There's excellent news for busy physicians – instead of using those time-consuming BMI calculators and inconvenient tape measures, you can use the simple ruler!

Many studies showed that abdominal height (AH) measured as the distance from the exam table to the top of the belly when the patient is lying supine, has been shown to be a better predictor of cardiovascular disease than any other anthropometric measurement including BMI, waist circumference, waist-hip ratio (WHR), and skin-fold thickness. Abdominal height also better correlates with an adverse metabolic profile including low HDL and increased triglycerides, blood pressure, inflammatory cytokines, renal sodium re absorption, blood glucose, insulin resistance, impotence, liver function abnormalities, and impaired pulmonary function.

Abdominal height predicts cardiovascular disease risk because it is an excellent measure of intra-abdominal fat, which is associated with insulin resistance. Visceral fat drains through the portal circulation and bathes the liver with high levels of free fatty acids, which in turn can accumulate in the liver, leading to a fatty liver and abnormalities in insulin action and lipid synthesis.

Why hasn’t measurement of abdominal height caught on in the mainstream clinical practice? It is fast, simple, reliable and a better predictor of cardiovascular disease than either BMI or waist-hip ratio. One major obstacle is the lack of reference ranges and outpoints to assign risk categories. Another may be the embarrassment of telling a patient their beer belly is too big.

Also read:

Relation of abdominal height to cardiovascular risk factors in young adults: the Bogalusa heart study.
Am J Epidemiol. 2000; 151(9):885-91