highly correlated with the metabolic risk factors than an elevated BMI, and one noting that some men develop multiple metabolic risk factors at a waist only marginally increased, 94 to 102 cm.
Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and Management of the Metabolic Syndrome: An American Heart Association / National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735–2752; DOI 10.1161/CIRCULATIONAHA.105.169404. Cited by figure for the three changes this page implements in its 2005 column: the fasting glucose threshold lowered to 100 mg/dL or above; the waist criterion restated inclusively as 102 cm (40 in) or above in men and 88 cm (35 in) or above in women; and drug treatment named as an alternate indicator for elevated triglycerides, for reduced HDL cholesterol, for elevated blood pressure (an antihypertensive) and for elevated glucose. Also the source of the explicit either-limb wording of the blood pressure criterion, systolic 130 mmHg or above or diastolic 85 mmHg or above, which resolves the ambiguity of the 2001 table’s 130/85 notation. Three or more of the five, unchanged. No table and no passage of text is reproduced.
International Diabetes Federation. The IDF consensus worldwide definition of the metabolic syndrome (consensus 2005, published 2006). Cited by figure: central obesity is a NECESSARY requirement, defined by an ethnicity-specific waist circumference — 90 cm or more in South Asian men and 80 cm or more in South Asian women, with different figures published for other ethnic groups which are not restated here — plus any two of raised triglycerides at 1.7 mmol/L (150 mg/dL) or above or specific treatment, reduced HDL below 1.03 mmol/L (40 mg/dL) in men or 1.29 mmol/L (50 mg/dL) in women or specific treatment, raised blood pressure with systolic 130 mmHg or above or diastolic 85 mmHg or above or treatment of previously diagnosed hypertension, and raised fasting plasma glucose at 5.6 mmol/L (100 mg/dL) or above or previously diagnosed type 2 diabetes. The document also provides that where BMI is above 30 kg/m² central obesity may be assumed and the waist need not be measured; this page does NOT implement that provision and says so on its face, because it takes no BMI and inferring a waist from a BMI is the substitution the page exists to refuse. No table is reproduced.
Alberti KGMM, Eckel RH, Grundy SM, et al. Harmonizing the Metabolic Syndrome: A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009;120:1640–1645; DOI 10.1161/CIRCULATIONAHA.109.192644. Cited by figure for: three abnormal findings out of five qualifying a person for the metabolic syndrome; the explicit reversal of the IDF position, that abdominal obesity should NOT be a prerequisite for diagnosis but is one of five criteria; and the instruction that the waist circumference threshold be population- and country-specific. One sentence is quoted on this page, because it is the page’s warrant for printing no probability and cannot be stated more briefly than its authors stated it: that the metabolic syndrome is not an absolute risk indicator, because it does not contain many of the factors that determine absolute risk, for example age, sex, cigarette smoking and low-density lipoprotein cholesterol levels. Also cited by figure for the statement’s own quantification: about twice the risk of developing cardiovascular disease over the next five to ten years, and a five-fold increase in risk for type 2 diabetes. ITS ETHNICITY-BY-ETHNICITY WAIST TABLE IS NOT REPRODUCED ANYWHERE ON THIS PAGE.
Misra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS, Chadha D, Joshi SR, Sadikot S, Gupta R, Gulati S, Munjal YP and the Consensus Group. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India 2009;57:163–70; PMID 19582986. Source of the waist figures used in the Indian column of this page: abdominal obesity at a waist circumference of 90 cm or more in men and 80 cm or more in women, on the evidence that body fat, insulin resistance and their cardiometabolic consequences appear at a smaller waist and a lower BMI in Asian Indians than in white Caucasians. Carried forward unchanged in Misra A, Vikram NK, Ghosh A, Ranjan P, Gulati S and the India Obesity Commission, Revised definition of obesity in Asian Indians living in India, Diabetes Metab Syndr 2025;19:102989, DOI 10.1016/j.dsx.2024.102989, which gives the same 90 cm and 80 cm figures and additionally prefers a waist-to-height ratio above 0.5. The same two figures are used on the waist-to-hip and waist-to-height pages in this set. Cited as two figures with their provenance; no criteria table is reproduced.
National Heart, Lung, and Blood Institute, Obesity Education Initiative Expert Panel. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. NIH Publication No. 98-4083, 1998. A United States Government work in the public domain, and the origin of the waist figures of more than 102 cm (40 in) in men and more than 88 cm (35 in) in women that the 2001 and 2005 criteria carry, applied there to adults with a BMI of 25 to 34.9 and noted to lose added predictive value above a BMI of 35. VERIFIED ARITHMETIC, recorded because it is a real discrepancy inside the published documents rather than a rounding anybody chose: the parenthetical inch figures are roundings and not conversions. 40 inches is 101.6 cm against a stated 102 cm, and 35 inches is 88.9 cm against a stated 88 cm, so the inch form of the men’s criterion is 0.4 cm more sensitive than the metric form and the inch form of the women’s criterion is 0.9 cm less. This page tests the centimetre figure and reports the inch distance separately.
Centers for Disease Control and Prevention, Diabetes Testing. A United States Government work and therefore usable on a commercial site. VERIFIED: a fasting blood sugar of 99 mg/dL or below is given as normal, 100 to 125 mg/dL as prediabetes and 126 mg/dL or above as diabetes; the corresponding A1C figures are below 5.7%, 5.7 to 6.4% and 6.5% or above, and the two-hour glucose tolerance figures are 140 mg/dL or below, 140 to 199 and 200 or above. This gives the figure 100 mg/dL a clean Government route independent of any of the four metabolic syndrome documents, and it is the source of the diabetes-range note on this page.
Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, et al. The metabolic syndrome and cardiovascular risk: a systematic review and meta-analysis. J Am Coll Cardiol 2010, published 28 September 2010; PMID 20863953. 87 studies and 951,083 patients. Relative risks reported: about 2.35 for cardiovascular disease, 2.40 for cardiovascular mortality, 1.99 for myocardial infarction, 2.27 for stroke and 1.58 for all-cause mortality, with the association persisting in patients without diabetes. Cited by figure. HONEST LIMITATION: the confidence intervals around these point estimates were not verified against the primary article when this page was written, and are therefore not printed anywhere on it.
Kahn R, Buse J, Ferrannini E, Stern M. The metabolic syndrome: time for a critical appraisal. Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2005;28(9):2289–2304; DOI 10.2337/diacare.28.9.2289 (published in parallel in Diabetologia 2005). The case against the construct, cited because a page that showed only the meta-analysis would be presenting a contested question as settled. Its conclusions, cited as positions rather than reproduced: that certain cardiovascular risk factors are prone to cluster; that the metabolic syndrome has been imprecisely defined; that there is a lack of certainty about its pathogenesis and considerable doubt about its value as a cardiovascular risk marker; that too much critically important information is missing to warrant its designation as a syndrome; and that clinicians should evaluate and treat all cardiovascular risk factors without regard to whether a patient meets the criteria for diagnosis of the metabolic syndrome.
Mangat C, Goel NK, Walia DK, Agarwal N, Sharma MK, Kaur J, Singh R, Singh G. Metabolic Syndrome: a challenging health issue in highly urbanized Union Territory of north India. Diabetol Metab Syndr 2010;2:19; DOI 10.1186/1758-5996-2-19. A community-based cross-sectional survey of 605 adults in Chandigarh, cited on this page for one thing only: the metabolic syndrome was found in 47.4% of them on the IDF criteria and 38.5% on the ATP III criteria, with a kappa agreement of 0.636. The same people, measured once, nine percentage points of prevalence apart purely by choice of definition. Sex-specific subtotals in the published tables were not independently reconciled for this page and are not quoted here.
Anjana RM, Unnikrishnan R, Deepa M, et al. Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study. Lancet Diabetes Endocrinol 2023. 113,043 participants across 31 states and union territories. Weighted prevalence: abdominal obesity 39.5%, dyslipidaemia 81.2%, hypertension 35.5%, diabetes 11.4%, prediabetes 15.3%, generalised obesity 28.6%. Cited purely as context for how common these criteria are among this site’s largest readership, and not as a reason to interpret any individual figure differently.
Waist circumference measurement sites and their association with visceral and subcutaneous fat and cardiometabolic abnormalities (2023; PubMed Central PMC10118742), the source already used on the waist-to-hip page in this set. Differences between pairs of waist measurement sites in the same individuals ranged from 0.2 to 6.9 cm in men and from 0.1 to 10.1 cm in women. Cited here because 6.9 cm is more than half the twelve-centimetre gap between the two published men’s waist thresholds and 10.1 cm is larger than the whole eight-centimetre gap for women, which is the honest scale of the measurement against the choice of threshold.
LICENSING POSITIONS, recorded because they determined what this page could and could not say. (1) NIH Publication No. 01-3670 is a United States Government work carrying no copyright notice, so the 2001 ATP III criteria are reproduced here in full, as criteria, including the figures in their published table. They are the only criteria on this page reproduced that way. (2) The 2005 AHA/NHLBI statement is an American Heart Association journal article, and the 2005 IDF consensus and the 2009 joint interim statement are copyrighted. Their thresholds are facts and are used as such; no table, criteria list or passage of text from any of the three is reproduced, and the comparison table on this page is a comparison assembled here, which no one of the four documents publishes. Exactly one sentence is quoted, from the 2009 statement, on what the syndrome is not. (3) The 2009 statement’s ethnicity-by-ethnicity waist table is specifically not reproduced; the Asian Indian figure used here is taken from the Indian national consensus instead. (4) No material from the international health body whose publications carry a NonCommercial licence term is used anywhere on this page, directly or through any third party that has reprinted it, because copyright does not launder. That excludes its own 1998 definition of the metabolic syndrome, which is not used and is not described here, and its expert-consultation waist cut-offs, which are where most calculators take South Asian figures from and which this page takes from Misra and colleagues instead. (5) No guidance from the UK national institute is used anywhere on this site: its open content licence is United Kingdom-only and forbids displaying the licensed information next to advertising, and this site carries advertising. Both exclusions are licensing outcomes and neither is a judgement about the content.
DERIVATIONS AND VERIFICATION PERFORMED FOR THIS PAGE, recorded so they can be checked. (1) Each definition is implemented as its own document words it, including the inequality directions: the 2001 waist criterion as a strict inequality above 102 or 88 cm and the 2005 one as 102 or 88 cm or above, so a waist of exactly 102.0 cm meets the second and not the first. (2) The whole decision-relevant space was swept exhaustively rather than sampled: both sexes, thirteen waist values spanning every side of both thresholds, nine triglyceride values, ten HDL values, fourteen fasting glucose values, seven blood pressure pairs and all eight combinations of the three treatment answers, which is 1,834,560 combinations. Exactly SIX distinct patterns of the four verdicts arise and no others, and the record returns a non-finite value, and therefore the incomplete message, for any pattern outside those six rather than binning a reader into a neighbouring row. (3) The three count-any-three definitions are strictly nested over the whole sweep: the 2001 count never exceeds the 2005 count and the 2005 count never exceeds the 2009 count applied with the Indian waist figure, so anything meeting an earlier one meets the later ones. (4) The IDF definition does not nest with them, and the six positions therefore do NOT form a total order — the opposite of the finding on the blood pressure category page in this set, and a direct consequence of making central obesity compulsory. Verified over the same sweep: every position reported as requiring a waist below the Indian figure does require it, every position reported as requiring the waist window between the two figures does require it, and position 2 arises only when exactly two of the four non-waist criteria are met. (5) Inside the window between the two published waist figures, the IDF verdict differs between the two figures exactly when at least two of the other four criteria are met, and the 2009 verdict differs exactly when exactly two are met; outside the window the choice of figure changes nothing. Both proved over the sweep. (6) Unit round-trips were checked on a 0.1 mg/dL grid across the whole accepted range of each analyte: the worst mg/dL to mmol/L to mg/dL error is below 5e-13 mg/dL, a relative error of about 2e-16. (7) Every threshold was tested from both sides in both unit systems, and the three cases in which the published mmol/L figure and the converted mg/dL figure fall on opposite sides of the same criterion are printed in the conversion table rather than resolved silently. (8) Every input was tested absent, zero, negative, out of range and non-numeric on every branch. Each plausibility guard returns a non-finite value and the guards are multiplied together, so every criterion term is non-finite if any single field is bad: no NaN can fall through the chained comparisons into a last real branch and return a confident figure from the wrong row. The pattern-to-position mapping is by equality rather than by a chain of inequalities for the same reason.
A note on what the answer on this page is. It is a count of published criteria, reported four ways, and a position in a list of six. It is not a diagnosis, it is not a risk, and it is not a statement about anybody. Two of the four definitions on this page can disagree about a person whose measurements have not changed by so much as a millimetre, and the thing that decides which answer they get is which country’s centimetre figure their waist was compared against. That is worth seeing, which is why this page shows both figures on every result, every time, and swaps neither in for the other.

CalcEngines health calculators are for education and for checking arithmetic that has already been decided elsewhere. They are not medical advice, they do not decide what to give, and they do not replace the judgement of a doctor, nurse, midwife or dietitian who knows the person in front of them. Every figure depends on the values you enter and on the assumptions stated on the page — check it against the prescription, the product label and your local policy before acting on it.