BMI has been the benchmark in evaluating health and fitness for many years. The formula is quite simple: weight in kilograms divided by the square of height in meters. This would easily tell if one is underweight, within the healthy weight range, overweight, or obese. But with new research findings, scientists are now questioning its accuracy and usefulness as a total measure of body composition.

The report, published in The Lancet Diabetes & Endocrinology, has sparked a global conversation on rethinking BMI. Supported by more than 50 international medical experts, the report suggests classifying obesity into "clinical" and "pre-clinical" types for better diagnosis and treatment. The shift underscores a growing consensus: BMI alone may not tell the full story of your health.

While BMI is simple to calculate and universally accessible, it is far from perfect. It does not consider muscle mass, bone density, or fat distribution, leading to misleading conclusions in some cases. For example, athletes with a high muscle mass may be considered overweight, whereas individuals with normal BMI might carry unhealthy amounts of visceral fat.

A landmark study in JAMA Network Open studied more than 155,000 postmenopausal women and found that women with a normal BMI but a waist size over 35 inches were more likely to die from heart disease or cancer compared with their counterparts whose waists are smaller. That makes a great case for how BMI can be insufficient and fat distribution must be factored into account.

Not all body fat is equal. Subcutaneous fat, which lies just beneath the skin, is relatively harmless. The real health danger lies in visceral fat—fat that surrounds internal organs. Unlike subcutaneous fat, visceral fat is metabolically active, releasing stress hormones like cortisol and inflammatory substances that raise blood pressure, blood sugar, and cholesterol levels. These effects significantly increase the risk of conditions such as heart disease, type 2 diabetes, and certain cancers.

BMI Isn't Always the Best Measure of Body Composition — Here's What to Use Instead

Since BMI is not the most reliable measure, scientists and doctors have sought other means to measure body composition more accurately.

1. Waist Circumference

A simple tape measure can provide valuable insight into your health. Measure your waist at the level of your belly button, ensuring the tape is parallel to the ground. For women, a waist measurement under 35 inches is considered healthy, while for men, the goal is under 40 inches.

2. Waist-to-Hip Ratio

This is the ratio of your waist circumference to that of your hips. To calculate it, divide your waist measurement by your hip measurement. According to the National Center for Biotechnology Information, a ratio under 0.8 for women and 0.9 for men is considered healthy.

3. Body Roundness Index (BRI)

A newer method that seems to be receiving more attention involves the Body Roundness Index or BRI: height, weight, and girth are placed together to represent a more advanced view of what body composition says. Research presented in JAMA Network Open offers evidence that this BRI predicts mortality risk greater than BMI in some cases- a promising weapon for public health.

Also Read: Using BMI To Classify People As Obese Is Flawed Say Experts

Ways To Cut Off Unhealthy Fat

The good news is that visceral fat responds well to lifestyle changes. Here are three evidence-based strategies:

Time-Restricted Eating

Adopting an eating window of 12 hours—such as from 7 a.m. to 7 p.m.—can significantly reduce visceral fat, according to a study published in Nutrition Research Reviews. This approach not only helps control caloric intake but also reduces late-night snacking, a known risk factor for abdominal obesity.

Limit Alcohol Intake

Excessive alcohol consumption is associated with increased belly fat. A 2017 study published in Public Health Nutrition revealed that alcohol increases the levels of insulin and encourages the storage of fat in the abdominal area. Limiting alcohol to occasional indulgence helps avoid weight gain in this region.

High-Intensity Interval Training (HIIT)

HIIT involves repeated episodes of high-intensity exercise separated by periods of rest. A review in *Sports Medicine* concluded that HIIT is very effective in reducing visceral and total body fat. It can be noted that adding just 20 minutes of HIIT two times a week can make all the difference.

The reliance on BMI as a sole indicator of health is increasingly being challenged. While it remains a convenient screening tool, its limitations necessitate a broader approach that considers factors like fat distribution, waist circumference, and new metrics such as BRI.

In the simplest of words, health is multi-dimensional, and shifting perspectives from considering weight solely to broader measures of body composition will get people a much clearer understanding of where their health risks are so that they can take the action required for a better quality of life. Through adjustment to diet, exercise, or perhaps through innovative metrics like BRI, health is well within reach of the individual.

This dynamic conversation raises the point about personalized health screenings, which helps everyone get more relevant tools fitting their unique lives and circumstances. As body composition research is enhanced, so do the futures look brighter and brighter for the times of measurement when it comes to health.

Definition and diagnostic criteria of clinical obesity. The Lancet Diabetes & Endocrinology.

Association of Normal-Weight Central Obesity With All-Cause and Cause-Specific Mortality Among Postmenopausal Women. JAMA Netw Open. 2019

Waist-Hip Ratio. NIH.

Physiological responses to food intake throughout the day. Nutr Res Rev. 2014

Association between abdominal obesity and alcohol drinking pattern in normal-weight, middle-aged adults. Public Health Nutr. 2017

Working out is usually associated with a healthier heart, stronger muscles, and better overall fitness. But in rare cases, intense physical exertion can expose an underlying heart problem, devastatingly resulting into an unforeseen casualty.

That's what happened in the case of a 47-year-old doctor in Assam after he reportedly collapsed while working out and passed away. The incident has once again raised questions about sudden cardiac emergencies during intense workouts.

What Happened?

According to multiple reports, Dr Sahin Rahman, an associate professor at Nagaon Medical College and Hospital, collapsed at a gym in Nagaon.

He was taken to hospital but could not be revived. Reports have described the incident as a suspected cardiac arrest, although the exact cause is yet to be established.

The tragedy is particularly striking because being physically active does not completely eliminate the possibility of an underlying heart condition.

Also read: How Fit You Really Are? Your Grip Strength & Walking Speed Could Reveal Your Biological Age

Looking Fit Does Not Always Mean Heart Is Healthy

Regular exercise is one of the most effective ways to reduce cardiovascular risk. It can improve blood pressure, cholesterol, blood sugar, body composition, and overall cardiovascular fitness. So why have there been so many cases of deaths due to cardiac emergencies in the gym?

In an X post, Dr Sudhir Kumar, Neurologist, Apollo Hospitals, Hyderabad, explained why intense workouts can trigger a heart attack and how to prevent the next cardiac emergency in the gym:

He wrote that India reportedly recorded 35,715 heart-attack deaths in 2023. Around 40% of victims were under 45.

During intense exercise, the body sees an increase in heart rate, blood pressure, and the body's demand for oxygen. If someone has an undiagnosed structural or electrical heart problem, that sudden increase in demand can, in rare circumstances, trigger a dangerous rhythm or other serious cardiac event.

Dr Kumar wrote, "Exercise does not “cause” the arrest. It unmasks a silent problem. Under 35–40: Cardiac arrest is usually caused by inherited conditions such as hypertrophic cardiomyopathy, anomalous coronaries, Long QT, ARVC, and myocarditis. Over 35–40 (his age), atherosclerotic coronary disease becomes the leading cause."

One of the worst risks of sudden cardiac events is that they can happen in people who appear healthy. Someone who has a healthy lifestyle can still have conditions like high blood pressure, cholesterol, inherited heart disorder, or an electrical rhythm problem.

Risk can also build silently over years through factors like smoking, diabetes, high cholesterol, chronic stress, inadequate sleep, and a family history of cardiovascular disease.

He added, "The heart can look and feel fine until the extra demand of heavy lifting or HIIT hits an abnormal muscle, a blocked artery, or an electrical fault. Then it fibrillates and stops pumping."

Doctors and other healthcare workers, who work stressful long shifts and have an uneven sleep pattern, face additional risk.

Also read: Sweetener In Sugar-Free Gum Linked To 57% Higher Heart Attack And Stroke Risk: What Is Xylitol?

Warning Signs You Should Not Ignore

During a workout, you are likely to experience a racing heart. But you must not simply push through events like:

• Chest pressure, pain or tightness
• Unexplained severe breathlessness
• Fainting or nearly fainting
• Sudden dizziness
• A new or unusual irregular heartbeat
• Extreme weakness that feels disproportionate to the workout
• Pain spreading to the arm, jaw, back or shoulder

If any of these symptoms occur, stop exercising and seek medical attention immediately.

How To Prevent A Cardiac Emergency In The Gym?

Dr Kumar suggests that getting tested regularly can help you understand how healthy your heart is. He suggests a list of tests that can catch underlying heart conditions.

He recommends, "Family history of sudden death under 50 + personal history of unexplained fainting or chest pain, resting ECG, 2D echo, lipids and blood sugar, stress test or CT coronary scan if you are 35+ and going intense."

The expert also explained what to do in case you witness a cardiac emergency unfolding in front of you.

He explains, "If it happens, immediate CPR doubles or triples survival. An automated external defibrillator (AED) used in the first few minutes can push neurologically intact survival above 80–90% in gyms that have one. Every minute without compression or shock drops the chance of survival by ~10%. Hands-only CPR is enough: hard, fast, centre of the chest, 100–120/min. Call ambulance first."

He concludes, "Do the tests if you have risk factors or are starting heavy training after being sedentary. Learn hands-only CPR this week. Ask your gym where the AED is. Regular exercise still saves far more lives than it takes. The goal is to stop preventable ones."

Perimenopause is a natural transition in a woman’s reproductive life, but the hormonal fluctuations during this phase can bring several uncomfortable symptoms. Hot flashes—sudden episodes of intense warmth, sweating, flushing and sometimes palpitations—are among the most common. They can interfere with sleep, work, mood and overall quality of life.

While hormone therapy and non-hormonal medications can be considered for women with bothersome symptoms, lifestyle measures and exercise also play an important role. Two commonly discussed approaches are yoga and strength training. But which one is more helpful for hot flashes?

Yoga and strength training Both help—but in different ways, and the evidence leans toward strength training for the vasomotor symptoms themselves, with yoga excelling at symptom management and distress reduction. The physiological backdrop Perimenopausal estrogen decline destabilizes the hypothalamic thermoregulatory "set point," narrowing the thermoneutral zone — the window in which the body doesn't trigger sweating or shivering.

This narrowing is why small temperature fluctuations suddenly provoke a hot flash. Exercise-related improvements in insulin sensitivity, vascular tone, and fat distribution appear to help widen that zone back out, which is part of why both modalities show benefit, though through different mechanisms.

What The Evidence Shows?

Strength training:

Strength training: More than just building muscle Strength or resistance training is another valuable component of exercise during perimenopause. Declining oestrogen levels during the menopausal transition can contribute to loss of muscle mass, changes in body composition and progressive reduction in bone density.

Resistance exercise helps preserve muscle strength and supports bone health. It can also improve metabolic health, physical function and confidence. However, unlike some mind-body practices, strength training does not have strong evidence to suggest that it directly reduces hot flashes in every woman.

Regular resistance exercise improves body composition, bone density, and insulin sensitivity — all relevant since declining estrogen affects metabolic and skeletal health. Several studies show reduced frequency and severity of hot flashes with consistent resistance training, likely mediated through better thermoregulatory control and reduced visceral fat, which is independently linked to more frequent flashes.

Also read: Working Throughout Pregnancy: What's Safe And What Isn't?

Yoga:

Yoga combines physical movement, controlled breathing and relaxation. Although yoga should not be considered a replacement for medical treatment when hot flashes are severe, it may be particularly useful for women whose symptoms are accompanied by stress, anxiety or poor sleep.

Breathing and relaxation practices may help reduce sympathetic nervous system activation and promote a sense of calm. Regular yoga may also improve sleep, flexibility, mood and general well-being, which can indirectly make menopausal symptoms easier to cope with.

Gentle forms of yoga, stretching and mindfulness-based practices can be especially suitable for women who are new to exercise.

Strong evidence supports yoga's role in reducing the bother-and distress of hot flashes, sleep disruption, and mood symptoms — even in trials where flash frequency itself doesn't change much. The parasympathetic activation from slow breathing and mindful movement appears to lower the sympathetic overactivation that seems to trigger flashes. Yoga also directly targets anxiety and sleep quality, both of which commonly amplify perimenopausal symptom burden.

Also read: THIS Is What Happens To Your Body When You Do Yoga Everyday

Bottom line yoga is better studied for symptom perception and coping, strength training is better for the underlying physiology— weight, bone loss, cardiometabolic risk — that worsens with estrogen decline.

Practical takeaway Rather than choosing one, combine both:

• Strength training 2–3x/week, focused on compound movements (squats, deadlifts, presses) for bone and metabolic protection
• Yoga or slow-flow/restorative practice 2–3x/week, especially in the evening, for sleep quality and hot flash distress

Nuance Worth Flagging

Not all yoga is equal here — restorative or yin styles have better evidence for symptom relief than vigorous vinyasa or power yoga, which can transiently spike core temperature and sympathetic activation, occasionally triggering a flash rather than easing one. Pacing and breathable clothing matter more than intensity per se.

Women should also identify individual hot-flash triggers. Common triggers can include excessive heat, spicy foods, alcohol, caffeine, stress and smoking. Wearing breathable clothing, maintaining a cool sleeping environment and maintaining a healthy weight may also help.

Most importantly, persistent or severe hot flashes should not simply be accepted as something a woman has to “live with.” If symptoms are affecting sleep, daily functioning or quality of life, consultation with a gynaecologist can help identify appropriate treatment options.

One must also never forget that exercise is adjunctive, not a replacement for MHT (menopausal hormone therapy) in women with significant vasomotor symptoms.

The goal during perimenopause is not merely to control hot flashes, but to maintain muscle, bone health, cardiovascular fitness, mental well-being and overall quality of life.

By Dr. Asha Dalal, Director, Obstetrics and Gynecology, Sir H. N. Reliance Foundation Hospital

As a doctor I often hear the line: "I know I should take care of my health but I’ll start after things settle down." Unfortunately for people that "later" never comes. Whether people postpone exercise delay a health check-up cut back on sleep or hold off on eating habits these small choices can add up and cause big health problems later.

Lifestyle-related diseases do not appear all at once. Diabetes, hypertension, obesity, heart disease, fatty liver disease and even some cancers change slowly over years. The problem is that these diseases are often quiet in the beginning. Many people feel perfectly healthy while hidden damage goes on unnoticed.

How Postponing Exercise And Health Check-Ups Can Add Up

Also read: What Rock–Paper–Scissors “Run And Eat” And Other Eating Challenges Are Really Doing To Your Health?

Exercise is one of the signs of healthy ageing. Yet sitting and not moving has become more common. When exercise is always put off the body starts to lose muscle metabolism slows weight goes up and the danger of insulin resistance and heart disease rises. Regular movement is not about being fit; movement is a vital investment in long-term health moving easily and staying independent.

Preventive health check-ups are equally vital. Many people skip screenings because they have no symptoms. High blood pressure, bad cholesterol, early diabetes kidney problems and several kinds of cancer may not show symptoms until health problems are advanced. Timely health assessments find risk factors early letting health care stop complications later.

Why Sleep And Food Choices Matter In The Long Run

Also read: Foods That Boost Immunity In Children

Sleep is another area where people often give up because they think work is more important than rest. In truth not enough sleep hurts every body system. Long-term lack of sleep links to risk of obesity, diabetes, high blood pressure, weak immunity, bad mood, memory loss and heart disease. Good sleep is not an extra, it is a biological need.

Food choices add up over time. Eating processed food, much sugar and bad fats may seem small each day but years of poor food can cause inflammation, metabolic problems, digestive issues and heart problems. Healthy, balanced eating habits last longer than diet fads.

As a doctor who works with adults and older people I see the long-term impact of delayed health decisions. Many problems we treat could have been. Reduced by earlier lifestyle changes and regular health check-ups. The good news is that the body reacts well to habits at nearly any age. Even tiny changes such as a walk better sleep habits, healthier food choices or a routine health check-up, can bring real benefits.

Health is rarely set by one choice. Instead health comes from habits that are practiced each day for years. The price of delaying choices may not show today but it appears later. The best time to put health first is not when symptoms show, it is now.

By Dr. Yogesh Gupta, Director – Internal Medicine & Geriatrics, Sterling Hospitals, Gurukul, Ahmedabad