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Burr Ridge Doctor: Belt Size Can Be An Indicator of Mortality

Study shows waist circumference is better indicator of mortality than body mass index (BMI), another common measure of obesity.

It’s Thanksgiving and I’m sure the last thing you want to think about are the risks from a larger belt size. But, that’s my job. To help people stay healthy I wanted to share findings from a study led by one of my colleagues.

The research team, led by Loyola Nephrologists Dr. Holly Kramer, MD, MPH, found that the larger a kidney patient’s waist circumference, the greater the chance the patient would die during the course of the study.

In fact, this study showed waist circumference was a better indicator of mortality than body mass index (BMI), another common measure of obesity.

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In some cases BMI can be misleading. A muscular person with little body fat could have a BMI higher than a flabby person with little muscle mass. Waist circumference, by contrast, simply measures abdominal fat.

Researchers examined data from 5,805 adults age 45 and older who had kidney disease and participated in a study called REGARDS (Reasons for Geographic and Racial Differences in Stroke). They were followed for a median of four years and during that time 686 kidney patients (11.8 percent) died.

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The average BMI of the kidney disease patients who died was 29.2. This was lower than the average BMI, 30.3, of the patients who survived. (A BMI between 25 and 29.9 is considered overweight, while a BMI of 30 and above is obese.)

By contrast, the kidney patients who died had a larger average waist circumference (40.1 inches) than the patients who survived (39.1 inches.)

Researchers compared kidney disease patients with large waists to patients who had more normal waist sizes. After adjusting for BMI and other risk factors, women with waists equal to or greater than 42.5 inches and men with waists equal to or greater than 48 inches were 2.1 times more likely to die than those with trimmer waists (less than 31.5 inches for women and less than 37 inches for men).

Researchers concluded that in adults with kidney disease, BMI by itself may not be a useful measure to determine mortality risks associated with fat. The reason is that BMI reflects several components, including muscle mass and abdominal fat.

"In contrast," the researchers conclude, "waist circumference reflects abdominal adiposity [fat] alone and may be a useful measure to determine mortality risk associated with obesity in adults with chronic kidney disease, especially when used in conjunction with BMI.

Dr. Heidi Renner is an integral part of the Loyola University Health System’s primary care team. She is double boarded in adult internal medicine and pediatrics and enjoys seeing patients of all ages from infants to geriatrics at the Loyola Center for Health at Burr Ridge. In addition, she is an assistant professor at Loyola University Chicago Stritch School of Medicine in the departments of internal medicine and pediatrics. When not seeing patients she enjoys spending time with her husband and two kids, traveling and hiking.

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