Waist size a better predictor of heart disease risk than BMI, study finds

A recent study has found that waist circumference and waist-to-hip ratio may be more accurate indicators than body mass index (BMI) for assessing the risk of cardiovascular disease, highlighting the importance of fat distribution in the body rather than just overall weight.

BMI is widely used to determine overweight and obesity, which are known risk factors for heart disease, as it is based on the relationship between a person's weight and height. However, researchers noted that BMI does not indicate where fat is distributed in the body.

Previous studies have shown that visceral fat, which accumulates around abdominal organs, is more strongly linked to chronic diseases such as heart disease and diabetes than fat located directly under the skin.

The researchers, in a study published in a journal of the American College of Cardiology, explained that overlooking waist circumference or waist-to-hip ratio when assessing cardiovascular risk could lead to inaccurate risk classification.

Dr. Michael Blaha, lead researcher from Johns Hopkins University, said that people with a normal weight but higher abdominal fat and a high waist-to-hip ratio face greater risks in most health outcomes assessed.

260,000 people studied

The research team analyzed data collected over 20 years from more than 260,000 individuals to examine the link between fat distribution and cardiovascular disease risk.

The results showed that people of normal or overweight status with a large waist circumference and high waist-to-hip ratio were 15% to 50% more likely to suffer fatal and non-fatal strokes and heart disease.

Conversely, obese individuals with a low waist circumference had outcomes similar to those of normal-weight individuals who also had a low waist circumference.

Call to move beyond BMI

Dr. Harlan Krumholz, editor-in-chief of the journal and not involved in the study, said it is time to move away from focusing exclusively on BMI.

He added that the study, which relied on data from hundreds of thousands of participants in large-scale cohort studies, shows that waist circumference and waist-to-hip ratio provide important information about cardiovascular risk.

Krumholz emphasized that fat distribution is a key factor and called for waist circumference and waist-to-hip ratio measurements to be included in routine cardiovascular risk assessments.