Using the BMI, Not Cholesterol, to Predict Cardiovascular Risk
Using the BMI rather than blood cholesterol to predict future risk of cardiovascular disease would have profound effects on the affordability and availability of a screening program in developing countries. Initial screening without having to use blood would keep testing to a minimum.
The study, published in the March 15, 2008 issue of Lancet, explains that it is too expensive to use laboratory tests to identify patients at highest risk of developing heart disease in the developing nations. The study compared the so-called “laboratory model” (i.e. cholesterol measurements) with the “non-laboratory-based model” which focused on substituting Body Mass Index for cholesterol. How well either model could predict first-time fatal and nonfatal cardiovascular events was then assessed on a total of 6186 people who were free of cancer or history of cardiovascular disease and who were participating in the NHANES I Epidemiologic Follow-up Study.
Results of the comparative study showed that there was no difference in predictive capacities and that both predictive models adequately discriminated risk.
The study researchers state that the next step in the process of using a simpler screening process such as the one just described is further validation and calibration in individual countries.
This approach was taken from a population cohort in one country, the US.
Conclusions are that “non-laboratory methods may increase the affordability and practicality of screening individuals at risk for cardiovascular disease but they should not compromise the safety of patients. For equitable care in cardiovascular and other major noncommunicable diseases, universal access to a set of essential interventions, including laboratory assays be required, even in settings with limited resources.”
Using the BMI as an indicator of cardiovascular risk is a novel approach in nutritional assessment and definitely requires further testing and study.
About the Author
Kathy Shattler received her Master of Science degree from Michigan State University in E. Lansing Michigan in Human Nutrition. Her twenty-two years of practice includes holding positions as a Lecturer, Chief Clinical Dietitian and Program Manager. Kathy is the Founder of Nutri-Care Consulting and is currently the Nutrition Director of www.CEU4U.COM, an online continuing education management company for Registered Dietitians and Dietetic Technicians.
