Disease Proof

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.

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Comments (3) Read through and enter the discussion with the form at the end
Robin K - November 21, 2005 9:00 AM

I like this easy measurement to asess heart disease risk. Thank you.
However, my question is on the comment, "if you've gained as little as 10 lbs since you were 18 you are at increased risk for..." What if someone DID gain 10-40 lbs until she (or he) was in her 40s. Then she read Dr. Fuhrman's book and changed her ways and lost all the weight? Will the risk factors be reduced as if that weight was never gained? Will adopting this healthy lifestyle in the 40s be useless because from 25-45 the person was overweight and at risk? In other words, will mid-life adopters of a healthy lifestyle be able to wipe away the increased health risks of heart disease (and cancer) stemming from weight gain in earlier years?

Henry Abbott - November 23, 2005 5:07 PM


I took your question to Eat to Live and found, in essence, a lot of information that says you can do yourself a lot of good by eating well. On page 147, for instance, Dr. Fuhrman writes "numerous studies have documented that heart disease is reversible for the majority of patients following a vegetarian diet." He says a lot more, and after scanning it all, I think it's safe to say that Dr. Fuhrman believes that it would not be useless at all to start eating a healthy diet now. Would your health be the same as if you had never gained the weight? I wish I could answer that! But if you're wavering, try clicking the Success Stories link on the left. It's amazing what healthy eating has done for a lot of people already.

dandi - April 27, 2006 6:41 PM

We need easy/simple ways to monitor health. This article gives us two ways. My husband and I have started using both, the waist/hip ratio and the pinch test. Thank you for this information.

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