What is the average hip size for your age and sex?

Why Hip Circumference Matters Clinically

For many years, hip circumference received relatively little attention in clinical risk assessment compared to waist circumference, which was widely recognized as a marker of central obesity and metabolic risk. However, a growing body of research has demonstrated that hip circumference provides valuable and independent information about cardiovascular and metabolic health — and that the relationship runs in the opposite direction from what one might intuitively expect. Rather than being a neutral or passive measurement, a larger hip circumference, when adjusted for overall body size and waist girth, is consistently associated with lower cardiovascular and metabolic risk.

The most influential work in this area comes from Seidell and colleagues, whose 2001 analysis published in the European Journal of Clinical Nutrition demonstrated that waist and hip circumferences have independent and opposite effects on cardiovascular disease risk. Using prospective data from multiple cohorts, Seidell showed that for any given waist circumference, a larger hip circumference was associated with reduced risk of cardiovascular events, type 2 diabetes, and all-cause mortality. The biological basis for this protective effect lies in the distinct metabolic characteristics of gluteofemoral adipose tissue compared to visceral adipose tissue. Gluteofemoral fat cells have higher lipoprotein lipase activity, meaning they are more efficient at taking up and storing circulating triglycerides. This essentially acts as a metabolic buffer, trapping free fatty acids that would otherwise be deposited in the liver, skeletal muscle, and pancreas, where they contribute to insulin resistance and lipotoxicity. Gluteofemoral adipose tissue also secretes lower levels of pro-inflammatory adipokines and higher levels of adiponectin, an insulin-sensitizing hormone, compared to visceral fat. These findings fundamentally reframed hip circumference from a simple anthropometric measure to a clinically meaningful indicator of metabolically protective peripheral fat stores. A 2001 analysis from the Swedish Obese Subjects (SOS) study by Lissner and colleagues reinforced this finding, demonstrating that hip circumference was inversely associated with mortality even after controlling for BMI and waist circumference.

The Protective Effect of Gluteofemoral Fat vs Visceral Fat

The metabolic divergence between upper-body and lower-body adipose tissue depots represents one of the most important concepts in obesity medicine. Visceral adipose tissue, stored within the peritoneal cavity surrounding the internal organs, is characterized by a high rate of lipolysis — the breakdown of stored triglycerides into free fatty acids. These free fatty acids drain directly into the portal vein, delivering a concentrated lipid load to the liver. This portal delivery contributes to hepatic insulin resistance, increased very-low-density lipoprotein (VLDL) production, and the development of non-alcoholic fatty liver disease. Visceral adipocytes also produce elevated amounts of pro-inflammatory mediators including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and plasminogen activator inhibitor-1 (PAI-1), all of which have been implicated in the pathogenesis of atherosclerosis and type 2 diabetes.

Gluteofemoral adipose tissue, by contrast, has a fundamentally different metabolic profile. Subcutaneous fat cells in the hip and thigh region are more insulin-sensitive and exhibit lower rates of basal lipolysis. They preferentially take up circulating free fatty acids through higher expression of fatty acid transporters and have greater lipoprotein lipase activity. This "lipid trapping" function diverts fatty acids away from ectopic sites such as the liver and skeletal muscle. Longitudinal studies have confirmed that individuals who preferentially store excess dietary fat in the gluteofemoral region rather than the abdomen maintain better insulin sensitivity and lipid profiles even at comparable levels of total body fat. The protective effect of larger hip circumference is not simply statistical — it has a well-characterized physiological basis rooted in the different developmental origins, receptor profiles, and secretory functions of upper-body versus lower-body adipocytes. These depot-specific differences are established during fetal development and are influenced by sex hormones throughout life, which explains why premenopausal women tend to accumulate more gluteofemoral fat than men and why menopause is associated with a redistribution toward visceral adiposity.

Hip Circumference Norms by Age and Sex

Based on NHANES 2011–2018 data from approximately 21,000 US adults, hip circumference follows distinct age and sex patterns. For men, the 50th percentile hip circumference among those aged 18–29 is approximately 99 cm, with the middle 50 percent of the population falling between roughly 94 and 105 cm. By ages 30–39, the median increases to about 102 cm, with an interquartile range of roughly 97 to 108 cm. For men aged 40–49, the median is approximately 104 cm, and by 50–59 it reaches about 105 cm. Among men aged 60 and older, the median hip circumference is roughly 104 cm, with relatively stable values across the later decades.

For women, hip circumference values are consistently larger than those of men at every adult age group. Among women aged 18–29, the median hip circumference is approximately 102 cm, with the interquartile range spanning roughly 96 to 109 cm. By ages 30–39, the median increases to about 105 cm, and for women aged 40–49 it reaches approximately 107 cm. Women aged 50–59 have a median hip circumference of roughly 108 cm. In the 60-and-older group, the median is approximately 107 cm. At every percentile level, women's hip measurements exceed men's by roughly 3 to 8 cm, reflecting the sex-hormone-mediated preferential deposition of gluteofemoral fat in women. The 5th and 95th percentiles range from approximately 88 to 119 cm in women and 84 to 114 cm in men in middle age. These norms demonstrate that hip circumference alone varies substantially within the population and that sex-specific comparisons are essential for meaningful interpretation. While hip circumference tends to be relatively stable through midlife, it may decline in very advanced age due to loss of subcutaneous fat and muscle atrophy in the gluteal region.

Relationship Between Hip Size and Cardiovascular Risk

The epidemiological evidence linking hip circumference to cardiovascular outcomes has accumulated steadily since the early 2000s. Multiple large prospective cohort studies have reported an inverse association between hip circumference and cardiovascular disease incidence, coronary heart disease mortality, and total mortality after adjustment for waist circumference and BMI. A meta-analysis of prospective studies including over 250,000 participants found that each 5 cm increase in hip circumference was associated with an approximately 10 percent lower risk of total mortality among both men and women, independent of waist circumference. This finding is consistent across European, North American, and Asian populations, suggesting that the protective association is not merely a consequence of confounding by ethnicity or body habitus.

The inverse relationship between hip size and cardiovascular risk is most pronounced when hip circumference is interpreted in the context of waist circumference — which is precisely what the waist-to-hip ratio captures. An individual with a waist of 90 cm and hips of 105 cm has a WHR of 0.86 and is considered at lower risk than someone with a waist of 90 cm and hips of 90 cm (WHR of 1.00), even though the latter individual has a smaller "frame." This counterintuitive finding — that a larger hip measurement can signal lower risk — stems from the ratio's ability to capture the balance between harmful visceral fat and protective gluteofemoral fat. Importantly, the protective association of hip circumference does not extend indefinitely: at very high BMI levels, the metabolic burden of total adiposity may outweigh any protective partitioning effect. However, within the range seen in the general population, a larger hip circumference, relative to waist circumference, is consistently linked with better cardiometabolic profiles including lower fasting insulin, lower triglycerides, and higher HDL cholesterol.

How Hip Measurements Are Used Alongside Waist for WHR

Hip circumference is most clinically useful not as a standalone measurement, but as the denominator in the waist-to-hip ratio (WHR). The WHR expresses the relationship between central and peripheral fat distribution in a single number. The WHO has established sex-specific WHR risk thresholds: for men, WHR values below 0.90 are classified as low risk, 0.90 to 1.00 as moderate risk, and 1.00 and above as high risk. For women, the corresponding thresholds are below 0.80 for low risk, 0.80 to 0.85 for moderate risk, and 0.85 and above for high risk. These cutoffs were derived from population-level epidemiological data linking WHR to incident cardiovascular events and type 2 diabetes.

When measuring hip circumference for WHR calculation, the protocol matters. The WHO and NHANES specify that the measurement should be taken at the point of maximum circumference over the buttocks, with the individual standing erect, feet together, and the tape held in a horizontal plane. The tension of the tape should be sufficient to maintain contact with the skin without indenting the subcutaneous tissue. Measurements should be recorded to the nearest 0.1 cm and repeated to ensure accuracy. It is worth noting that hip circumference can also be used as a standalone indicator in certain clinical contexts. For example, low hip circumference in older adults has been associated with increased frailty risk and reduced gluteal muscle mass. In nutritional epidemiology, declining hip circumference may signal loss of peripheral subcutaneous fat stores. However, for most clinical applications, hip circumference is most informative when paired with waist circumference to calculate WHR, as the ratio captures the independent and opposing health effects of these two body sites in a single interpretable metric.

How to Measure Hip Circumference Accurately

Obtaining a reliable hip circumference measurement requires attention to positioning, landmark identification, and tape placement. The standardized protocol is as follows:

1. Position: Stand upright with your feet together and weight evenly distributed on both legs. Your arms should hang naturally at your sides. The measurement is best taken while wearing light, form-fitting clothing or directly on the skin. Heavy or bulky garments will add measurement error and should be removed.
2. Locate the landmark: Identify the widest point of your buttocks when viewed from the side. This is the maximum circumference of the hips and is the standard measurement site per WHO and NHANES protocols. For most individuals, this corresponds to the level of the greater trochanters of the femur, but anatomical variation means that the "widest point" rule takes precedence over fixed bony landmarks.
3. Apply the tape: Wrap a flexible, non-stretchable measuring tape around the hips at the identified level, ensuring the tape is parallel to the floor. The plane of measurement must be horizontal — a common error is allowing the tape to sag or angle upward at the back. Have an assistant check for parallelism, or use a mirror.
4. Tension: The tape should be snug against the skin but should not compress the subcutaneous tissue. The circumference is read at the point where the zero mark meets the tape, at the end of a normal expiration but without breath-holding.
5. Repetition: Take two measurements. If the difference between the two exceeds 1 cm, take a third measurement and record the average of the two closest values. Record all measurements to the nearest 0.1 cm.

Accuracy in hip measurement is especially important when calculating WHR, because the ratio is sensitive to small errors in either component measurement. A measurement error of just 2 cm in either the waist or hip circumference can shift the calculated WHR by approximately 0.02, which is enough to cross a WHO risk threshold in borderline cases. For this reason, self-measurement should be approached with care, and clinical or research assessments should be performed by trained examiners following a standardized protocol.