Researchers have put their seal of approval on a simple, do-it-yourself method to accurately assess your risk of acute heart trouble.
Up to now, BMI (body mass index) has been the time-honored measure of the coronary risk associated with overweight and obesity. However, data from INTERHEART, a study that enrolled 27,000 participants from around the world, has shown that the BMI is not as accurate at predicting the likelihood of an acute heart attack as another simple calculation: the waist-to-hip ratio.
In the study, the researchers found that the risk of an acute heart attack was about 50 percent higher among those with the highest BMI compared to those with the lowest BMI-a pretty decent showing as a predictor, right? However, this predictive value of the BMI was virtually lost when it was adjusted for waist-to-hip ratio or for other risk factors for coronary artery disease. When participants with the highest waist-to-hip ratio were compared with those having the lowest ratio, there was an 80 percent increase in risk.
By contrast, even after adjusting for BMI and the other risk factors, the waist-to-hip ratio remained a highly significant predictor. That is, each increase in the waist-to-hip ratio was associated with an increase in the risk of a heart attack. Further, the waist-to-hip ratio's ability to predict the risk of acute heart attack was superior to the BMI's at all ages and in all subgroups examined: men and women, smokers and nonsmokers, hypertensives and non-hypertensives, and those with and without high cholesterol levels. Clearly, the hip-to-waist ratio is one impressive predictor of trouble.
These results support other studies that have shown that the risk of coronary disease is higher in people who have a larger-than-normal waist size, even if they are of normal weight. This is because the type of fat that builds up within the abdomen and causes a large waist size has greater ill health effects than fat located in other places. Fat cells in the belly do more damage because they release fatty acids and other substances that travel directly to the liver.
I don't understand why so few doctors carry out the simple and useful measurement of waist circumference. You can check your own waist-to-hip ratio by wrapping a tape measure around yourself at the iliac crest, which can be located by feeling the tips of the pelvic bone at either side of the lower abdomen.
Waist circumference is considered too high when it is 35 inches or more in women and 40 inches or more in men. And the waist-to-hip ratio has been determined to be dangerously high if it exceeds 1.0-that is, when one's waist is larger around than one's hips. However, most experts agree that the waist-to-hip ratio needn't even be calculated in every case: A person's waist measurement alone is enough to determine the presence or absence of risk from excessive abdominal fat. Also, the lower values of waist circumference are too high for Asian-American men and women.
