What percent of people squat on the toilet?

September 28, 2025 •

4 min read

While hard statistics vary, it's estimated that a large portion of the world's population uses or prefers a squatting position for bowel movements. Understanding what percent of people squat on the toilet involves looking at global traditions, modern adaptations, and health research.

Quick Summary

A significant percentage of the global population, particularly across Asia, Africa, and the Middle East, traditionally uses squat toilets. This practice differs greatly from Western habits, where some people may hover over public toilets due to hygiene concerns, and others use stools to mimic a squatting posture at home.

Key Points

Global Preference: A large portion of the world's population, particularly in Asia, Africa, and the Middle East, traditionally uses squat toilets for bowel movements.
Western 'Squatting': In Western countries, a significant number of people, especially women, may 'hover' over public toilets due to hygiene concerns, a different practice from traditional squatting.
Anatomical Benefits: Squatting helps straighten the anorectal angle, which allows for easier, faster, and more complete bowel evacuation with less straining compared to sitting.
Health Linkages: The shift from squatting to sitting in Western cultures has been associated with higher rates of digestive issues like constipation, hemorrhoids, and diverticulosis.
Modern Adaptations: Ergonomic toilet stools (DPMDs) are increasingly popular in Western countries to help people achieve a beneficial squatting-like position on a standard toilet.
Considerations for All: While beneficial for many, squatting can pose musculoskeletal challenges for the elderly or mobility-impaired; having both options available can be ideal.

Global Habits: Squatting vs. Sitting

Globally, toileting habits are heavily influenced by culture and tradition. While Western societies predominantly use sitting toilets, much of the rest of the world, especially in rural areas of Asia, Africa, and the Middle East, uses traditional squat toilets. This difference leads to varied percentages, and it's important to distinguish between two distinct types of 'squatting': using a traditional squat toilet and hovering over a Western-style seat.

The Prevalence of Traditional Squatting

Historically, squatting was the universal human posture for defecation. Estimates suggest that up to two-thirds of the world's population, particularly in developing nations, still primarily use or have access to squat toilets. For many, this practice is not just a cultural norm but is also perceived as more hygienic, as there is no direct skin contact with the toilet surface. While there is a trend toward adopting Western-style sitting toilets in urbanized areas, traditional squat toilets remain widespread.

The American & Western Experience: Squatting to Hover

In contrast to traditional squatting, many in Western countries may 'squat' by hovering over a sitting toilet, primarily in public restrooms. A YouGov survey in 2023 indicated that 21% of US adults say they squat over public toilets, with women being significantly more likely to do so than men. This practice stems from a perception of public toilets as unclean and a desire to avoid direct contact with the seat. However, this hovering position is not the same as a full, deep squat and can increase muscle tension.

The Rise of Ergonomic Squatting

In recent years, there has been a growing interest in the health benefits of the squatting posture in Western countries, leading to the rise of ergonomic devices like toilet stools. These devices, sometimes called 'defecation postural modification devices' (DPMDs), are designed to elevate the feet and mimic the posture of a traditional squat toilet, even on a standard sitting toilet. Studies suggest that using a toilet stool can improve bowel emptying and reduce straining by straightening the anorectal angle.

Health Impacts of Squatting vs. Sitting

Research comparing squatting and sitting has revealed notable physiological differences and potential health implications for digestive and overall well-being.

Digestive Health

From an anatomical perspective, squatting is considered the more natural position for defecation. The anorectal angle, a natural bend that helps maintain continence when sitting, straightens out when a person squats, allowing for easier and faster bowel movements with less straining.

Constipation: Some studies link the sitting posture to higher rates of constipation in Western populations, suggesting that the sitting position can make bowel movements more difficult. Conversely, the use of DPMDs (toilet stools) has been shown to reduce straining and accelerate bowel emptying.
Hemorrhoids: Chronic straining, which can be exacerbated by the sitting position, is a risk factor for hemorrhoids. By facilitating easier bowel emptying, squatting can potentially reduce the likelihood of this issue.
Diverticulosis: Research suggests a correlation between the use of sitting toilets and higher rates of colonic diverticulosis. One study even reported that sitting toilet use was a risk factor for the condition.

Musculoskeletal & Other Health Considerations

While generally beneficial for digestion, squatting can present other challenges, especially for certain populations.

Musculoskeletal Strain: Some studies suggest that prolonged squatting can cause strain on the knees and leg muscles, potentially compromising stability. This is a particular concern for vulnerable individuals, such as the elderly or those with existing joint problems. Traditional squat toilets can also present a risk of injury from slipping.
Cardiovascular Effects: One study in India observed that a percentage of strokes occurred while individuals were in a squatting position, suggesting a link to transient blood pressure spikes. However, this needs more investigation, and it is most relevant for those with pre-existing conditions like hypertension.
Public Hygiene Concerns: The practice of hovering over public toilet seats, while an attempt to be hygienic, can lead to muscle tension and inefficiency. It’s important to differentiate this from the full squat, which is anatomically advantageous.

Comparison: Traditional Sitting vs. Ergonomic Squatting


Feature	Sitting (Western Toilet)	Ergonomic Squatting (with Stool)
Body Position	90° hip and knee angle; limited anorectal angle widening.	Knees are elevated above the hips; opens the anorectal angle.
Time to Evacuate	Often longer, requiring more effort and straining.	Significantly faster, with less effort and reduced straining.
Straining	More common due to the kink in the colon.	Reduced or eliminated straining, preventing pressure on the rectum.
Musculoskeletal Impact	Minimal stress on joints during use; easier for mobility-impaired individuals.	Mimics natural squat without full stress; safer than traditional squat toilets.
Ease of Use	Convenient for most people, especially those with mobility issues.	Requires adaptation; can be difficult for some to maintain balance initially.

Conclusion: Finding the Right Position for You

Determining what percent of people squat on the toilet is complex and depends heavily on cultural context. While traditional squatting is widespread across large parts of the world and offers potential digestive benefits, Western habits have led to a preference for sitting toilets. However, the rise of ergonomic footstools allows individuals in Western cultures to combine the comfort of a sitting toilet with the anatomical advantages of a squatting position. The best approach for your health and comfort ultimately depends on your cultural background, personal preferences, and any specific health conditions. For those interested in improving their digestive process, adopting a modified squatting posture with a footstool is a simple and effective adjustment. Further information on the health impacts can be found in detailed reviews, such as those conducted by the National Institutes of Health. For instance, a scoping review on toilet postures and health outcomes is available on the NIH website.

By understanding the different ways people around the world go to the bathroom, we gain a more complete picture of human health and physiology.

Frequently Asked Questions

While precise figures are difficult to obtain, estimates suggest that the majority of the world's population, particularly in countries across Asia, Africa, and the Middle East, has historically used or still uses traditional squat toilets for defecation.

In Western countries, people often hover or crouch over toilet seats in public restrooms due to concerns about hygiene and avoiding direct skin contact. This is different from the full squat used with traditional squat toilets.

The primary difference is the anorectal angle. Sitting on a Western toilet maintains a kink in the colon that can require more straining, while squatting straightens this angle, making bowel movements easier and more efficient.

Many people perceive traditional squat toilets as more hygienic because there is no direct skin contact with the toilet seat. However, some studies have noted that squat toilets can be associated with higher levels of bioaerosols if not properly flushed, and the practice of hovering over a sitting toilet is not inherently more hygienic.

You can use a toilet stool or defecation postural modification device (DPMD) while using a standard sitting toilet. This elevates your knees above your hips, simulating the beneficial squatting position to facilitate easier bowel movements.

For most healthy individuals, squatting is safe and may even be beneficial for digestive health. However, for certain populations, such as the elderly or those with joint issues, prolonged squatting can cause musculoskeletal strain. A potential link to transient blood pressure spikes has also been suggested, but this mainly concerns vulnerable individuals.

Yes, research supports that toilet stools can work. Studies have shown that devices that modify defecation posture by elevating the feet can reduce straining, shorten bowel movement duration, and increase the feeling of complete bowel emptying.