A 14-year study of nearly 7,000 US adults aged 65+ finds that higher BMI is linked to lower mortality risk, but larger waist circumference independently increases death risk, even among those with normal weight.
A large-scale study published in the Journal of the American College of Cardiology indicates that waist circumference and waist-to-hip ratio are superior predictors of cardiovascular disease risk compared to body mass index (BMI). Analyzing nearly 260,000 adults over 20 years, researchers found that individuals with normal or overweight BMI but high waist measurements faced a 15% to 50% higher risk of heart-related events. Conversely, those with obesity but small waists showed outcomes similar to normal-weight individuals, suggesting that fat distribution, not just total weight, drives health risks.
New evidence shows waist-to-height ratio (WHtR) outperforms body mass index (BMI) for predicting cardiometabolic disease and mortality, with large studies and the US military adopting WHtR-based criteria; while BMI remains useful for population trends, WHtR better reflects abdominal fat and health risk across ages, potentially reshaping obesity assessment.