Reacción a "Abdominal fat is a better predictor of cardiovascular risk than body mass index"

‘Your waistline matters more to your heart than your weight’ would be the headline. We have known for a long time that we need to look beyond body mass index.

This is a high-quality study and, whilst the findings come as no surprise, they reinforce our long-held view that, beyond body mass index, it is not total weight that matters, but rather where that weight is distributed and, above all, visceral fat – which we already knew to be the most metabolically harmful from a cardiovascular perspective. In my view, this study is quite good, as it covers 20 years and nearly 260,000 patients followed up for cardiovascular events; it tells us that we can reclassify each patient’s risk based on a parameter as simple as measuring waist circumference or the waist-to-hip ratio, which can easily be done in the doctor’s surgery using a tape measure. In addition to weighing the patient and calculating their body mass index, it is essential to measure waist circumference and the waist-to-hip ratio using a tape measure, and even to use advanced technology such as body composition analysis to reclassify risk.

Why? Because there are patients who are not obese – those of normal weight or who are overweight – who, due to high levels of abdominal obesity, are at greater risk of these nine major cardiovascular events identified in this study. Even in patients with a higher body mass index, classified as obese, but who do not have abdominal obesity – possibly because their weight consists of muscle rather than fat – we see that this cardiovascular risk decreases. Therefore, this study highlights something essential in medical consultations: assessing where the fat is located. Doing so in a straightforward manner can save lives, as we can reclassify risk and treat people who might otherwise have been considered safe because they were of normal weight, yet had a high cardiovascular risk. Beyond weight, abdominal fat can reveal the true, hidden cardiovascular risk.

In summary, in my view, this is highly relevant and important. Our waist circumference (abdominal fat) reveals the true, hidden cardiovascular risk. The scales alone are not enough; it is essential to know not only body weight but also body composition, specifically abdominal fat (AF), which is more harmful to our heart.
Thus, the study reclassifies people who appear healthy based on their BMI (normal weight and overweight) but who, depending on their abdominal fat (measured by waist circumference), have a high risk of suffering cardiovascular events (heart attack, stroke or heart failure: 15 per cent and 50 per cent respectively). Conversely, the study found that 45 per cent of people with obesity have a low waist-to-hip ratio, which is associated with a lower cardiovascular risk than would be expected for their weight.