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Waist better than BMI

Focus on body mass index rather than waist measurement is leaving a vast swath of cardiovascular risk undiagnosed, research suggests.

Focus on body mass index rather than waist measurement is leaving a vast swath of cardiovascular risk undiagnosed, research suggests.

Waist circumference was shown to be a far better predictor of metabolic syndrome than BMI in two new studies presented at the Diabetes UK conference in Birmingham last week.

The findings ­ which add to an already substantial body of evidence on the association between abdominal fat and cardiovascular risk ­ led to renewed calls from experts for waist measurement to be included in the QOF.

Dr Kamlesh Khunti, a GP in Leicester and clinical senior lecturer at the city's university, told delegates: 'Waist circumference should be measured routinely in clinical practice. It's clear metabolic syndrome increases risk of CVD and diabetes independent of BMI.'

New research by Dr Khunti, who was on the expert reference group for the diabetes NSF, showed the mean number of risk factors for metabolic syndrome rose with increasing waist circumference for white Europeans and south Asians.

He found that in white European females, a waist less than 75cm was only associated with 0.79 risk factors compared with 1.9 risk factors for a waist greater than 120cm.

A second study by research-ers in Sheffield of 179 patients attending hospital diabetes clinics found measuring waist circumference identified 92 per cent of those with metabolic syndrome compared with 58 per cent identified using BMI.

Dr Eugene Hughes, an Isle of Wight GP and member of the Primary Care Diabetes Society, said: 'In theory we should all be doing waist circumference rather than anything else. It demands a culture change if we're going to be serious about assessing true cardiovascular risk.'

Dr Sarah Jarvis, a GP in west London who was involved in the National Obesity Forum QOF submission, said: 'We pushed very hard for waist measurement as a substitute and will be pushing again. It's a very accurate indicator of risk.'

Waist measurement guide

Measure from the side just above the bony pelvis or halfway between there and the bottom of the rib cage. If it's not possible to feel the bony line, measure at the naval.


Not Asian

· Increased risk 94-101 cm

· High risk =102 cm


· High risk =90 cm


Not Asian

· Increased risk 80-87 cm

· High risk =88 cm


· High risk =80 cm

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