Apple Shape Predicts Heart Attack Risk Better than BMI

Discussion in 'Food and nutrition' started by Roger Zoul, Jan 8, 2006.

  1. Roger Zoul

    Roger Zoul Guest

    Tags:


  2. Anthony

    Anthony Guest

    Roger Zoul wrote:
    > A pot belly increases the risk of a heart attack -- even if the rest of the
    > physique is as skinny as a beanpole
    >
    > http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=3237


    One sentence reads:

    "Dr. Sharma and colleagues showed last year with Interheart data that
    abdominal obesity accounts for about 90% of the risk for myocardial
    infarction around the world, with eight other risk factors -- including
    cigarette smoking, diabetes, poor diet, and lack of exercise --
    accounting for the rest."

    The researchers appear to be genuine and the results were published in
    The Lancet, nonetheless I find the above assertion astonishing and I
    wonder whether there has been some misinterpretation. Any thoughts
    anyone?
     
  3. Roger Zoul

    Roger Zoul Guest

    Anthony <[email protected]> wrote:
    :> Roger Zoul wrote:
    :>> A pot belly increases the risk of a heart attack -- even if the
    :>> rest of the physique is as skinny as a beanpole
    :>>
    :>>
    http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=3237
    :>
    :> One sentence reads:
    :>
    :> "Dr. Sharma and colleagues showed last year with Interheart data that
    :> abdominal obesity accounts for about 90% of the risk for myocardial
    :> infarction around the world, with eight other risk factors --
    :> including cigarette smoking, diabetes, poor diet, and lack of
    :> exercise --
    :> accounting for the rest."
    :>
    :> The researchers appear to be genuine and the results were published
    :> in
    :> The Lancet, nonetheless I find the above assertion astonishing and I
    :> wonder whether there has been some misinterpretation. Any thoughts
    :> anyone?

    Why? I find them totally believable. I would like to get my mitts on the
    actual article, though. Anyone know how (other than paying for a
    subscription)?
     
  4. Anthony

    Anthony Guest

    Roger Zoul wrote:
    >
    > Why? I find them totally believable. I would like to get my mitts on the
    > actual article, though. Anyone know how (other than paying for a
    > subscription)?


    I understand it to say that only 10% of risk for MI comes from a
    combination of smoking, diabetes, diet and lack of exercise and all the
    rest from having a fat tum. Does that really seem right to you, and if
    so do you think that all that cardio exercise is largely a waste of
    time.

    I'd also like to see the original article, soo if you find a way please
    post it.
     
  5. Roger Zoul

    Roger Zoul Guest

    Anthony <[email protected]> wrote:
    :> Roger Zoul wrote:
    :>>
    :>> Why? I find them totally believable. I would like to get my mitts
    :>> on the actual article, though. Anyone know how (other than paying
    :>> for a subscription)?
    :>
    :> I understand it to say that only 10% of risk for MI comes from a
    :> combination of smoking, diabetes, diet and lack of exercise and all
    :> the rest from having a fat tum. Does that really seem right to you,
    :> and if
    :> so do you think that all that cardio exercise is largely a waste of
    :> time.

    Given that we're talking about MI, no, it doesn't seem weirdly "off" to me.
    Those other things can obviously contribute to other health problems,
    though. As far as exercise goes, if a person can remain trim then I don't
    see why lack of exercise would contribute much to MI.

    :>
    :> I'd also like to see the original article, soo if you find a way
    :> please post it.

    I will. I'd hate to pay $30 for a single day sub, though.
     
  6. Roger Zoul

    Roger Zoul Guest

    Anthony <[email protected]> wrote:
    :> Roger Zoul wrote:
    :>>
    :>> Why? I find them totally believable. I would like to get my mitts
    :>> on the actual article, though. Anyone know how (other than paying
    :>> for a subscription)?
    :>
    :> I understand it to say that only 10% of risk for MI comes from a
    :> combination of smoking, diabetes, diet and lack of exercise and all
    :> the rest from having a fat tum. Does that really seem right to you,
    :> and if
    :> so do you think that all that cardio exercise is largely a waste of
    :> time.
    :>
    :> I'd also like to see the original article, soo if you find a way
    :> please post it.

    I'd be happy to e-mail the article to you, if you give me permission and a
    valid e-mail address. I believe the copyright permits this for individual
    use.
     
  7. Hannah Gruen

    Hannah Gruen Guest

    "Anthony" <[email protected]> wrote in message
    news:[email protected]
    > One sentence reads:
    >
    > "Dr. Sharma and colleagues showed last year with Interheart data that
    > abdominal obesity accounts for about 90% of the risk for myocardial
    > infarction around the world, with eight other risk factors -- including
    > cigarette smoking, diabetes, poor diet, and lack of exercise --
    > accounting for the rest."
    >
    > The researchers appear to be genuine and the results were published in
    > The Lancet, nonetheless I find the above assertion astonishing and I
    > wonder whether there has been some misinterpretation. Any thoughts
    > anyone?


    Yes, I noted that assertion too. What they seem to be *trying* to say is
    that the *association* between apple shape and MI is higher than that
    between MI and the other named risk factors. It isn't saying that the
    abdominal fat *causes* the MI, though.

    Look at it this way. Assume that MI is very much associated with the whole
    insulin resistance/hyperinsulimia/Syndrome X thing. One of the primary
    indications of insulin resistance is... yep, apple shape/abdominal fat. Many
    people with IR are diabetic, but many are not, and many will have their
    first MI before they become diabetic. Therefore, you'd expect the
    correlation between apple shape and MI to be stronger than that between
    diabetes and MI.

    As for those other factors, many people with IR smoke, fail to exercise, and
    smoke cigarettes. But many people who do those things aren't IR, because
    they are young and/or they are not genetically predisposed. That also
    lessens the correlation between those health factors and MI.

    In fact, if you look at it this way, this study appears to be doing little
    more than reiterating the very strong correlation between heart disease and
    IR, hyperinsulin, or Syndrome X (whatever you want to call this condition).
    Not really news.

    HG
     
  8. Roger Zoul

    Roger Zoul Guest

    Hannah Gruen <[email protected]> wrote:
    :> "Anthony" <[email protected]> wrote in message
    :> news:[email protected]
    :>> One sentence reads:
    :>>
    :>> "Dr. Sharma and colleagues showed last year with Interheart data
    :>> that abdominal obesity accounts for about 90% of the risk for
    :>> myocardial infarction around the world, with eight other risk
    :>> factors -- including cigarette smoking, diabetes, poor diet, and
    :>> lack of exercise --
    :>> accounting for the rest."
    :>>
    :>> The researchers appear to be genuine and the results were published
    :>> in
    :>> The Lancet, nonetheless I find the above assertion astonishing and I
    :>> wonder whether there has been some misinterpretation. Any thoughts
    :>> anyone?
    :>
    :> Yes, I noted that assertion too. What they seem to be *trying* to
    :> say is that the *association* between apple shape and MI is higher
    :> than that between MI and the other named risk factors. It isn't
    :> saying that the abdominal fat *causes* the MI, though.
    :>
    :> Look at it this way. Assume that MI is very much associated with the
    :> whole insulin resistance/hyperinsulimia/Syndrome X thing.

    That could be tricky.

    One of the
    :> primary indications of insulin resistance is... yep, apple
    :> shape/abdominal fat. Many people with IR are diabetic, but many are
    :> not, and many will have their first MI before they become diabetic.
    :> Therefore, you'd expect the correlation between apple shape and MI
    :> to be stronger than that between diabetes and MI.
    :>
    :> As for those other factors, many people with IR smoke, fail to
    :> exercise, and smoke cigarettes. But many people who do those things
    :> aren't IR, because they are young and/or they are not genetically
    :> predisposed. That also lessens the correlation between those health
    :> factors and MI.
    :>
    :> In fact, if you look at it this way, this study appears to be doing
    :> little more than reiterating the very strong correlation between
    :> heart disease and IR, hyperinsulin, or Syndrome X (whatever you want
    :> to call this condition). Not really news.

    The study is saying that WHR is better indicatior than BMI as a risk factor
    for HI. All the others factors you mention are inferences.

    :>
    :> HG
     
  9. Anthony

    Anthony Guest

    Hannah Gruen wrote:
    >
    > Yes, I noted that assertion too. What they seem to be *trying* to say is
    > that the *association* between apple shape and MI is higher than that
    > between MI and the other named risk factors. It isn't saying that the
    > abdominal fat *causes* the MI, though.
    >

    In USA Today today the study was interpreted to mean that smoking,
    diabetes, diet, exercise, high BP and fat tum accounted for 90% of the
    MI risk and the rest, genetics and such, for 10%. This sounds more
    reasonable to me.
     
  10. Roger Zoul

    Roger Zoul Guest

    Anthony <[email protected]> wrote:
    :> Hannah Gruen wrote:
    :>>
    :>> Yes, I noted that assertion too. What they seem to be *trying* to
    :>> say is that the *association* between apple shape and MI is higher
    :>> than that between MI and the other named risk factors. It isn't
    :>> saying that the abdominal fat *causes* the MI, though.
    :>>
    :> In USA Today today the study was interpreted to mean that smoking,
    :> diabetes, diet, exercise, high BP and fat tum accounted for 90% of
    :> the MI risk and the rest, genetics and such, for 10%. This sounds
    :> more reasonable to me.

    I find no mention of the 90% in the actual paper, ie, the researchers didn't
    say it there if they said it at all.
     
  11. Roger Zoul

    Roger Zoul Guest

    nanner <[email protected]> wrote:
    :> "Roger Zoul" <[email protected]> wrote in message
    :> news:[email protected]
    :>>A pot belly increases the risk of a heart attack -- even if the rest
    :>>of the physique is as skinny as a beanpole
    :>>
    :>>
    http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=3237
    :>>
    :>
    :> I didn't read the article but isn't it old news that the Apple shaped
    :> over-weight person is at greater risk of health problems (such as
    :> heart disease) than the Pear shaped over-weight person?

    From the paper:
    "On the basis of two previous smaller studies,10,11 we had postulated that
    markers of central obesity (especially the waist-to-hip ratio) would be more
    strongly related to the risk of myocardial infarction than BMI (the
    conventional measure). We aimed to investigate the relation of BMI, waist
    and hip circumferences, and waist-to-hip ratio to the risk of myocardial
    infarction using data from the INTERHEART study,12,13 of about 15 000 cases
    and a similar number of controls representing many ethnic groups."
     
  12. Roger Zoul

    Roger Zoul Guest

    Anthony <[email protected]> wrote:
    :> Hannah Gruen wrote:
    :>>
    :>> Yes, I noted that assertion too. What they seem to be *trying* to
    :>> say is that the *association* between apple shape and MI is higher
    :>> than that between MI and the other named risk factors. It isn't
    :>> saying that the abdominal fat *causes* the MI, though.
    :>>
    :> In USA Today today the study was interpreted to mean that smoking,
    :> diabetes, diet, exercise, high BP and fat tum accounted for 90% of
    :> the MI risk and the rest, genetics and such, for 10%. This sounds
    :> more reasonable to me.

    This statement:
    "Dr. Sharma and colleagues showed last year with Interheart data that abdominal obesity accounts for about 90% of the risk for myocardial infarction around the world, with eight other risk factors -- including cigarette smoking, diabetes, poor diet, and lack of exercise -- accounting for the rest. "
    from http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=3237

    is wrong.

    From a pervious paper coming out of the INTERHEART Study (2004) one finds (along with other related statements)
    "Incorporation of all nine independent risk factors (current or former smoking, history of diabetes or hypertension, abdominal obesity, combined psychosocial stressors, irregular consumption of fruits and vegetables, no alcohol intake, avoidance of any regular exercise, and raised plasma lipids) indicates an odds ratio of 129·20 (99% CI 90·24-184·99; table 3), compared with not having any of these risk factors. Substituting the odds ratios for current smoking, the extremes of abdominal obesity (top vs lowest tertile) and ApoB/ApoA1 ratio (top vs lowest quintile) increases the combined effect of all nine risk factors to 333·7 (99% CI 230·2-483·9; figure 2). This represents a PAR of 90·4% (99% CI 88·1-92·4), suggesting that these risk factors account for most of the risk of acute myocardial infarction in our study population. In view of the overlap in the effect of the nine risk factors, most of the PAR could be accounted for by a combination of various risk factors, as long as they included smoking and the ApoB/ApoA1 ratio (PAR for their combination is 66·8% [99% CI 62·8-70·6]). The estimate of the combined effect of all nine risk factors is derived from a model, since very few individuals had zero risk factors or all nine risk factors. However, confidence that the majority of risk is indeed accounted for by these risk factors is lent support by the fact that of the 18 708 individuals with complete data on all risk factors, 43 controls and 24 cases had no risk factors and 49 cases and 11 controls had eight or more. Also, just five risk factors (smoking, lipids, hypertension, diabetes, and obesity), which a large proportion of individuals had, accounted for about 80% of the PAR."

    where PAR = population attributable risks

    So, Anthony, you were correct.
     
  13. nanner

    nanner Guest

  14. jbuch

    jbuch Guest

    Roger Zoul wrote:
    > Anthony <[email protected]ol.com> wrote:
    > :> Roger Zoul wrote:
    >
    > :> The researchers appear to be genuine and the results were published
    > :> in
    > :> The Lancet, nonetheless I find the above assertion astonishing and I
    > :> wonder whether there has been some misinterpretation. Any thoughts
    > :> anyone?
    >
    > Why? I find them totally believable. I would like to get my mitts on the
    > actual article, though. Anyone know how (other than paying for a
    > subscription)?
    >
    >


    Medical Centers and University Libraries

    You can often use the library, if they have one, at your local medical
    center. Call ahead to verify :

    1) Yes, they have a library
    2) Yes, you can come in to use it
    3) Yes, they have that journal (Lancet) in the library.

    If you are near a university with a medical school, you can generally
    freely go in (after paying for parking) and make a copy of the journal
    article for a reasonable fee. Most of my experience like this was with
    California universities, including the private Cal Tech university.

    You can also often get a reprint from the author. It helps if you
    contact them by mail or email.

    Since time is money, you can see why high fees for journal articles make
    sense for the publisher.


    --
    1) Eat Till SATISFIED, Not STUFFED... Atkins repeated 9 times in the book
    2) Exercise: It's Non-Negotiable..... Chapter 22 title, Atkins book
    3) Don't Diet Without Supplimental Nutrients... Chapter 23 title, Atkins
    book
    4) A sensible eating plan, and follow it. (Atkins, Self Made or Other)
     
  15. Roger Zoul

    Roger Zoul Guest

    jbuch <[email protected]_HERE.revealed.net> wrote:
    :> Roger Zoul wrote:
    :>> Anthony <[email protected]> wrote:
    :>> :> Roger Zoul wrote:
    :>>
    :>> :> The researchers appear to be genuine and the results were
    :>> :> published
    :>> :> in
    :>> :> The Lancet, nonetheless I find the above assertion astonishing
    :>> :> and I wonder whether there has been some misinterpretation. Any
    :>> :> thoughts anyone?
    :>>
    :>> Why? I find them totally believable. I would like to get my mitts
    :>> on the actual article, though. Anyone know how (other than paying
    :>> for a subscription)?
    :>>
    :>>
    :>
    :> Medical Centers and University Libraries
    :>
    :> You can often use the library, if they have one, at your local
    :> medical center. Call ahead to verify :
    :>
    :> 1) Yes, they have a library
    :> 2) Yes, you can come in to use it
    :> 3) Yes, they have that journal (Lancet) in the library.
    :>
    :> If you are near a university with a medical school, you can generally
    :> freely go in (after paying for parking) and make a copy of the
    :> journal article for a reasonable fee. Most of my experience like
    :> this was with California universities, including the private Cal
    :> Tech university.
    :>
    :> You can also often get a reprint from the author. It helps if you
    :> contact them by mail or email.
    :>
    :> Since time is money, you can see why high fees for journal articles
    :> make sense for the publisher.

    Thanks. I ended up doing just this (more or less)! :)
     
  16. Hannah Gruen

    Hannah Gruen Guest

    "Roger Zoul" <[email protected]> wrote in message
    news:[email protected]
    > Hannah Gruen <[email protected]> wrote:
    > :> Look at it this way. Assume that MI is very much associated with the
    > :> whole insulin resistance/hyperinsulimia/Syndrome X thing.
    >
    > That could be tricky.


    Do you really think there is a lot of controversy over the association
    between IR/Syndrome X and heart disease/MI?

    > The study is saying that WHR is better indicatior than BMI as a risk
    > factor for HI. All the others factors you mention are inferences.


    A risk factor... any risk factor... is an inference. It's an association and
    does not necessarily imply any causal relationship. The relationship
    demonstrated in this study, between WHR and MI, is purely associative. Are
    you implying otherwise?

    HG
     
  17. Roger Zoul

    Roger Zoul Guest

    Hannah Gruen <[email protected]> wrote:
    :> "Roger Zoul" <[email protected]> wrote in message
    :> news:[email protected]
    :>> Hannah Gruen <[email protected]> wrote:
    :>> :> Look at it this way. Assume that MI is very much associated with
    :>> :> the whole insulin resistance/hyperinsulimia/Syndrome X thing.
    :>>
    :>> That could be tricky.
    :>
    :> Do you really think there is a lot of controversy over the
    :> association between IR/Syndrome X and heart disease/MI?

    Well, people now are starting to question to usefulness of the Syndrome X
    set of conditions.

    :>
    :>> The study is saying that WHR is better indicatior than BMI as a risk
    :>> factor for HI. All the others factors you mention are inferences.
    :>
    :> A risk factor... any risk factor... is an inference. It's an
    :> association and does not necessarily imply any causal relationship.
    :> The relationship demonstrated in this study, between WHR and MI, is
    :> purely associative. Are you implying otherwise?

    No, I'm referring to your statements about what the study achieved. In
    particular:

    :> In fact, if you look at it this way, this study appears to be doing
    :> little more than reiterating the very strong correlation between
    :> heart disease and IR, hyperinsulin, or Syndrome X (whatever you want
    :> to call this condition). Not really news.

    The study in question didn't track or associate any of these items with MI.
     
  18. Hannah Gruen

    Hannah Gruen Guest

    "Roger Zoul" <[email protected]> wrote in message
    news:[email protected]
    > Hannah Gruen <[email protected]> wrote:


    > :> Do you really think there is a lot of controversy over the
    > :> association between IR/Syndrome X and heart disease/MI?
    >
    > Well, people now are starting to question to usefulness of the Syndrome X
    > set of conditions.


    As well they should, but it still unquestionably represents a substantial
    association between insulin and various serious diseases (diabetes, heart
    and kidney disease, etc.). But there is also the inflammation factor that
    needs to be addressed and that does not appear to necessarily be part of the
    "metabolic syndrome" set of factors.

    > :> A risk factor... any risk factor... is an inference. It's an
    > :> association and does not necessarily imply any causal relationship.
    > :> The relationship demonstrated in this study, between WHR and MI, is
    > :> purely associative. Are you implying otherwise?
    >
    > No, I'm referring to your statements about what the study achieved. In
    > particular:
    >
    > :> In fact, if you look at it this way, this study appears to be doing
    > :> little more than reiterating the very strong correlation between
    > :> heart disease and IR, hyperinsulin, or Syndrome X (whatever you want
    > :> to call this condition). Not really news.


    Well, duh. Sometimes I think people like to disagree just to keep their
    fingers moving. *Obviously* *I* was just speculating about why there might
    be a closer association between MI and WHR than between BMI and the other
    risk factors, such as smoking, exercise, etc.

    > The study in question didn't track or associate any of these items with
    > MI.


    The study, as I recall, labeled those as risk factors and cited the higher
    level of correlation between MI and WHR, compared to BMI or the other
    factors. It specifically tracked WHR and BMI, versus MI, but my impression
    was that they took into account data re risk from the other factors in
    drawing their conclusions. The close association between "metabolic
    syndrome" and high WHR, compared to BMI and the other factors, may explain
    their findings, IMO.

    HG
     
  19. Roger Zoul

    Roger Zoul Guest

    Hannah Gruen <[email protected]> wrote:
    :> "Roger Zoul" <[email protected]> wrote in message
    :> news:[email protected]
    :>> Hannah Gruen <[email protected]> wrote:
    :>
    :>> :> Do you really think there is a lot of controversy over the
    :>> :> association between IR/Syndrome X and heart disease/MI?
    :>>
    :>> Well, people now are starting to question to usefulness of the
    :>> Syndrome X set of conditions.
    :>
    :> As well they should, but it still unquestionably represents a
    :> substantial association between insulin and various serious diseases
    :> (diabetes, heart and kidney disease, etc.).

    Well, if you start with a vague set of conditions and start to build
    assiciations, then you just end up with more confusion.

    But there is also the
    :> inflammation factor that needs to be addressed and that does not
    :> appear to necessarily be part of the "metabolic syndrome" set of
    :> factors.
    :>
    :>> :> A risk factor... any risk factor... is an inference. It's an
    :>> :> association and does not necessarily imply any causal
    :>> :> relationship.
    :>> :> The relationship demonstrated in this study, between WHR and MI,
    :>> :> is purely associative. Are you implying otherwise?
    :>>
    :>> No, I'm referring to your statements about what the study achieved.
    :>> In particular:
    :>>
    :>> :> In fact, if you look at it this way, this study appears to be
    :>> :> doing little more than reiterating the very strong correlation
    :>> :> between
    :>> :> heart disease and IR, hyperinsulin, or Syndrome X (whatever you
    :>> :> want
    :>> :> to call this condition). Not really news.
    :>
    :> Well, duh. Sometimes I think people like to disagree just to keep
    :> their fingers moving.

    I agree. A characteristic of posting on usenet, methinks :)

    *Obviously* *I* was just speculating about why
    :> there might be a closer association between MI and WHR than between
    :> BMI and the other risk factors, such as smoking, exercise, etc.
    :>

    In other parts of your post you were speculating, I had no issue with that.
    However, in the paragraph above (the one I quoted), you aren't speculating.
    Phrases such as "this study appears to be doing little more than reiterating
    .... " and "Not really news" are your opinions, and are drawn from your own
    inferences and have nothing to do with the point of the study (see the
    "Farewell to BMI" post). As I said before, the study isn't attempting to
    address what you're saying it does in that paragraph, even though it might
    be valid to draw the conclusions you made (which, are not really news, IMO
    :) ). I simply think you were being unfair to the authors (and the study)
    with that statement. That's my opinion and beyond that, it's not really a
    big deal. And I don't hate you because of it, either, :)

    :>> The study in question didn't track or associate any of these items
    :>> with MI.
    :>
    :> The study, as I recall, labeled those as risk factors and cited the
    :> higher level of correlation between MI and WHR, compared to BMI or
    :> the other factors. It specifically tracked WHR and BMI, versus MI,
    :> but my impression was that they took into account data re risk from
    :> the other factors in drawing their conclusions. The close
    :> association between "metabolic syndrome" and high WHR, compared to
    :> BMI and the other factors, may explain their findings, IMO.

    I'm not sure if they really took into account the data re risk from other
    factors even though they drew independent associations with MI for them as a
    means of comparison. However, I think your last sentence is fair and I
    appreciate it, but I'm not sure if even the authors make that association.
     
  20. Hannah Gruen

    Hannah Gruen Guest

    "Roger Zoul" <[email protected]> wrote in message
    news:[email protected]

    > Well, if you start with a vague set of conditions and start to build
    > assiciations, then you just end up with more confusion.


    Well, I guess we'll just have to disagree on this one, Roger. I see insulin
    resistance/hyperinsulimia/Syndrome X/metabolic syndrome as more than a
    "vague set of conditions." Further, there seems to be some decent science
    that goes beyond mere correlation to link the endocrine issues with the
    disease conditions. I personally see the awareness that obesity, diabetes,
    heart disease, kidney disease, etc. are all associated with insulin
    resistance/hyperinsulimia to be significantly helpful. I'm old enough to
    remember when this concept was revolutionary, even among the medical
    community.

    The problem comes, as usual, when people start seeing this as the *only*
    factor involved, thereby ignoring all the zillion other factors that may
    influence development of the subject diseases.


    > In other parts of your post you were speculating, I had no issue with
    > that. However, in the paragraph above (the one I quoted), you aren't
    > speculating. Phrases such as "this study appears to be doing little more
    > than reiterating ... " and "Not really news" are your opinions, and are
    > drawn from your own inferences and have nothing to do with the point of
    > the study (see the "Farewell to BMI" post). As I said before, the study
    > isn't attempting to address what you're saying it does in that paragraph,
    > even though it might be valid to draw the conclusions you made (which, are
    > not really news, IMO :) ). I simply think you were being unfair to the
    > authors (and the study) with that statement. That's my opinion and beyond
    > that, it's not really a big deal. And I don't hate you because of it,
    > either, :)


    Actually, *anything* I would say about a scientific study would be fairly
    labeled as speculation. However, part of science is looking at data and
    associated conclusions, and then speculating about what else that data set
    could mean. If you're a scientist in that field, you might go on to write a
    letter to the journal editor, or even design your own study to test your
    alternative hypothesis. If you're a layperson (like me) it never goes beyond
    the speculation stage.

    I didn't mean to denigrate the work of the study authors. Like most studies
    it's just another brick from the pile of data used to build a new wall. It
    will do a good job of convincing the medical community to use WHR rather
    than BMI to assess risk for MI, which is a good thing. I do stand by my
    opinion that the results were predictable, given the known associations
    between WHR and "metabolic syndrome"/hyperinsulimia and between "metabolic
    syndrome"/hyperinsulimia and cardiovascular disease. Still, statistical
    demonstration of same is a good thing.

    HG
     
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