"The simple reality is that BMI is a crude measure of both fatness and fat distribution. It is excess body fat in the wrong places that raises the risk of mortality and morbidity," said Katz.
"This has long been known, and use of the BMI as a proxy measure has mostly been a matter of convenience. This paper suggests the costs of that convenient practice may be high, distorting our assessment of cardiovascular risk."
People who are relatively thin overall but have an excess of fat around the middle are at highest risk, Katz said.
"Many clinicians, myself included, routinely measure waist circumference already," Katz said. "It's simple and readily added to the standard exam. It seems time to add it to the standard of practice as well, since the evidence is increasingly compelling that it is a better measure of what really matters."
For more information on heart disease, visit the American Heart Association.
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