Study: A Better Measure than Body Mass Index

Canadian researchers have just had an article published in The Lancet that suggests their may be a simple technique to determine your risk of heart disease that is more effective than the standard Body Mass Index. Nicholas Bakalar reports in The New York Times. Warning: you'll be wanting a tape measure and a calculator, so you might as well get those now...

A waist-to-hip ratio (waist measurement divided by hip measurement) below 0.85 in women or 0.9 in men is average. Anything above that is a risk for heart disease.

The researchers, led by Dr. Salim Yusuf, a professor of medicine at McMaster University near Toronto, studied 12,461 people who had had a first heart attack and compared them to a matched group of 14,637 without heart disease.

A body mass index greater than 28.2 in women or 28.6 in men did indicate an increased risk of heart attack, but the relationship disappeared after adjusting for age, sex, geographic region and tobacco use.

Waist-to-hip ratio, on the other hand, showed a continuous relationship to heart attack risk even after adjusting for other risk factors. Those in the highest fifth were 2.52 times as likely to have a heart attack as those in the lowest fifth.

Dr. Fuhrman wrote about this in his book Eat to Live. In fact, Amazon.com will let their customers read that part of Eat to Live online for free.

You'll see he cites the work of Harvard's Dr. I-Min Lee--who studied nearly 20,000 men over nearly thirty years. She found that you practically can not be too thin: the lightest group of men had the lowest mortality. (Of course, he cautions, there is such a thing as being too thin, which is usually anorexia and is a topic for another time.)

And as you can read, Dr. Fuhrman describes various favored techniques for measuring body fat: like Dr. Yusuf, he finds that fat around the waist is a more useful measure than body mass index.

Two quickie rules of thumb from Eat to Live to assess whether or not you are at your ideal weight:

  • Men shouldn't be able to pinch more than a half-inch of skin near the belly button. Women should not be able to pinch more than an inch.
  • If you have gained as little as ten pounds since you were 18 or 20 years old, then you could have a significantly increased risk for health problems like heart disease, diabetes, and high blood pressure.