Abdominal fat predicts heart disease risk better than BMI
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Waist circumference predicts heart disease risk more accurately than BMI alone, study finds.
A study in JACC analyzing over 260,000 people across 20 years found that waist circumference (WC) and waist-to-hip ratio (WHR) reclassify cardiovascular risk beyond BMI. Among those with normal BMI, 5% had high WC and 18% had high WHR, correlating with 15-50% greater risk for most outcomes. Researchers urge clinicians to assess central adiposity across all BMI ranges.
The study's senior author, Michael J. Blaha, noted that individuals with normal weight but high central adiposity had higher risk. JACC Editor-in-Chief Harlan Krumholz called for abandoning sole reliance on BMI. Limitations include single assessments of WC and WHR and lack of data on diet, physical activity, and genetics.
What commenters are saying
A dominant sentiment among commenters is that the finding is not new; waist circumference has been discussed alongside BMI for years. Many acknowledge BMI's simplicity and population-level utility but point out its individual inaccuracy, especially for muscular people who may be "overweight" but not "overfat."
Several commenters distinguish between "overfat" and "overweight," noting that a person can be normal-weight yet overfat ("skinny fat") or overweight but not overfat (e.g., athletes). The thread also discusses BMI's shortcomings for tall individuals and the difficulty of accurately measuring body fat percentage or waist circumference in practice.