A Better Measure than BMI?

Medical News Today carried an article about a study published last week in The Lancet that found waist-hip ratio is a stronger predictor of heart disease risk than BMI.

If obesity is redefined using waist-to-hip ratio instead of BMI the proportion of people at risk of heart attack increases by threefold, calculate the authors. Previous research has shown that obesity increases the risk of heart disease.

In the latest study, Salim Yusuf (McMaster University, Ontario, Canada) and colleagues aimed to assess whether other markers for obesity, especially waist-to-hip ratio, would be a stronger predictor of heart attack than the conventional measure of BMI in different ethnic populations.

Their findings were impressive. The researchers looked at BMI, waist-to-hip ratio, waist measure, and hip measure in over 27,000 people from 52 countries. Half of those assessed had previously had a heart attack, the other half had not. Both groups were age and sex-matched.

The team found that BMI was only slightly higher in heart attack patients than in controls, with no difference in the middle east and South Asia. By contrast, heart attack patients had a strikingly higher waist-to-hip ratio than controls, irrespective of other cardiovascular risk factors.

Larger waist size (which reflects the amount of abdominal fat) was harmful, whereas larger hip size (which may indicate the amount of lower body muscle) was protective.

To me, this makes perfect sense.

We know that heart attacks do not strike only those who are overweight or obese, so a better measurement of risk may in fact be waist-hip ratio since even a thin person would still have a measurable ratio of their waistline and their hips to assess their risk.