Fact: BMI is Not a Perfect Measure of Body Fat-Related Health
It turns out that a high BMI is not always indicative of increased health risks.
In fact, some studies have found a “paradox,” in which some people with higher BMI have lower than expected rates of obesity-realted conditions such as diabetes, hypertension and abnormal lipids.
This can create confusion about how to assess risk and treat people with obesity.
One possible reason for this paradox is that BMI isn’t a perfect measure of body fat. It doesn’t account for differences in muscle mass, fat distribution and other important factors (see myths #1 and #4 for more details).
So, researchers are now looking at other ways to measure body fat (called adiposity-related anthropometrics) across diverse populations.
These alternative measures could help improve:
- Our understanding of how body fat affects health outcomes
- How we diagnose and manage obesity in people at high risk
A recent study in JACC from a team of Mass General Brigham researchers led by John Ostrominski, MD, and Muthiah Vaduganathan, MD, MPH, found that even people with a “normal” BMI (below 30) often had excess abdominal fat, which was linked to serious heart problems, including heart failure, atrial fibrillation and cardiovascular death. This was especially common among older adults and women.
The researchers also looked at how the medication finerenone, which is used to treat heart and kidney disease, worked for people with different body fat patterns.
They found that finerenone helped reduce the risk of heart failure and heart-related death in all groups, no matter their BMI or waist size.
People with more body fat saw even greater benefits, showing that this treatment may be especially helpful for those with higher levels of abdominal fat.
