If you have an elevated BMI, or body mass index, does this mean you're at increased risk of experiencing a serious health problem? It all depends, according to a new study.

BMI and Health
The medical community often relies on BMI as an indicator of overall health, but recently researchers at the US Centers for Disease Control and Prevention's National Center for Health Statistics found that while very obese people (who have a high BMI) have higher mortality rates than people at normal weights, people who were slightly overweight had a lower risk of dying than their thinner counterparts. These findings, published in the Journal of the American Medical Association (JAMA) in 2013, call attention to the weakness of using BMI to gauge your risk of heart disease.

The use of health assessment tools other than BMI is an important trend, according to Howard Weintraub, MD, a clinical associate professor at the Leon H. Charney Division of Cardiology at NYU Langone Medical Center. Although there are some weaknesses in the JAMA paper, says Weintraub, the research suggests that using BMI alone isn't typically the best indicator of health and mortality risk.

The Waist-Hip Ratio
Instead, Weintraub stresses the importance of using waist-hip ratios to determine who is at risk for cardiac issues and other health problems. "At NYU, waist-hip ratio is one of our vital signs because it's a much more accurate way of looking at cardiovascular risk," he says. In particular, people who have an apple shape, or having a stomach bigger than your hips, can be at increased risk for diabetes, heart disease, and stroke. "This is because abdominal obesity is associated with visceral fat, which is not only on the belly but also around the organs," he explains.

Weintraub points out that body shape also provides a more realistic view of patients who fall outside of the "typical" range, he says. Consider, for instance, a very muscular athlete who has a higher BMI than his thinner counterpart, but who is healthier and in better shape.

Measure Your Waist-Hip Ratio
When measuring waist-hip circumference, Weintraub says that it's important to get a proper reading, which means measuring just above the belly button. This is essential because some men may think that their pants size is their waist size. While sometimes this can be true, if your husband is wearing his pants down by his hips and has his belly hanging over, the size is misleading.

Heart Disease Prevention
What all this means is that you don't have to be ultra focused on your BMI level if you are slightly above the normal range. In addition, it's important to talk to your doctor at your next office visit and make sure he checks your waist-hip ratio and, if needed, suggest some lifestyle modifications to lower your health risks.

Other Healthful Steps
It's also a good idea to have the following measures, which are related to cardiac health, checked regularly:

  • cholesterol
  • triglycerides (fats that circulate in the blood)
  • blood pressure

Finally, remember that the best way to prevent cardiovascular disease is to eat a healthy diet, pay attention to your portion size, and make an effort to exercise on an ongoing basis.

Howard Weintraub, MD, reviewed this article.

Sources:

Flegal KM, Kit BK, Orpana H, Graubard BI. "Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis." Journal of the American Medical Association (JAMA). 309 (2013): 71-82. Web. 25 March 2013.
http://www.ncbi.nlm.nih.gov/pubmed/23280227

Howard Weintraub, MD, clinical associate professor, Department of Medicine, Leon H. Charney  Division of Cardiology at NYU Langone Medical Center. Phone interview. 14 March 2013.
http://medicine.med.nyu.edu/cardiology/for-patients/center-prevention-cv-disease http://www.med.nyu.edu/biosketch/weinth01