Submitted by admin on Fri, 2005-11-04 09:01. ::
TORONTO (CP) - Carpenters have an old adage: "Measure twice and cut once." With some slight modifications, that simple rule could also help many Canadians reduce their risk of having a heart attack.
But the measurements they need to take are of the waist and hips, concludes a Canadian-led international study, which found that the two circumferences are a much better yardstick of risk than body mass index (BMI) - a simple ratio of weight and height.
"BMI is not as good an indicator of the risk of a heart attack as is the waist-hip ratio," said lead investigator Dr. Salim Yusuf, director of cardiology at McMaster University. "The waist-hip ratio is three times stronger than BMI in predicting the risk of a heart attack."
"What we know is that fat in the abdomen, which is associated with a larger waist, is metabolically active and produces various hormones that can cause harmful effects, such as causing diabetes, affecting blood pressure, affecting lipid (blood fat) levels," he said.
Yet a comparatively large hip measurement seems to have a protective effect on heart health, said Yusuf, explaining that some studies suggest hip fat is different from abdominal fat. As well, larger hips are associated with greater muscle mass, he said.
"Many of us have seen athletes who seemed to be overweight, but in reality most of the excess weight is coming from muscle rather than fat. And clearly that is the difference from another person whose overweight is entirely coming from fat."
The research, published in Friday's issue of The Lancet, is part of the larger Interheart study led by the McMaster team, which found that major risk factors for cardiovascular disease - among them smoking, diabetes and high blood pressure - are the same the world over.
The Lancet study involved more than 27,000 men and women from 52 countries and every ethnic group. About half had already suffered a heart attack, and their risk factors were compared with an equal number of people matched for age and sex who had not had a heart attack.
On average, waist measurements in the study were about 90 per cent of hip measurements. Subjects in China scored best at 88 per cent, followed by 89 per cent in Southeast Asia, 90 per cent in North America, 92 per cent in Africa, 93 per cent in the Middle East and 94 per cent in South America.
For example, the combination of a 76-centimetre waist and 91-centimetre hips works out to a favourable 83 per cent. Dr. Arya Sharma, one of the McMaster researchers, said the optimal waist-to-hip ratio is 85 per cent for women and 90 per cent for men.
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