Chronic disease risk has long been measured by body mass index (BMI)—height in relation to weight—but a new Chinese study indicates that body roundness index (BRI) might be better.
In a study of almost 10,000 Chinese adults aged 45 or older, those who had a high BRI—defined as height in relation to waist circumference—had a 163 percent higher risk of heart disease than participants in a low-BRI group.
Cardiovascular disease—the more accurate term for diseases of the heart and blood vessels, which these researchers studied—is the leading cause of death worldwide, killing 931,578 Americans in 2021 alone, according to the American Heart Association. Obesity is a major risk factor for the disease.
"Our findings indicate that six years of moderate-to-high stable BRI appeared to increase the risk of cardiovascular disease, suggesting that BRI measurements may potentially be used as a predictive factor for cardiovascular incidence," said senior study author Dr. Yun Qian, chronic disease researcher at Nanjing Medical University's Wuxi Centers for Disease Control and Prevention, China, in a statement.
"This could be explained by the correlation between obesity and hypertension, high cholesterol and type 2 diabetes, all of which are risk factors for cardiovascular disease.
"Obesity has also been shown to lead to inflammation and other mechanisms in the body that can affect the heart and cardiac functioning."
The study authors said that BRI might be a more accurate predictor of lifestyle-related diseases, such as cardiovascular disease than BMI, which is often still used in medical settings as a proxy for obesity.
However, BMI has long been criticized as a blunt instrument, because it doesn't take body composition into account, so a person with large muscles might be classed as 'obese' because they have a high BMI, even though their extra weight is coming from muscle rather than fat.
BRI, on the other hand, specifically focuses on waist circumference, which previous research has indicated may be a better measure of heart disease risk than BMI-defined obesity.
"This is the first large study to evaluate BRI over time and how it may be associated with the incidence of cardiovascular disease among middle-aged and older Chinese adults," said Qian.
To come to these conclusions, the scientists used data from the China Health and Retirement Longitudinal Study, as part of which Chinese adults had their waists measured every two years, from 2011 through 2020.
They then analyzed the trajectories of the BRI measurements over time, and put the participants into three groups: low, moderate and high BRI.
During the last four years of the study, from 2017 to 2020, there were 3,052 heart disease-related events recorded, including 894 deaths.
The scientists found that risk of heart disease in the moderate BRI group was 61 percent higher than the low BRI group; and the difference in risk between high and low was 163 percent.
This was before adjusting for other variables that could have made a difference—but even when factors like blood pressure, cholesterol levels, and medical history were accounted for, people with higher BRIs were still significantly more likely to be affected by heart disease.
There were a few limitations to this study. For instance, the researchers relied upon the participants to report heart attacks, strokes, coronary heart disease, or other possible heart disease events and diagnoses, so this data may not have been as accurate as if the scientists, or participants' doctors, had relayed this information.
Also, all of the participants were Chinese adults, with an average age of 58, so these results may not be generalizable for populations of different ethnicities and ages.
Do you have a tip on a food story that Newsweek should be covering? Is there a nutrition concern that's worrying you? Let us know via science@newsweek.com. We can ask experts for advice, and your story could be featured in Newsweek.
Reference
Yang, M., Liu, J., Shen, Q., Chen, H., Liu, Y., Wang, N., Yang, Z., Zhu, X., Zhang, S., Li, X., Qian, Y. (2024) Body Roundness Index Trajectories and the Incidence of Cardiovascular Disease: Evidence From the China Health and Retirement Longitudinal Study, Journal of the American Heart Association. https://doi.org/10.1161/JAHA.124.034768
Disclaimer: The copyright of this article belongs to the original author. Reposting this article is solely for the purpose of information dissemination and does not constitute any investment advice. If there is any infringement, please contact us immediately. We will make corrections or deletions as necessary. Thank you.
