To the Editor: The latest report on the Nurses' Health Study by Manson et al. (March 29 issue)1 describes a positive association between the Quetelet index and coronary heart disease. The Quetelet index, however, may substantially misrepresent the most important aspect of adiposity in relation to the risk of coronary heart disease and mortality — namely, body-fat distribution,2 3 4 which was not measured in this study. The authors briefly acknowledge this defect. Central (android) obesity, but not lower-body-segment (gynecoid) obesity, is strongly linked with the risk factors for coronary heart disease, specifically elevated LDL cholesterol levels, reduced HDL cholesterol levels, elevated.