BMI, waist circumference, and waist-to-hip ratio, whether assessed singly or in combination, do not importantly improve risk prediction of disease suggests 58 prospective studies that included 221,934 participants
The result is applicable to people in developed countries and when additional information is available for systolic blood pressure, history of diabetes, and lipids. This means that in population-wide assessment of the risk for heart disease, the established risk factors play a more important role as compared with factors such as BMI and waist-to-hip ratio.
AdvertisementRecommendations regarding the value of clinical measures of adiposity for prediction of heart disease risk vary in different national and international guidelines. While some recommend omission of adiposity measures, others advise formal inclusion of such measures as risk factors in prediction models. This ambiguity arose due to uncertainties in relation to data from previous studies. For example, one large study said that waist-to-hip ratio was three times more strongly related to risk of heart attack than was BMI. However, none of the recommendations had been tested by powerful prospective studies.
There has been no reliable comparison of the long-term reproducibility of BMI, waist circumference, and waist-to-hip ratio according to the results from this group of large study
The results of the study published in the Lancet, stresses the importance of information about blood pressure, history of diabetes, and cholesterol measures. Authors state that they do not want to diminish the importance of adiposity as a major modifiable determinant of cardiovascular disease.
Adiposity (state of containing fat) is indeed a major risk factor. Controlling obesity is important in preventing heart disease. The result of the study is applicable when it comes to population-wide assessment of the risk of heart disease. When additional information about blood pressure, history of diabetes, and cholesterol measures, is available on factors used in standard risk scores, adiposity measures alone provide little or no additional information.
The findings rebut the existing recommendations to adopt baseline waist-to-hip ratio instead of BMI as the principal clinical measure of adiposity.The long-term reproducibility of BMI has been found to be superior to that of waist-to-hip ratio (or waist circumference).
Source: The Lancet
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