Abdominal fat predicts heart disease risk better than BMI
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Study shows BMI does not reflect overall body composition since central adiposity is not measured
Contact: Olivia Walther, owalther@acc.org ,
The size of a person’s midsection is a better indicator of cardiovascular disease risk when compared to their body mass index (BMI) alone, according to a study published in JACC , the flagship journal of the American College of Cardiology. BMI has traditionally been used to determine overweight or obesity, common risk factors for heart disease, but this study shows that not accounting for waist circumference (WC) or waist-to-hip ratio (WHR) can lead to misclassification of cardiovascular disease risk.
“Indeed, it appears that WC and WHR reclassify risk defined by traditional BMI thresholds,” said Michael J. Blaha, MD, MPH, senior author of the study and director of clinical research at Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease. “We saw individuals with clinically determined normal weight who had elevated central adiposity and high WHR, associating them with higher risk across most outcomes.”
BMI is calculated by dividing weight in kilograms by height in meters squared and is a common practice for diagnosing obesity. However, BMI cannot account for distribution of body fat. Studies have shown that visceral fat, which is fat that surrounds the internal organs in the abdominal area, is associated with chronic diseases like heart disease and diabetes, while subcutaneous fat, which is located directly under the skin, is not as strongly associated.
Despite evidence linking central adiposity, the accumulation of both visceral and subcutaneous fat in the abdominal area, to adverse cardiovascular health outcomes, BMI is still the most used metric to determine overweight and obesity and future cardiovascular risk.