A recent medical study has warned that a person’s waist size can provide information about cardiac health that is not revealed by body mass index, which is calculated using only height and weight.
According to the research, individuals whose BMI appears to fall within the normal range may still face an elevated risk of heart disease if excess fat has accumulated around the abdomen.
Researchers analysed data from approximately 260,000 adults across 15 long-term medical studies, with participants’ health status reviewed over a period of nearly two decades.
The results showed that individuals whose BMI was normal or slightly above normal, but whose waist circumference or waist-to-hip ratio was high, faced a risk of various cardiovascular diseases and death that was approximately 15 to 50 percent greater.
According to the research, published in the Journal of the American College of Cardiology, BMI expresses a person’s weight in proportion to their height but does not indicate where fat is distributed in the body. Experts said that fat accumulating around the abdomen in particular can prove more harmful to health.
Dietitian Erin Palinski-Wade told Fox News that where fat is located in the body is sometimes more significant for health than the total amount of it.
She said fat that accumulates deep within the abdomen surrounds vital organs and can contribute to increased inflammation in the body, disrupt the insulin system and damage blood vessels.
The research examined a range of medical outcomes, including heart attack, stroke, heart failure, irregular heartbeat and deaths caused by cardiovascular disease.
According to the researchers, the findings reinforce the position that weight or BMI alone should not be the standard when assessing a person’s health, and that the distribution of fat in the body — particularly excess fat around the waist — should also be given importance.
Researchers acknowledged certain limitations in the study. They did not have complete information on participants’ physical activity, diet or genetic predisposition to obesity. In addition, participants’ waist circumference and waist-to-hip ratio were recorded only once.
For this reason, it was not possible to fully assess the relationship between changes in abdominal fat over time and the risk of heart disease.
The distinction the research draws is between subcutaneous fat, which sits beneath the skin, and visceral fat, which accumulates within the abdominal cavity around the liver, pancreas and intestines. The two behave differently in metabolic terms, with visceral tissue more metabolically active and more closely associated with inflammatory markers and insulin resistance.
The finding carries particular relevance for South Asian populations, in whom research has consistently documented a tendency toward central fat distribution and elevated cardiometabolic risk at lower body weights than in European populations — a pattern that has prompted discussion internationally about whether standard BMI thresholds are appropriate across all groups.
The study’s central conclusion is that a normal overall weight or BMI does not exclude cardiovascular risk where excess fat has accumulated around the waist, and that assessment of health requires attention to fat distribution rather than weight alone.
Individual health assessment remains a matter for a qualified physician.
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