Waist Size Is a Better Predictor of Heart Disease

When it comes to either your waist or your body mass index, bigger isn’t better. But the size of your waist predicts whether you will get diabetic heart disease even better than the body mass index (BMI) does.

A collaborative team of nine researchers from the Intermountain Heart Institute in Salt Lake City and Johns Hopkins Hospital in Baltimore reported their findings this month at this year’s scientific sessions of the American College of Cardiology. I obtained a copy of the study and the poster presented at the scientific sessions from a representative of the institute.

A strong predictor

The researchers studied 200 men and women who have type 1 or type 2 diabetes who hadn’t showed any symptoms of heart disease. They found that if you have a large waist it is a strong predictor of heart disease, the most deadly complication of diabetes. Abdominal obesity, or having a large stomach, has a strong association with regional left ventricular dysfunction, which is a common cause of heart disease, including congestive heart failure.

The left ventricle is the chamber of the heart that pumps oxygen-rich blood to your brain and your body. When your left ventricle doesn’t function well, blood backs up into your lungs and legs, and this often leads to heart failure and can increase your risk of sudden cardiac arrest.

The current study builds on earlier research by the same team at the Intermountain Heart Institute and Johns Hopkins Hospital. One of the team’s earlier studies showed that when you have diabetes, the higher your BMI, the greater your risk for getting heart disease.

Worse for men

The women in the study had better heart function at each increasing level of abdominal obesity than the men did. “In general, abdominal obesity had a greater adverse effect on men than women,” Dr. Muhlestein said. He advises women to keep their waist size down to about 34 inches or less. Men should try to keep their waist circumference at 40 inches or less.

The new study supports the old theory that it’s better to be shaped like a pear — with weight around your hips — than like an apple — with weight around your stomach. This study emphasizes that having an apple shape can motivate you to reduce all of your cardiovascular risk factors, including your waist circumference, Dr. Muhlestein said.

I’ve never resonated with the comparison between pear and apple shapes. The banana shape attracts me more, and for about the past 10 years, I have been able to keep my waist size down to 33 inches — from 58 inches at one point. Whatever shape you have, please consider the wisdom encapsulated in the title of E.F. Schumacher’s book that “Small is beautiful.”

This article is based on an earlier version of my article published by HealthCentral.