WASHINGTON (dpa-AFX) - New research suggests that belly fat may be a better indicator of heart disease risk than body mass index (BMI) alone.
The study, published in the Journal of the American College of Cardiology, looked at more than 260,000 people over an average of 20 years. Researchers examined their risk of heart problems, including heart attacks, strokes, heart failure, irregular heartbeat and death from heart disease.
Doctors commonly use BMI to determine whether someone is overweight or obese. However, in this study, researchers wanted to find out whether measuring waist size and the waist-to-hip ratio could give a clearer picture of heart disease risk.
The study found that some people who had a normal BMI still had a large waist or a high waist-to-hip ratio. Among people with a normal BMI, 5 percent had a high waist measurement and 18 percent had a high waist-to-hip ratio. Among overweight people, 39 percent had a high waist measurement and 40 percent had a high waist-to-hip ratio. Meanwhile, people who were normal weight or overweight but had a high waist measurement or waist-to-hip ratio had a 15 percent to 50 percent higher risk of most of the heart-related problems studied.
'It is time to abandon a sole focus on body mass index,' said Harlan Krumholz, MD, FACC, Editor-in-Chief of JACC and the Harold H. Hines, Jr Professor at the Yale School of Medicine. 'This enormously important study, based on data from hundreds of thousands of participants in large-scale cohort studies, authoritatively shows that waist circumference and waist-to-hip ratio provide critical information about cardiovascular risk, even among people with a BMI considered normal. Where fat is distributed matters, and these simple measures should be part of routine cardiovascular risk assessment.'
The researchers also found that some people with obesity had a lower waist measurement or waist-to-hip ratio. Their risk of most heart problems was not significantly higher than that of people with normal weight and a low waist measurement.
'Our findings emphasize the critical role of identifying elevated central adiposity, even in individuals with a normal BMI or with a BMI in the overweight range. Relying solely on BMI may result in misclassification of cardiovascular risk across a wide range of cardiovascular outcomes,' lead author Zeina Dardari commented. 'We encourage clinicians to consider central adiposity distribution across the entire BMI spectrum when evaluating cardiovascular risk in primary prevention settings.'
However, the study had some limitations as it did not include information about participants' physical activity, diet or genetic risk of obesity. It also measured waist size and waist-to-hip ratio only once, so it could not fully show how changes in belly fat over time affect heart disease risk.
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