Easily found with a tape measure around the waist, the familiar body mass index may fail to identify those health risks. New studies from Rutgers University indicates that waist girth without and with BMI performs close to if higher than more complex systems using several body measurements in identifying those with excess adiposity. Can we do better at identifying excess adiposity? Published in JAMA Network Open, this study looked at the ability of various methods for identifying excess adiposity.

It was found that BMI alone failed to identify many individuals who identified with body-fat standard of disease; yet, a combination of waist measurement, or reliance upon the waist number was optimal. “It is easy to find warning signs, ” said lead author Aayush Visaria of Rutgers Health, “A hastening to loosen a belt or go up a pant size may be the first sign of accumulating belly fat despite a decent step on the scale and a decent BMI.

Taking the waist measurement, he said, offers healthcare professionals and the people they treat a ‘simple way of identifying who is at increased risk of developing diabetes, cardiovascular disease, stroke and some of the cancers earlier.

‘ Most dangerous is visceral fat, fat around the internal organs. This is much more metabolically risky (linked to inflammation, insulin resistance, cardiovascular disease) than fat stored elsewhere. BMI is not able to differentiate between fat deposits and muscle and can give no indication of fat distribution.

An athlete with a muscular build (BMI over 25) may not have excess fat, while a person with a healthy BMI may still have a high ratio of misdirected central fat. The Rutgers group tested waist circumference versus a newer model including various anthropometric measures. While the more complicated model detected more overweight individuals, the simpler methods performed also with a significant reduction in complexity.

At no time in my clinical experience have I ever measured hip circumference although it is included in some proposed systems. The ease of measuring waist circumference and its readily available inclusion in many guidelines make it ideal. Additional current research echoes the same message. For those with either a healthy or overweight BMI but a large waist, the risk for a heart attack stroke heart failure, and death doubles and triples respectively.

Then again, some of the individuals who were obese as the BMI had heart failure and death rates as low as many of the leaner individuals. As for people, the message is simple. If the waist is measured at the umbilical level, the measurey says something that canNOT be said by the weight and height.

Usually, guidelines point to increased risk if the waist is bigger than 40 inches for men and 35 inches for women (sometimes the threshold differs by ethnicity and sex). Monitoring the measure over time illuminates slow changes the scale can steal undetected. Health care professionals have historically understood the shortcomings of BMI.The indicator was never meant to be a definitive health indicator for individuals.Still, it still is widely adopted because of its ease of use and accessibility. The revised indication indicates that one additional marker adds to far a great extent, and a lot without additional cost, effort and extravagance.