Which is worse for your heart – general obesity or simply having the bad luck to have the wrong body shape? On the one hand, bolstered by a body of supporting evidence, some medical professionals believe that body shape is the best predictor indicating the likelihood that you will develop and later die, from cardiovascular or heart disease. Proponents of this theory believe that those who are “apple” shaped, that is, those who carry extra weight around their mid-section, are at much greater risk of developing and dying from heart disease than their pear shaped counterparts. For more information on how body shape influences your heart health, visit The Real Heart Disease Culprit: 'Apple' Body Shape or BMI? How Our Shapes Influence Our Health at https://www.empowher.com/heart-disease/content/real-heart-disease-culprit-apple-body-shape-or-bmi-how-our-shapes-influence-ou .
Not everyone is convinced that an apple body shape is the greatest predictor in determining future heart health outcomes. Some believe that general obesity as determined by body mass index is more predictive of future heart outcomes.
Body Mass Index Theory
Body Mass Index, or BMI, is a measure based on height and weight used to calculate the total amount of body fat. This is a general measure of total body fat independent of your body shape. Considered a reliable predictor of the total amount of body fat, BMI is easily calculated as follows:
Weight (in pounds) / Height (in inches)
The result of the calculation produces a measure of your body fat which is then categorized as underweight, normal, overweight, or obesity. A BMI score between 18.5 and 24.9 is normal, over 25.0 is overweight, and persons with scores over 30 are considered obese. According to the Centers for Disease Control and Prevention, the ranges represented “the relationship between body weight and disease and death.” The more excess fat you carry, the greater your BMI score, and the higher your risk for developing weight-related conditions and diseases such as cardiovascular or heart disease, diabetes, high blood pressure, high cholesterol, stroke, sleep apnea, osteoarthritis, gallbladder issues, and endometrial, breast and colon cancer.
Whether or not BMI is a better predictor of heart disease than body shape is still a matter of debate. However, one study funded by the British Heart Foundation and the United Kingdom Medical Research Council, concluded that one method is a better predictor of heart disease. After examining records involving 58 cohorts, 17 countries, and almost 222,000 people, researchers concluded that when additional information such as high blood pressure, cholesterol levels, and diabetes history are available to physicians, there was no difference between BMI or body shape – waist circumference and waist-to-hip ratio - in terms of predicting heart disease. In other words, it didn’t matter which method was used to predict heart disease if other supporting information was available. In fact, researchers found that BMI and body shape together only contributed about 25 percent of the information necessary to predict heart disease.
Researchers were quick to point out that their conclusions didn’t mean you shouldn’t pay attention to your weight or waist circumference. Obesity contributes to many conditions such as high blood pressure, which raises your risk of heart disease and stroke. Maintaining a healthy weight is still a worthy goal because it helps manage or eliminate other risk factors for heart disease. But, by itself, researchers concluded more information on blood lipid levels - such as cholesterol and triglyceride levels - were of more predictive benefit than either BMI or body shape.
Calculate Your Body Mass Index, National Heart Lung and Blood Institute, 15 Jun 2011, http://www.nhlbisupport.com/bmi/
About BMI for Adults, Centers for Disease Control and Prevention, 2 Jun 2011, http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies, The Lancet, Volume 377, Issue 9771, Pages 1085 - 1095, 26 March 2011, doi:10.1016/S0140-6736(11)60105-0, Published Online: 11 March 2011, http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960105-0/abstract
Reviewed June 16, 2011
Edited by Alison Stanton