Waist measurements predict heart disease risk better than BMI

A large-scale pooled analysis involving more than 250,000 adults suggests that waist circumference and waist-to-hip ratio may be more effective indicators of cardiovascular risk than Body Mass Index (BMI) alone.

Published in the Journal of the American College of Cardiology, the study followed participants for a median of 20 years. Researchers found that individuals classified as having a normal BMI can still carry significant abdominal fat, which is linked to higher risks of heart attack, stroke, heart failure, and atrial fibrillation. Specifically, among those in the normal-weight or overweight BMI categories, high waist circumference or a high waist-to-hip ratio was associated with a 15% to 50% increased risk of various cardiovascular outcomes.

While BMI is a standard clinical tool endorsed by the World Health Organization, it does not account for fat distribution. The study highlights that visceral fat, which surrounds internal organs, is more metabolically active and dangerous than subcutaneous fat. Experts suggest that relying solely on BMI may lead to an erroneous classification of cardiovascular risk, as it can obscure the presence of dangerous abdominal fat patterns.