Belly Fat Matters More Than BMI When Determining Your Heart Disease Risks

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January 11, 2007 | 16,703 views


Body mass index (BMI), which gauges weight in relation to height, is only a crude way to judge obesity-related heart disease risk. According to the results of a new study, belly fat is a better measure of the risks than BMI, and abdominal obesity could be a greater risk factor than overall obesity.


Researchers looked at data from more than 100,000 men and women to test whether measuring sagittal abdominal diameter, or SAD, would improve the accuracy of predicting heart disease risk.

SAD is the distance from the back to the upper abdomen midway between the top of the pelvis and the bottom of the ribs. SAD is a more standardized measurement than waist circumference, and therefore less subject to error.

Men with the largest SAD were 42 percent more likely to develop heart disease, and a large SAD similarly increased heart disease risk by 44 percent for women. Heart disease risk also rose with SAD within BMI categories, even among men of normal weight.

The relationship between SAD and heart disease risk was strongest among the youngest men and women, indicating that people who develop central obesity earlier in life are more likely to have more serious problems.



No, this SAD is not seasonal affective disorder (though it sure feels like it in the middle of winter) -- it is short for sagittal abdominal diameter.  This is really a mouth full but is actually quite a simple concept.

In theory it is easy to measure if you have the right equipment. You need a giant caliper that can measure the distance from a person's belly to their back. So if you have the caliper it is easier to measure and likely more accurate than a waist circumference.

However, if you don't have one of these special calipers then simply measuring your waist size will also work, especially since waist circumference is a powerful predictor for disease.

For some time now there has been a sense that body mass index (BMI) may be a far less accurate barometer of your health than you think -- since many athletes (especially weight trainers and football players) and patients who are completely out of shape may have similar scores.

Also, increased organ or abdominal adipose tissue in particular (a "beer belly") has been shown to be more strongly associated with heart disease and a variety of chronic diseases than just weight in relation to height. I'm glad to see that more accurate measures are being proposed.

There's no better way to trim the fat around your waist than following an approach that emphasizes diet AND exercise. Emphasizing one and ignoring the other is just not a solid strategy to help you achieve optimal health.

The easiest way to get your diet under control:

Eating the foods your body burns best based on your unique nutritional type. Because exercise can be the tricky, but essential, part of your optimal health plan, keep in mind that you must treat it like a drug in that it is best prescribed precisely to get the most benefit and avoid side effects.

On Vital Votes, reader Joshua, from Vista, California, points out the following:

"The midsection has most of the receptor sites for cortisol in the body. That is why most americans living the crappy lifestyles that they live and eating the crappy foods are becoming belly obese. 

When cortisol goes up from chronic stress, insulin goes up as well. At that point, insulin unlocks the door so fat can enter and be stored. So to make a long story short, most americans that have belly fat, the pear shape look or spare tire look are most likely insulin resistant and have cortisol dysfunctions as well."

Other responses to this article can be viewed at Vital Votes, and you can add your own thoughts or vote on comments by first registering at Vital Votes.




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