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“BMI is dead” claim West Midlands health experts


A team of university researchers across the West Midlands have discovered BMI (body mass index) is unfit for purpose to predict major health conditions.

Alan Nevill, Research Professor in the Faculty of Education Health and Wellbeing at the University of Wolverhampton has been working in collaboration with colleagues Michael J. Duncan and Tony Myers to identify an alternative method to predict cardiometabolic risk after finding BMI is unfit for purpose of predicting health risks such as Diabetes.

Body mass index (BMI) has long been used as the primary anthropometric index for monitoring weight status in clinical and public health settings, despite its limitations being historically well established. It is so flawed as a measure of weight status, that its use has been described as unethical.

Research has also shown that waist circumference (WC) indices are better than BMI at predicting of non-communicable diseases and cardiometabolic risk (CMR) but there is still considerable debate as to which WC index is likely to be the best to replace BMI.

The team examined the efficacy of BMI and three waist-circumference indices; waist-to-height ratio, unadjusted waist circumference, and a waist circumference index independent of height, in explaining cardio-metabolic risk (CMR) in 53,390 participants.

The four available CMR factors were high-density lipoproteins (HDL) cholesterol, glycated haemoglobin (HbA1c), systolic (SBP) and diastolic blood pressure (DBP).

The research team found three waist-circumference indices were superior to BMI when predicting CMR factors, before and after controlling for age, sex and ethnicity. However, no single waist circumference index was consistently superior.

Results suggested that the waist-to-height ratio is the strongest predictor of glycated haemoglobin (HbA1c) confirming that shorter individuals are at great risk of Diabetes.

The most appropriate waist-circumference index associated with diastolic blood pressure was the waist ‘independent of height’ ratio WHT∙5R. For systolic blood pressure, it was unadjusted WC. Given HDL cholesterol is independent of height, the best predictor of HDL was also the waist ‘independent of height’ ratio WHT∙5R.

Overall, findings found that there is ‘no one size fits all’ in accurately predicting cardiometabolic risk.

Alan_NevillAlan Nevill, Research Professor in the Faculty of Education Health and Wellbeing at the University of Wolverhampton said: “As we’ve established, BMI is unfit for purpose and I think we can agree, ‘no one size fits all’ regarding which is the optimal waist circumference index to use to predict CMR.

However, if we had to recommend a single waist-circumference index to predict the combination of CMR factors, based on our analyses reported in Nutrition, metabolism, and cardiovascular diseases, we would have to recommend the waist “independent of height” ratio WHT∙5R.

“Nonetheless, we continue our research to identify the optimal WCI to best accurately predict health conditions.”

The research team continue to explore the optimal WCI to best predict health outcomes.

To find out more about the team’s research click here.

Find out more about the University's research in these publications:

For more information please contact the Corporate Communications Team.

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