Weight isn't the main thing, fear the belly. A new approach to the BMI indicator

A large study in the journal JACC showed that BMI is insufficient for assessing cardiovascular risk. Even with normal weight, a large waist circumference increases the risk of heart attack, stroke, and other diseases by 15-50%. Doctors recommend considering fat distribution, especially visceral fat.

A new study published in the medical journal JACC showed that body mass index (BMI) is insufficient for assessing cardiovascular risk. Even in people with normal or slightly elevated BMI, the risk of heart attack, stroke, heart failure, and atrial fibrillation was 15-50% higher in the presence of a large waist circumference or excess visceral fat. The scientists combined data from 15 studies involving 259,388 people without ischemic heart disease, following them for an average of 20 years. Dr. Anat Berkovich, deputy head of the cardiology department at Sheba Hospital, explains that BMI remains important but does not account for body composition and fat distribution. Visceral fat, surrounding internal organs, is metabolically active and increases risks. The 2021 ESC guidelines already emphasized the importance of waist circumference: optimal up to 94 cm for men and 80 cm for women, dangerous above 102 cm and 88 cm, respectively. The study found frequent discrepancies between BMI and abdominal fat parameters, which changed risk assessment. In people with obesity by BMI but small waist, risks were similar to normal weight, except for overall mortality. In men with obesity, a low waist-to-hip ratio reduced risks, but not in women. Experts urge considering multiple indicators, including waist circumference, for accurate assessment.