Abdomen Size Could Predict Stroke Better Than BMI

A new study suggests that belly size and other markers of abdominal fat may be a better predictor of stroke than body mass index (BMI).

Researchers at the University of Heidelberg (Germany), the University of Duisburg (Essen, Germany), and other institutions in Germany enrolled 379 adults who suffered stroke or transient ischemic attack (TIA) and matched them with 758 controls of the same age and sex living in the same region. Among the subjects enrolled, 79% (301 members) had had a stroke, 10% (37) had had bleeding in the brain, and 11% suffered a TIA. The study group was comprised of 141 women and 238 men with an average age of 67 years. The researchers took various measures of obesity (including BMI) and waist to hip ratio, waist circumference, and waist to height ratio (which are all markers of abdominal fat). They then analyzed the links between these measures and stroke or TIA risk.

The results showed that there was a strong link between markers of abdominal adiposity and risk of stroke and TIA, regardless of other risk factors. Participants with wider waists (over 101 centimeters for men and 89 centimeters for women) had 4 times the risk of developing a stroke or TIA compared to those with more typical waist sizes; participants with the largest waist-to-hip ratio had nearly eight times the risk of developing a stroke or TIA. Moreover, although a strong positive link was also established between BMI and cerebrovascular risk, it became non-significant when the researchers eliminated other risk factors such as physical inactivity, smoking, blood pressure, and diabetes. The study was published in the August 14, 2008, issue of the journal Stroke.

"Markers of abdominal adiposity showed a graded and significant association with risk of stroke and TIA, independent of other vascular risk factors,” concluded lead author Yaroslav Winter, M.D., of the department of neurology at Heidelberg, and colleagues. "Waist circumference and related ratios can better predict cerebrovascular events than BMI.”

The World Health Organization (WHO, Geneva, Switzerland) has estimated that 17 million people each year die of various cardiovascular diseases. A great number of these can be attributed to tobacco smoking, which increases the risk two or three-fold, while physical inactivity and poor diet are other main risk factors.

Related Links:
University of Heidelberg
University of Duisburg
World Health Organization