Abdominal adiposity is an independent predictor of death, the New England Journal of Medicine reports. European researchers measured the BMIs, waist circumferences, and waist-to-hip ratios of more than 350,000 adults and then followed them for roughly 10 years. During that time, 4% of the participants died.

After adjustment for confounders including BMI, mortality risk rose with increasing waist circumference and waist-to-hip ratio. In particular, a 2-inch increase in waist circumference raised the risk for death by 1.17 among men and 1.13 among women, and a 0.1-unit increase in waist-to-hip ratio raised mortality risk by 1.34 in men and 1.24 in women. (Current guidelines propose cutoffs for waist circumference of 40 inches in men and 35 in women, and for waist-to-hip ratio of 1.0 and 0.85, respectively).

The researchers say their findings "support the use of waist circumference or waist-to-hip ratio in addition to BMI in assessing the risk of death." If your BMI is normal, it doesn’t mean that you are in a safer side. The reason is that a study conducted by Mayo clinic USA found that people with normal BMI who had the highest percentage of body fat were also those who had metabolic disturbances linked to heart disease. The researchers use the phrase "normal weight obesity" to describe this new type of patient at risk for metabolism problems and risk factors for heart disease, but who rates as "normal" on standard weight charts. They defined normal weight obesity as a condition of having a normal BMI with high body fat percentage.