November 3, 2005

Waist and hips best heart attack checks for obese

By Paul Majendie

LONDON (Reuters) - Measuring the ratio between waist and
hip sizes is the best way of checking for the risk of heart
attack in the obese, a global study showed on Friday.

After studying over 27,000 people in 52 countries,
researchers said the waist-to-hip ratio was a far more
effective way of measuring heart attack risk than the
traditional body mass index (BMI) method.

"Substantial reassessment is needed of the importance of
obesity for cardiovascular disease in most regions of the
world," said Professor Salim Yusuf, from McMaster University in
Ontario, Canada.

Obesity already affects more than 300 million people

Currently it is calculated with the BMI -- dividing weight
in kilograms by height in meters squared. A BMI of more than 25
is overweight. Above 30 is considered obese.

But the latest study, whose findings were published in The
Lancet medical journal, concluded that the waist-to-hip ratio
was a much better heart attack calculator than BMI.

"The standard method by which we have been measuring
obesity is obsolete and should be replaced by the waist-to-hip
ratio," Yusuf told Reuters.

Fat deposited on the stomach or abdomen -- the classic beer
gut -- is more dangerous than extra pounds on the thighs
because the fat cells around the waist pump out chemicals that
can damage the insulin system, raising the risk of diabetes and
heart disease.

"A larger waist is bad for you, larger hips are good for
you, Yusuf said. "What matters is where your fat is and how big
your muscles are."

And now the problem could be far worse than health experts

The study said that if the risk of heart attack in the
obese is redefined using the waist-to-hip ratio, the proportion
of people in danger would increase threefold.

"The global burden of obesity has been substantially
underestimated by the reliance on BMI in previous studies,"
Yusuf's team concluded.

Obesity has become a major medical headache worldwide with
its prevalence highest in developed countries like the United
States and lowest in Asian countries.

The new study argued that was not the case.

If the waist-to-hip ratio were used to calculate who among
the obese was at risk of having a heart attack, then the
proportion would increase substantially in the Middle East,
South Asia and Southeast Asia, the study found.

"Most of us think of obesity as a problem of rich and
western industrialized countries. But our data shows that it
also affects low and middle income countries especially people
living in cities," Yusuf said.