Wednesday, August 19, 2015

BMI vs. Waist-To-Height Ratio in Determining Cardiometabolic Risk

BMI is probably the most commonly used obesity related measurement. However, BMI is not necessarily the best measurement for all types of obesity. Indeed, it is not the most accurate measurement for abdominal obesity which is often associated with cardiometabolic risks. Anthropomorphic measurements involving waist are better indicators of these risks in most cases. These measurements include waist, waist-to hip ratio, and waist-to-height ratio (WHtR), which may be one of the best.

Two reasons why BMI is the measurement used most often for obesity is its ease of calculation (Weight in Kilograms/(Height in Meters2) and the U.S. government's recommendation that the measurement be used by physicians. The "government guidelines urge physicians to screen all adult patients for obesity, and offer health and lifestyle counseling for those with a high body mass index (BMI)."

Still, studies show that WHtR is a better measurement for predicting cardiometabolic risks. According to a study published in 2013, "WHtR appears to be superior to BMI in detecting several outcomes, including incident cardiovascular disease, cardiovascular disease mortality, and all-cause mortality." It should be noted that the investigators did find that WHtR was a more useful measurement in Asians than in non-Asians. But the investigators indicated that their study results supported "the use of WHtR in identifying adults at increased cardiometabolic risk."

Investigators conducting another more recent study also concluded that "WHtR measurements were .. good markers for ... cardiometabolic risk." Let us note here that unlike some who say that BMI should be thrown out completely, we do not advocate this. Investigators have used BMI for some time in many studies, and BMI has proven to be useful.

But physicians and other healthcare providers might want to consider using WHtR as well as BMI. Including WHtR in their set of patient assessment tools could give a provider more insight into unhealthy cardiometabolic conditions.  Using this measurement could help the provider deliver better care to the patient.


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