Abdominal fat predicts heart disease risk better than BMI

A new study suggests that abdominal fat, as measured by waist circumference and waist-to-hip ratio, is a more accurate predictor of heart disease risk than body mass index (BMI) alone. Researchers from the Cross Cohort Collaboration analyzed data from over 260,000 individuals over an average of 20 years, examining nine cardiovascular outcomes.

They found that individuals with normal weight but high waist circumference or waist-to-hip ratio had a 15% to 50% greater risk for most outcomes compared to those with overweight or obesity and similar measurements. Even those with obesity and low waist circumference did not show significantly different risk compared to normal weight individuals with low waist circumference, except for all-cause mortality, where the risk was lower.

The study's lead author, Zeina A. Dardari, PhD, MS, emphasized the importance of considering central adiposity distribution in all BMI ranges when evaluating cardiovascular risk. The study's senior author, Michael J. Blaha, MD, MPH, pointed out that relying solely on BMI may result in misclassification of cardiovascular risk. Experts agree that waist circumference and waist-to-hip ratio should be included in routine cardiovascular risk assessments.