New research found that excess belly fat, or visceral fat, may increase the risk of heart failure because of inflammation. The study found that higher levels of visceral fat were more strongly linked to heart failure than body mass index (BMI). Even if a person had a BMI in the normal range, their risk was higher if they had excess visceral fat. That suggests that where fat is stored may matter more than weight for heart health.
The study used data from 260,000 people gathered over 20 years.
“This research helps us understand why some people develop heart failure despite having a body weight that seems healthy,” said Szu-Han Chen, lead author of the study and a medical student at National Yang Ming Chiao Tung Univ. “By monitoring waist size and inflammation, clinicians may be able to identify people with higher risk earlier and focus on prevention strategies that could reduce the chance of heart failure before symptoms begin.”
BMI is calculated by dividing a person’s weight by the square of their height. It is often used to determine if a person is overweight or obese. While that can be one indication of heart disease risk, not accounting for a person’s waist circumference (WC) and waist-to-hip ratio (WHR) can cause a “misclassification” of risk.
The study’s senior author, Dr. Michael Blaha of Johns Hopkins, said, “Indeed, it appears that WC and WHR reclassify risk defined by traditional BMI thresholds. We saw individuals with clinically determined normal weight who had elevated central adiposity and high WHR, associating them with higher risk across most outcomes.”
While BMI may be able to identify obesity, it doesn’t look at the distribution of fat. Other studies have linked visceral fat to chronic health problems like blood sugar concerns.
“It is time to abandon a sole focus on body mass index,” said Harlan Krumholz, of Yale, who is editor-in-chief of the Journal of the American College of Cardiology, which published the research. “This enormously important study, based on data from hundreds of thousands of participants in large-scale cohort studies, authoritatively shows that waist circumference and waist-to-hip ratio provide critical information about cardiovascular risk, even among people with a BMI considered normal.”
We have written in the past about the fact that BMI is just one measurement of health among many. While it can give some insight into health, it is far from perfect. The formula is based on European men, so it’s not a perfect model for everyone. And, even if it were, one number doesn’t give doctors insight into every aspect of a person’s health. When it comes to heart health, there are many factors to consider; BMI may not be the most critical.
