The Dark Past of BMI: A More Accurate Option

Author’s note: This article is summarized from various sources, and attributions are linked within.

BMI versus WHR. Which is the better assessment of health?Photo bySiora PhotographyonUnsplash

BMI, or Body Mass Index, a measurement used by doctors, insurance companies, and many others, was originally developed between 1830 and 1850 by “Adolphe Quetelet, a Belgian astronomer, mathematician, statistician, and sociologist.” He never intended this calculation to be used for medical diagnoses but merely as a “component of his study of l'homme moyen, or the average man.”

His use of this calculation was “as a means of discovering the socially ideal human person.” Quetelet’s “idealization of the average man would be elaborated upon by Francis Galton a decade later in the development of Eugenics.” Eugenics, would later be used to breed selectively, or commit genocide, all to create the ideal human race, as seen at its worst in Nazi Germany and the Holocaust.

In 1972, the term body mass index and its handy acronym BMI was first coined to put a positive spin on this calculation with a dark and tragic history. The ratio, weight to squared height, was first published in the “Journal of Chronic Diseases by Ancel Keys and others. In this paper, Keys argued that what he termed the BMI was "if not fully satisfactory, at least as good as any other relative weight index as an indicator of relative obesity."

Since that time, BMI is touted as the gold standard for assessing someone’s medical health. Unfortunately, BMI is not the same for everyone. Different ages, genders, and nationality can affect fat distribution. People who are very fit and with a lot of muscle mass can often have high BMI but be healthy.

So what’s a better option? Research suggests that the Weight to Hip Ratio (WHR) “per the American Diabetes Association…is even more accurate than BMI for predicting the risks of cardiovascular disease and premature death.”

The BMI, calculates the ratio of weight to height but WHR measures the ratio of waist circumference to hip circumference. Per the World Health Organization (WHO), a moderate WHR is: .9 or less in men and 0.85 or less for women.

There are proven benefits to WHR over BMI. In a study with more than 15,000 adults, a high WHR was “linked to an increased risk of early death — even in people with a moderate BMI.” Other studies have shown WHR is effective for predicting hypertension, complications in trauma patients, and a “a significant predictor of death in women with heart failure (although researchers didn’t find a link between WHR and men with heart failure).”

To measure your WHR, which you should strive to keep below 1.0:

“Stand up straight and breathe out. Use a tape measure to check the distance around the smallest part of your waist, just above your belly button. This is your waist circumference.”

Next measure “the distance around the largest part of your hips — the widest part of your buttocks. This is your hip circumference.”

The simple calculation is made by dividing your waist circumference by your hip circumference. Note, the measurement may not be accurate for those “shorter than 5 feet tall and people who have a BMI of 35 or higher” and is not recommended for use in children.