It’s the Belly, Not the BMI

Men’s Health Month calls for a closer look at factors associated with the #1 American killer–heart disease–especially since nearly twice as many men as women die from it.1 While it has long been known that obesity plays a role in cardiovascular issues, that picture has recently become more clear as we learn the limitations of certain tools that have long been relied upon.

Take the body mass index (BMI) for example. It appears that this formula–a ratio of height to weight used to define obesity–is not a viable indicator of heart disease risk, according to a recent analysis in the Journal of the American College of Cardiology. This new research found that waist size provides a far more accurate means of predicting premature death from heart attack or related causes.2

In fact, heart patients with a large waist size–over 35 inches for women, or 40 inches for men–were 70% more likely to die during the study period than those with smaller waists. In his article accompanying the study, Jean-Pierre Després, Ph.D., director of research at the Quebec Heart and Lung Institute at Laval University, noted that one of the primary shortcomings of the BMI is that it fails to assess body shape–specifically body fat distribution–nor does it distinguish between fat and muscle.

Fat nestled at the waistline–belly fat–appears to be the root of considerable evil where heart disease is concerned, in part because it’s visceral fat, which gathers around the organs in the abdomen. This visceral fat in turn appears to promote insulin resistance, unhealthy cholesterol numbers, and inflammation, the study further noted. The good news, however, is that since visceral fat is more metabolically active, it’s also easier to lose than subcutaneous fat under the skin, especially if you have plenty of it, according to Penn State researcher Penny Kris-Etherton, PhD, RD.

The take away? If you’re sporting a generous belly, increasing lean protein while cutting overall calories and boosting daily exercise will not only help you look and feel better, it can also extend the quality–and quantity–of your life.

References
1 http://www.menshealthnetwork.org/library/silenthealthcrisis.pdf
2 J Am Coll Cardiol, 2011; 57:1877-1886, doi:10.1016/j.jacc.2010.11.058