For years, doctors have used Body Mass Index (BMI) to assess the risk of obesity-related conditions like heart failure. But a new study suggests that there might be a better way to predict your heart health by measuring your waist.
Presented at Heart Failure 2025, a scientific meeting of the European Society of Cardiology in Belgrade, Serbia, the research proposes that waist-to-height ratio could offer a more accurate picture of heart failure risk than BMI. The study, led by researchers from Lund University in Sweden, found that fat distribution, particularly fat stored around the waist, has a stronger link to heart failure than overall body weight.
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What the research says
"BMI is the most common measure of obesity, but it is influenced by factors such as sex and ethnicity and does not take into account the distribution of body fat. Waist-to-height ratio is considered a more robust measure of central adiposity, the harmful deposition of fat around visceral organs," explained Dr Amra Jujic, who presented the findings.
The study tracked 1,792 individuals between the ages of 45 and 73 for a median duration of 12.6 years. All participants were part of the Malmö Preventive Project and were divided into three groups based on their blood glucose levels: normal, impaired fasting glucose, and diabetes.
Throughout the study, 132 people developed heart failure. The researchers discovered that a higher waist-to-height ratio was clearly associated with a greater risk of developing the condition, regardless of other health markers.
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So, what's a healthy waist size?
"Having a waist measurement that is less than half your height is ideal," said Dr John Molvin, co-author of the study and a researcher at Lund University and Malmö University Hospital.
This simple calculation can give you a better idea of your risk than relying on BMI alone. For example, if you're 170 cm tall, your waist should ideally be under 85 cm.
Why this matters
The team recommends that waist measurements should become a routine part of health checkups, right alongside blood pressure monitoring. Since BMI doesn't account for where fat is stored, it can sometimes misrepresent the actual risk. Fat that collects around the abdomen and vital organs (known as visceral fat) is considered particularly dangerous when it comes to heart health.
These findings are likely to spark new conversations around how we define obesity and monitor heart health. Instead of focusing purely on weight loss, future health guidelines may place greater emphasis on where fat is stored, not just how much of it you have.
