Is BMI a good measure of a healthy weight for me?
For some people, BMI might not accurately gauge their health risk. For example, because muscle weighs more than fat, a very muscular person may have a BMI over 25, even though they are not really overweight or at increased risk for heart disease. BMI can also be inaccurate for South Asians, Arabs, and mixed-race Africans, because people with this ancestry tend to have a higher percentage of body fat than white people do.24-27 For Asian Americans, BMI may underestimate their health risk.28, 29 Increasingly, studies show that waist measurement and/or waist-to-hip ratio may be better than BMI for assessing the risk your weight poses to your overall health.1
Is pear-shaped really better than an apple-shaped figure?
The location of your body fat, not just how much you have, makes a difference in the impact on your risk of developing heart failure. People with excess fat in their belly area, or abdominal adiposity (so-called "apple" shape), are more at risk of developing heart failure risk factors such as diabetes and high blood pressure than people who carry their weight in their hips and thighs (pear-shaped).30-32 The fat around the organs in the gut (called visceral fat) has been shown to produce high levels of interleukin 6, an inflammatory protein.33 The accumulation of visceral fat may increase a woman's risk of dying from heart disease 8 times compared with 2 times in men, although this increase may be higher in women than in men because women tend to live longer than men.34
Increasingly, studies show that waist measurement and/or waist-to-hip ratio may be better than BMI for assessing the risk your excess weight poses to your overall health.35, 36 One recent study of more than 2400 adults (56% were women) found that otherwise healthy people who carried excess weight around the waist—measuring 35 inches or more—had double the risk of developing heart failure compared with those who were slimmer around the middle.6
| Waist Circumference13 | ||
| Women | Men | |
| High Risk | More than 35 inches (88 cm) | More than 40 inches (102 cm) |
| Waist-to-Hip Ratio = Waist ÷ Hip | ||
| Desirable | 0.80 or less for women | |
| At-risk | 1.0 or more | |
Your waist circumference is the distance around your waist, measured at the level of your belly button.37 A waistline greater than 35 inches for women and 40 inches for men increases the risk for having obesity-related risk factors and heart problems. However, these cutoffs may be too high for very short people (less than 5 feet tall) and people from Asia and East India.1, 24 Another way to measure abdominal obesity is the waist-to-hip ratio, which is the distance around your waist divided by the distance around your hips. An ideal waist-to-hip ratio for women is 0.80 or less; a waist-to-hip ratio of 1.0 or more increases your risk for heart disease.
Regardless of where you carry your weight, being overweight or obese increases your risk of developing heart failure.
