8 ms·
Abdominal fat predicts heart disease risk better than BMI
https://pmc.ncbi.nlm.nih.gov/articles/PMC13470613/ https://pmc.ncbi.nlm.nih.gov/articles/PMC13470613/
- purpleshellx 2mo ago[flagged]
- teolandon 2mo agoMaybe the olympic athletes that are pushing their bodies to achieve the limits of human capability, yes. I think it's obvious why some (not "ALL") of them die young. You're not going to die of a heart condition if you hit the gym 3 times a week. Also nobody says "don't eat food" other than thinspo instagram pages. You should eat food, if you don't eat food you die.
- nradov 2mo agoOlympic athletes typically live several years longer than regular people. https://bjsm.bmj.com/content/55/4/206 https://bjsm.bmj.com/content/55/4/206
- dplgk 2mo agoSteroids are bad for your heart
- tonyedgecombe 2mo agoI do wonder how much of a problem we are facing with the amount of steroid use going on in gyms.
- ajma 2mo agoThis is new? I thought they have been saying this for years
- basisword 2mo agoThey have. BIM is usually talked about in the same breath as waist circumference which would be a better measure of abdominal fat.
- downrightmike 2mo agoI
- rezaprima 2mo agoand because it is comparative ratio (cm / cm), it works in any length metric. CMIIW
- GuB-42 2mo agoSame for me, no one considers BMI to be a good indicator of anything, but it is better than nothing, and more importantly, it is super simple. Any idiot with a bathroom scale and a measuring tape can do it. And by adulthood, height doesn't change significantly and you probably know it, so you may not even need that measuring tape. Other metrics need specialized equipment, error prone or complex procedures, etc... I don't even know how to make a waist measurement. Where exactly? How relaxed should the subject be? How long after eating?... That's the value of BMI: simple repeatable. Not the best but enough to get and idea and make statistics.
- jrapdx3 2mo ago> And by adulthood, height doesn't change significantly and you probably know it ... But height does change in adulthood [0]. On average people living past 40 gradually lose height. At age 80, it's likely height loss will be >=2 inches. This loss is reflected in higher BMI even when body fat content hasn't changed. Average BMI increase isn't large, but think about a person losing 4 or 5 inches of height while maintaining body fat unchanged. Self-reported height is generally greater than measured height. Adding 1/2 to 1 inch is common (per experience measuring height). "Height inflation" has modest effect on BMI but problematic in research and workup for medical procedures. In the latter cases, measuring height is necessary. [0] https://www.uhhospitals.org/blog/articles/2024/10/why-do-people-get-shorter-as-they-age https://www.uhhospitals.org/blog/articles/2024/10/why-do-peo...
- strongpigeon 2mo agoI thought this was pretty well known already. Being “overfat” is the problem, not being overweight (though they’re often correlated). BMI is really easy to measure, and is mostly accurate, that’s why it’s so pervasive. However it remains a pretty rudimentary metric (and really should use the third power or your height instead of the second).
- kennyadam 2mo agoGenuine question: What is the difference between overfat and overweight? Isn’t the extra weight in an overweight person comprised of fat?
- piva00 2mo agoNot necessarily, a bodybuilder or very athletic person might be overweight in the sense of above average for their height but not overfat.
- arximboldi 2mo agoA muscular person can be "overweight" by BMI standards but not overfat at all. This is the case for many types of athletes, specially in strength disciplines but not only. It is the case in the fitness world that people ignore BMI and are intesterested in body-fat-percentage instead. This is hard to measure accurately so not so useful metric for the general population.
- wjholden 2mo agoIt's also possible to be overfat without being overweight! These "skinny fat" people often look normal enough but they carry very little muscle. It is a concerning condition because a doctor might not recommend a normal-weight person to hit the weights. I like to think of this as four quadrants around two axes. Low fat/low muscle is simply skinny. High fat/high muscle is the "big guy/gal" look that I associate with laborers. Low fat/high muscle is an athletic look; unhealthy in extremes (bodybuilding) but generally desirable. High fat/low muscle is skinny fat, which I associate with sedentary knowledge workers.
- SoftTalker 2mo ago> Studies have shown that visceral fat, which is fat that surrounds the internal organs in the abdominal area, is associated with chronic diseases like heart disease and diabetes, while subcutaneous fat, which is located directly under the skin, is not as strongly associated. How does one determine if one has an excess of visceral fat?
- lowbloodsugar 2mo agoThere are scans for like $50 that will tell you. Google Dexa scan or something like that.
- dplgk 2mo ago$50? Are you talking about US Healthcare where $50 just gets you a call to the receptionist?
- noemit 2mo agowhats wild is there are people who look very fat - who have lots of subcutaneous fat, who don't have visceral fat. The excessive subcutaneous fat can be hard on your joints but doesn't seem to correlate to other health issues.
- sn9 2mo agoA waist measurement is the cheapest and simplest way other than just looking. You want to make sure you measure under similar conditions, like in the morning after relieving yourself (for example). If it's too high, losing a ~0.5-1 lbs per week while strength and endurance training with progressive overload will get it down sustainably. https://www.barbellmedicine.com/blog/visceral-fat-waist-vs-weight/ https://www.barbellmedicine.com/blog/visceral-fat-waist-vs-w...
- yellowcurtainx 2mo ago[flagged]
- scrumper 2mo agoWell this'll rightly be flagged and killed, but gets points for novelty for sure.
- billfor 2mo agoI just want to know why FEASTS was capitalized, otherwise good for submission….
- yellowcurtainx 2mo ago[dead]
- BaculumMeumEst 2mo agoFor two people that are the same height, one could have X lbs of pure muscle, and one could have X lbs of pure fat, and they would have the same BMI. Color me shocked that it is not always a good predictor of disease.
- draw_down 2mo agoMy problem is it’s usually the second guy advancing this argument.
- BaculumMeumEst 2mo agoCool, I am 185cm and 68kg, work out 6 days a week, and have very little body fat. I am making this argument because it bothers me that this measurement treats visceral fat and muscle as the same thing. It’s often useless, unless you’re measuring degrees of obesity or something.
- trentearl 2mo agoIf the muscular person has an obese bmi he is still unhealthy though.
- sublinear 2mo agoThe irony of BMI is that people with plenty of muscle mass are more likely to have a high BMI as well as lowered risk for heart disease. BMI was never meant to be used as a diagnostic measure. BMI is just a rough filter for large data sets, and entirely dependent on the average height and habits of that population. Anyone taller than about 6'3" could tell you the recommended weight according to their BMI has always been absurdly low. If it's a printed chart on the wall, they might not even be on it.
- rKarpinski 2mo agoThis is a common misconception. BMI while an ok population metric, for individual's the biggest problem with is its poor sensitivity - it fails to classify people as obese who are obese. Using your 6 3" male as an example, they are significantly more likely to be clinically obese (using waist circumference, body fat % etc) at a weight lower than BMI cut-off of 240 lbs.
- sn9 2mo agoIt only fails to classify people with excess body fat who are in the healthy weight range. It's really good at catching people who are obese who are overweight.
- GuB-42 2mo agoBMI is not a good metric for really short and really tall people. The "ideal weight" of a person is proportional to height to an exponent somewhere between 2 and 3. Simple physics would say 3 but because tall people are not just scaled up copies of small people, it is closer to 2 in practice, maybe around 2.3, but we say 2 because it is easier to calculate. The downside is that BMI overestimates the "ideal weight" for short people and underestimate it for tall people. But BMI is not great at capturing exceptions anyways, so there is little interest in "fixing" this.
- throwaway2037 2mo agoAmericans that are 6'3" (190.5cm) are about 1.5% of the population. It is a tiny fraction of the population.
- teleforce 2mo agoFor non-invasive heart disease risk prediction nothing beat ECG, period. Somehow American Heart Association and its European counterpart are in denial, and still pushing dinasour screening mechanism with very low accuracy for heart disease risk prediction. The standard risk model for CVD based on PREVENT (US) and SCORE-2 (Europe) like parameters are very poor as reported in the recently published paper on the their accuracy performance by the Swedish team [1]. As all CVD risk stratification with cardiologist review (expert-in-the-loop), the most important accuracy metric is sensivity/recall (avoiding false negative that will escape review) of PREVENT and SCORE-2, 26% and 48%, respectively. The paper alternative proposal increased the sensitivity to 58% by performing clustering instead of conventional regression models as practiced in the PREVENT and SCORE-2. These type of models including the latest proposal performed very poorly as indicated by their otherwise excellent and intuitive display of graphical abstract results [1]. [1] Risk stratification for cardiovascular disease: a comparative analysis of cluster analysis and traditional prediction models: https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwaf013/7954595 https://academic.oup.com/eurjpc/advance-article/doi/10.1093/...
- sscaryterry 2mo agoHow many ECGs can you sell vs how many other snake-oil products? :) (Edit: This is intended to be sarcastic. I agree 100% with the comment) (Edit 2: Added the smiley face)
- justsomehnguy 2mo agoPoe's law in a full swing.
- sscaryterry 2mo agoI didn't know... Thank you
- Aerroon 2mo ago>How many ECGs can you sell vs how many other snake-oil products? A lot, probably. You could sell people on the idea that it should be a part of your yearly health screening. "And if you really care about your health you should do them every 3 months to catch problems early!" or some such.
- TheRealPomax 2mo agoThe 2000's called. We've known this for decades because we did a LOT of studies back in the day when you could still get government funding.
- incognito124 2mo agotake a look at myticker.com (previously at https://news.ycombinator.com/item?id=45857053 https://news.ycombinator.com/item?id=45857053)
- chr15m 2mo agoYou can control your CVD risk. Cutting saturated fat to under 15g per day and increasing intake of viscose fibre (e.g. beans) will reduce your LDL particle count in a few weeks, which reduces your CVD hazard ratio. You can measure your LDL and look up the papers yourself. Statins will reduce it a lot too (potentially with side effects). Replace solid fats like butter with liquid fats like olive oil. Literally any amount of regular exercise, including walking, will decrease CVD HR. The more the better (up until quite a large amount e.g. professional athlete). The more your heart is steadily pumping during exercise the better. Every bit helps reduce CVD risk. Movement is medicine. For the love of God do not smoke. Literally one of the surest ways to die a horrible death. Stopping smoking reduces CVD risk by a large amount. Do not give yourself diabetes by eating vast amounts of sugar. If you are doing this, stop. Not having diabetes decreases CVD risk. Other factors you probably can't change so focus on these. Doctors, if I got anything wrong please correct me.
- Noaidi 2mo agoYou said all this like you know something, but you didn’t bring up oxidative stress once. I mean, smoking is the leading cause for increasing oxygen stress in the body so you kind of mentioned it there but oxidative stress can be controlled with nutrients like zinc, copper, and manganese.
- loeg 2mo ago> Do not give yourself diabetes by eating vast amounts of sugar. This can help sustain a high level of exercise (the more the better). Certainly don't if you're sedentary, but the sugar during exercise is really helpful for getting in 10+ hours/week of exercise.
- someothherguyy 2mo agoI think the recent stance (not really recent in terms of assumptive idea, but now there is evidence) is that not all forms of sugar intake are equal. For instance, habitually drinking beverages with sugar in them (what are called sugar-sweetened-beverages in literature) is associated with a risk of developing T2D, where getting sugar from normal foods isn't really. https://link.springer.com/article/10.1007/s13668-026-00740-w https://link.springer.com/article/10.1007/s13668-026-00740-w
- Supersam654 2mo ago> Those with obesity and low WC [waist circumference] were not found to be associated with a significantly different risk of outcomes compared with those who had normal weight and low WC, except for all-cause mortality, for which risk was significantly lower. If I'm reading that right, it sounds like obesity (and therefore BMI) is still a better predictor for all-cause mortality. Perhaps waist circumference is better at predicting cardiovascular risk but BMI is still useful.
- jamesgill 2mo agoA nitpick about the title: Not strictly abdominal fat, but visceral abdominal fat, which surrounds the organs. Not all abdominal fat is visceral; in fact, in many people the majority is not. The article mentions visceral early on, which is the subject.
- weird-eye-issue 2mo agoIf you have a lot of abdominal fat then you also have visceral fat so it's just a proxy
- Noaidi 2mo agoThis is not true. It is what is called “skinny fat“.
- weird-eye-issue 2mo agoIf you are skinny fat you still have noticeable abdominal fat. You might not see it when somebody has a t-shirt on but it's still very obvious
- weird-eye-issue 2mo agoTo put this another way skinny fat just means you are not overweight but you have a high body fat percentage (eg lacking lean mass). So while you might not look like the average American there will still be significant visible abdominal fat, likely love handles, etc
- mohamedkoubaa 2mo agoIt's not a remotely good proxy
- weird-eye-issue 2mo agoSeriously, you don't think there's a connection between visceral fat and abdominal fat even though there's plenty of evidence that there is along with just common sense? It's just a particular type of abdominal fat so obviously the more abdominal fat that you can see it means you also have more of the type that can't see as well... It's not that complicated
- Noaidi 2mo agoIt doesn’t matter how fat you are or how much cholesterol you have in your blood. What matters is the oxidative stress that oxidizes the lipids. They need to figure out a way to reliably Measure OXLDL.
- anon84873628 2mo agoRelatedly, there is evidence that certain types of "resistant starch" can help reduce visceral fat. This starch comes from green bananas, potatoes, legumes, etc. It has to be either raw (there are supplements for this) or cooked and cooled. "Resistant starch intake facilitates weight loss in humans by reshaping the gut microbiota" https://pmc.ncbi.nlm.nih.gov/articles/PMC10963277/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10963277/ Edit: Ah, HN submission 2 years ago: https://news.ycombinator.com/item?id=39592367 https://news.ycombinator.com/item?id=39592367
- mapotofu 2mo ago[flagged]
- judge2020 2mo ago"you people" > The study was conducted in Shanghai, China from 3 July 2013 to 14 October 2016 Figuring out and understanding the physiology of different gut bacteria is not just for people trying to shortcut weight loss while still eating unhealthy food or to be sedentary all day.
- benatkin 2mo agoEh, the "real food" of Jamie Oliver and Michael Pollan (shop the peripheries) and such isn't very health promoting. So I'll pass and keep eating a mix of fresh food and cheap food that keeps for a long time like legumes. Kthxbai.
- qbit42 2mo agoAre legumes not "real food"?
- benatkin 2mo agoTo Michael Pollan it seems they aren't worth mentioning right in the first breath when talking about real food, but perhaps an afterthought. "Shop the peripheries" causes them to be lumped in with potato chips and oreos and other stuff that aren't in the peripheries of a supermarket. I don't accept the same real food dichotomy that they do.
- shdwslrkr 2mo ago[dead]
- skywhopper 2mo agoYeah because it has an actual correlation, whereas BMI is a ridiculously oversimplified measurement designed for population statistics based on what data is easily available, not individual assessment.
- ellyagg 2mo agoVery interesting, now if only you could measure abdominal fat without need expensive specialists.
- liveoneggs 2mo agohttps://www.lih.lu/en/visceral-fat-calculator/ https://www.lih.lu/en/visceral-fat-calculator/ (thigh one) https://en.wikipedia.org/wiki/Waist%E2%80%93hip_ratio https://en.wikipedia.org/wiki/Waist%E2%80%93hip_ratio (hip to waist)
- faangguyindia 2mo agoSo this study basically compares, BMI Waist circumference (WC) Waist to hip ratio (WHR) Subsequent risk of nine cardiovascular/mortality outcomes in >260,000 people followed for ~20 years To make it even more useful they should have included DEXA scan bodyfat%. Also, BMI becomes somewhat biased at height extremes because body mass doesn't scale exactly with height². Humans aren't geometrically scaled copies of one another and empirical scaling exponents are often somewhere between 2 and 3. Conventional BMI tends to read relatively high in very tall people and relatively low in very short people. But changing the exponent would only fix one relatively small limitation of BMI For better height adjusted replacement for BMI itself, one option is Trefethen’s BMI WHR and WC is positively correlated to bodyfat% but this may get distorted for strongmen or sumo wrestler who tend to have much higher than average lean mass, may also have higher WC and WHR but difference maybe waist to shoulder ratio, they tend to have much bigger and powerful shoulders. what's interesting is, for sumo wrestlers specifically, WC still correlates strongly with BF% one study reported r ≈ 0.86 There is a category in fitness called "skinny fat" where you are at low bodyweight (so low BMI) but your fat mass is relatively higher when compared to lean mass, so higher bodyfat% Many skinny fat people refuse to believe they carry higher bodyfat% because they think they've low bodyweight so they can't possibly carry higher fat, which is wrong. If you are interested in knowing more about bodyfat, this may help you: https://aretecodex.pages.dev/knowledge/measure/bodyfat https://aretecodex.pages.dev/knowledge/measure/bodyfat
- dominotw 2mo agohow does it compare to cholestrol ? just got statin at 44 :( i am not fat and workout ( although diet can use some improvment)
- j45 2mo agoI am not sure if this is adjusted appropriately for different groups who are much more or less pre-disposed to heart disease.
- jona-f 2mo agoSugar is a drug and this whole discussion beats around the bush.
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- pagutierrezn 2mo agoA summary: Thirty years after we learned that abdominal fat distribution matters, large-scale longitudinal evidence shows that waist measurements meaningfully reclassify cardiovascular risk beyond BMI alone.
- arlattimore 2mo agoBMI isn’t a good metric, this has been known for a long time. For example, I’m 45yo/178cm/93kg and am obese by BMI measurement. However, my body fat is 20% (Dexa), VO2 of 50 (lab) & have the aerobic fitness to run a half marathon after work and not care. I’m not surprised that you need other metrics like hip/waist ratio, measured body fat, visceral fat, etc to better understand the composition of someone’s body and how it might relate to health outcomes like heart disease.
- PunchyHamster 2mo agoWell, BMI doesn't count fat, just mass, that includes muscles, so yeah nothing unexpected here
- kolinko 2mo agoWell any fat % predicts heart disease better than BMI. So the question is whether Abdominal fat predicts better than overall fat.
- M95D 2mo agoBut LDL-cholesterol is already better than both at predicting heart disease. Why waste money on this "research"?
- deleted 2mo ago[deleted]
- sorethescore 2mo agoBMI is an objectively terrible individual health metric, it's is literally just weight / height². It measures neither body fat nor visceral fat, cannot distinguish muscle from adipose tissue, says nothing about fat distribution, fitness, metabolic health, or organ function, and its interpretation varies with age, sex, ethnicity and body composition. And these aren't merely hypothetical bodybuilder edge cases. A systematic review found BMI had only ~50% sensitivity for detecting obesity when compared with body-fat reference methods—i.e. it missed roughly half the people classified as obese by adiposity. More importantly, the 2025 Lancet Commission on clinical obesity explicitly recommended that BMI be used only as a population-level risk surrogate or screening tool, not as an individual measure of health. For individual assessment they recommend actually confirming excess adiposity with waist measurements or direct body-fat measurement. Which is basically what this study is demonstrating again: where the fat is contains substantially more useful cardiovascular information than the number you get from dividing someone's mass by the square of their height.
- sebastianconcpt 2mo agoThe revenge of the six-pack. Now we have them as goal beyond aesthetics or vanity.
- 708145_ 2mo agoNo shit.
- tsoukase 2mo agoThis is known since decades. Male type fat, central obesity or belly fat, is much worse than female type, pear-like. Hormones play a role under the hood. I don't know if liposuction would play any preventive role.
- janmatejka 2mo agoThat's no surprise to anyone who knows anything about BMI.
- perrygeo 2mo agoVisceral fat really is the devil. It's not some inert glob of tissue padding your organs, it's metabolically active in all the wrong ways - increasing inflammation and insulin resistance. I've stopped worrying about weight (or BMI) and focus solely on waist circumference as a proxy for visceral fat.