Is BMI the best predictor of heart disease?

Here’s some interesting new research just published in the Journal of Clinical Endocrinology and Metabolism (2010 Apr;95(4):1777-85). The authors examined common measurements of “body size” and investigated which were most predictive of cardiovascular incidents and mortality. The winner was the waist size to height ratio (WHtR), whereas the more commonly used BMI was not always predictive of cardiovascular risk. The authors’ of this study discourage the use of BMI as a measure of health risk and encourages the use of WHtR instead.



BMI Flaws
BMI or body mass index is a relationship between a person’s height and weight. However, it doesn’t take into account where the weight is carried. Excess weight around the mid-section is a greater risk factor for chronic diseases than is excess weight around the hips. Moreover, muscle-bound athletes are often classified as “overweight” using the BMI scale even if they carry very little fat.


Waist to Height Ratio (WHtR)
WHtR in contrast to the BMI, takes into account a person’s body shape as well as gender. WHtR is measured by dividing waist size by height. For example, a 5’5” woman with a 31” waist would have a ratio of .47 (31 divided by 65 = .47), which is in the “healthy and attractive” range. (I’m not sure why they included “attractive” since that’s not a health predictor…)


The bottom line is what we’ve heard before that it’s better to have a pear shape than an apple shape. Only now they’ve given us numbers to work with. The following chart will help you determine if you’re in your “best shape”.
WOMEN
• Ratio less than .35: Abnormally Slim to Underweight
• Ratio .35 to .42: Extremely Slim
• Ratio .42 to .46: Slender and Healthy
• Ratio .46 to .49: Healthy and Attractive
• Ratio .49 to .54: Overweight
• Ratio .54 to .58: Seriously Overweight
• Ratio over .58: Highly Obese.

MEN
• Ratio less than .35: Abnormally Slim to Underweight
• Ratio .35 to .43: Extremely slim
• Ratio .43 to .46: Slender and Healthy
• Ratio .46 to .53: Healthy, Normal, Attractive Weight
• Ratio .53 to .58: Overweight
• Ratio .58 to .63: Extremely Overweight/Obese
• Ratio over .63: Highly Obese