Waist measurements may flag heart danger that BMI overlooks, study shows

A study published in the Journal of the American College of Cardiology analyzed almost 260,000 adults from 15 long-term health cohorts, tracking them for roughly 20 years. The investigators found that individuals deemed normal-weight by BMI but with larger waists or higher waist-to-hip ratios had a 15% to 50% greater risk of major cardiovascular events and related mortality. The research highlights that abdominal, visceral fat is metabolically active and can drive inflammation, insulin resistance, and arterial damage, unlike fat stored elsewhere.

Experts note that BMI alone does not reveal where fat is stored, which may be more critical for heart risk assessment. Limitations include lack of data on participants’ activity, diet, genetics, and only a single waist measurement, restricting insight into how changes over time affect risk.