Abdominal Fat Predicts Heart Disease Risk Better Than BMI, Study Finds

Abdominal Fat as a Superior Indicator

A new study published in JACC, the flagship journal of the American College of Cardiology, concludes that the size of a person’s midsection, measured by waist circumference (WC) or waist-to-hip ratio (WHR), is a more accurate predictor of cardiovascular disease risk compared to Body Mass Index (BMI). This finding challenges the traditional reliance on BMI for assessing obesity-related health risks.

Limitations of BMI

BMI, calculated by dividing weight in kilograms by height in meters squared, is a common metric for diagnosing overweight and obesity. However, BMI does not account for the distribution of body fat. Visceral fat, which surrounds internal organs in the abdominal area, has been linked to chronic conditions like heart disease and diabetes, whereas subcutaneous fat under the skin does not show as strong an association.

Study Methodology and Findings

Researchers from the Cross Cohort Collaboration analyzed data from over 260,000 individuals over an average of 20 years. Participants had WC or WHR data and at least one of nine cardiovascular outcomes, including myocardial infarction, stroke, heart failure, and various forms of coronary and cardiovascular disease. The study found that individuals with a clinically normal BMI could still have elevated central adiposity (high WC or WHR) and a higher associated risk for most cardiovascular outcomes.

Specifically, among individuals classified with normal weight by BMI, 5% had high WC and 18% had high WHR. For those categorized as overweight, 39% had high WC and 40% had high WHR. Among individuals with obesity, 9% had low WC and 45% had low WHR, indicating that BMI alone can misrepresent risk.

Implications for Risk Assessment

The study suggests that incorporating WC and WHR into cardiovascular risk assessments could lead to more accurate classifications and potentially improve preventive strategies. Michael J. Blaha, MD, MPH, senior author of the study, noted that WC and WHR reclassify risk defined by traditional BMI thresholds, highlighting the importance of considering central adiposity in health evaluations.