But is this waist to height ratio better? And I bet your doctor knows neither of them. My calculation here is .904; I'm not concerned about it. My BMI is 28.2, directly the result of my doctor COMPLETELY FAILING TO GET ME 100% RECOVERED!
Belly Fat May Be Stronger Predictor of Heart Damage Than BMI
Abdominal obesity was linked with more harmful changes in heart structure than body weight alone, especially in men, a large study using advanced imaging suggested.
Among more than 2,000 adults in Germany, greater waist-to-hip ratio was associated with a proportionally larger increase in left ventricular mass and reduced cardiac volume than body mass index (BMI), reported Jennifer Erley, MD, of University Medical Center Hamburg-Eppendorf in Germany, at the Radiological Society of North America (RSNA) annual meeting in Chicago.
The changes indicated concentric remodeling, or a thickening of the heart muscle without a corresponding increase in volume, which means the heart pumps less blood, she noted.
"Rather than focusing on reducing overall weight, middle-aged adults should focus on preventing abdominal fat accumulation through regular exercise, a balanced diet, and timely medical intervention, if necessary," Erley said in a press release.
The changes also were more prominent in men, especially in the right ventricle, which pumps blood to the lungs, she noted.
Sex-specific differences "suggest that male patients may be more vulnerable to the structural effects of obesity on the heart, a finding not widely reported in earlier studies," Erley said in the press release.
Greater heart damage in men could be tied to an earlier onset of more severe abdominal obesity or a cardioprotective effect of estrogen in women, Erley said.
Erley and team found that BMI was associated with significant increases in left ventricular end-diastolic mass in both men (β=2.40, 95% CI 2.05-2.75) and women (β=1.40, 95% CI 0.59-2.21), as well as left ventricular end-diastolic volume overall (β=0.72, 95% CI 0.27-1.18). They also saw increases in right ventricular volume, but to a lesser degree.
However, the associations were much more worrisome for waist-to-hip ratio, they found. They observed an increase in left ventricular mass (β=3.79, 95% CI 1.77-5.80) and a decrease in left ventricular volume (β=-4.04, 95% CI -6.50 to -1.55). In men only, decreases were significant for right ventricular end-diastolic volume (β=-4.42, 95% CI -7.14 to -1.70) and right ventricular systolic volume (β=-2.99, 95% CI -4.84 to -1.14).
"From the perspective of a radiologist, when we see this cardiac remodeling pattern, we currently think of cardiomyopathy, hypertensive heart disease or some other form of disease, but we don't clinically draw the line to obesity in our reports," Erley said. "This study should alert radiologists and cardiologists to be more aware that this remodeling could be attributed independently to obesity."
A total of 2,244 adult participants from the Hamburg City Health Study underwent 3T cardiovascular MRI. Overall, participants were ages 46 to 78 and free of cardiac diseases or interventions. Due to the ages of participants, the research team was not able to do a pre- versus post-menopausal analysis in women, Erley noted.
Overall, 43% of participants were women. Mean BMI was 27.2 in men and 26.5 in women, and mean waist-to-hip ratio was 0.99 and 0.87, respectively.
Waist-to-hip ratio can be determined with a tape measure by dividing waist circumference at its narrowest point by hip circumference at its widest point, according to RSNA. A ratio of 0.90 for males and 0.85 for females is an indicator of abdominal obesity and associated with increased risk of cardiovascular disease, according to the World Health Organization.
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