Discussion The present review is the first systematic review of the evidence supporting the use of WHtR, a proxy for abdominal fatness, as a predictor for cardiometabolic risk (i.e. predicting risk factors for CVD and diabetes). It draws on evidence from prospective and cross-sectional studies in both adults and children. Moreover, it puts the relationship between WHtR and disease into context with other proxies for obesity and abdominal obesity, namely BMI and WC.