Waist Circumference Better Than BMI at Predicting Cardiac Risk

Waist circumference (WC) correlates more strongly with several known cardiovascular risk factors than does body mass index (BMI), according to a report in the February issue of the American Journal of Clinical Nutrition.

The findings are based on an analysis of data from 10,969 subjects who participated in the third National Health and Nutrition Examination Survey from 1998 to 1994.

Dr. Shankuan Zhu, from the Medical College of Wisconsin in Milwaukee, and colleagues found that WC was more strongly tied to lipid profiles, blood pressure, and glucose levels than was BMI.

Among men, the WC cutoffs that provided a cardiovascular risk comparable to BMIs between 25 and 40 were highest for whites, lowest for blacks, and intermediate for Mexican Americans. By contrast, the WC cutoffs among women varied little by ethnicity.

Combining the data from the three ethnic groups, WC cutoffs of 89 and 101 cm in men conferred a cardiovascular risk comparable to BMIs of 25 and 30. The corresponding cutoffs among women were 83 and 94 cm.

"The present study reports WC cutoffs that correspond to well-established BMI cutoffs, recommended by the World Health Organization and the National Institutes of Health for overweight and obesity, in their association with cardiovascular disease risk factors," the authors conclude. "Our findings indicate that WC is a better indicator of CVD risk than is BMI across 3 race-ethnicity groups."

Am J Clin Nutr 2005;81:409-415.