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

The press release does indeed reflect the findings, but in reality it says nothing new: the waist-to-height ratio (WHR), when combined with BMI, appears to be a better predictor of cardiovascular risk.

The implications for clinical practice are very clear. Measuring waist circumference is cheap, quick and feasible in primary care, preventive cardiology, endocrinology and internal medicine. It is not a question of abandoning BMI, but of complementing it. When assessing cardiovascular risk, particularly in primary prevention, we should pay more attention to where fat accumulates, not just to how much a person weighs.

The main limitation is that, as the press release also notes, complete information on physical activity, diet or genetic risk was not available – factors that can influence both adiposity and cardiovascular risk. Furthermore, waist circumference and the waist-to-hip ratio were measured only once, so we do not know how changes over time affect risk. Even so, these limitations do not invalidate the main message: BMI should not be used as the sole measure of cardiometabolic risk.

On the other hand, in clinical practice, we are quite clear about the need to use BMI and body fat index (BFI) in all clinical assessments and to evaluate the risk of obesity. This is not the case for the waist-to-hip ratio, as the measurements are too variable for clinical use.