A fat belly is bad for your heart – even in people who are not otherwise overweight, warns a new study.
People whose waist is bigger than their hips may be at twice the risk of a dangerous heart attack and should see their doctor immediately, researchers warn.
The obesity epidemic is widely cited for driving the down life expectancy for two-thirds of Americans.
But the new study from the Mayo Clinic and Czech researchers suggests that you do not have to be overweight for your belly to threaten your heart health.
Body mass index (BMI), which is weight relative to height, is used to categorize adults as underweight, normal weight, overweight or obese.
But BMI does not account for the amount and distribution of fat and muscle.
Central obesity is a store of excess fat around the middle of the body and is a marker of abnormal fat distribution.
The fat that gathers there tends to be a more dangerous kind, called visceral fat.
Visceral fat lies deep in your abdominal tissue, close to important vital organs where they release destructive compounds like free fatty acids that can tamper with the liver’s functioning. This in turn raises risks for high blood pressure and bad cholesterol, as well as insulin resistance, which can lead to type 2 diabetes. Collectively, these predispositions raise the risks of an early death.
Genetics play an important role in weight gain around the middle, but the phenomenon is more common in men and in all people as we age.
The researchers sent a clear warning: “See your doctor if your waist is bigger than your hips,” said study author Dr. Jose Medina-Inojosa, of the Mayo Clinic and The International Clinical Research Centre of St. Anne’s University Hospital in the Czech Republic.
He and his team tested the hypothesis that people with normal weight and central obesity would have more heart problems than people with normal weight and normal fat distribution.
In 1997 to 2000 the study enrolled 1,692 people in Minnesota, aged 45 years or older.
Participants underwent a clinical examination and measurements were taken of weight, height, waist circumference and hip circumference.
Central obesity was defined as a ratio dividing the waist circumference by the hip circumference of 0.90 or above for men and 0.85 or above for women.
Patients were followed-up from 2000 to 2016 for the occurrence of major adverse cardiovascular events (MACE) using linked medical records from the Rochester Epidemiology Project.
The Western diet is loosely defined as one full of fatty and sugary foods, such as burgers, fries and soda.
Health effects have been linked to things such as hypertension, heart disease, diabetes, obesity, colorectal cancer and dementia.
MACE was defined as heart attack, a medical procedure to open blocked arteries, stroke, or death from cardiovascular causes.
Participants with a normal BMI (18.5-24.9 kg/m2) and central obesity had an approximately two-fold higher long-term risk of any of these dangerous heart events compared to participants without central obesity, regardless of their BMI.
“People with a normal weight but a fat belly have more chance of heart problems than people without a fat belly, even if they are obese according to BMI,” Dr. Medina-Inojosa warned.
“This body shape indicates a sedentary lifestyle, low muscle mass, and eating too many refined carbohydrates.
“The belly is usually the first place we deposit fat, so people classified as overweight BMI but without a fat belly probably have more muscle which is good for health.
“Muscle is like a metabolic storehouse and helps decrease lipid and sugar levels in the blood.”
Participants with a normal BMI and central obesity also had a higher risk of MACE than overweight and obese participants with central obesity, according to the findings.
Dr. Medina-Inojosa says that overweight and obese people with central obesity might also have more muscle mass, which could be protective.
He said: “If you have fat around your belly and it’s greater than the size of your hips, visit your doctor to assess your cardiovascular health and fat distribution.
“If you have central obesity the target will be waist loss rather than weight loss,” he added.
To lose the belly fat, Dr. Medina-Inojosa advises people to ‘exercise more, decrease sedentary time by taking the stairs or getting off the train one stop early and walking, increase your muscle mass with strength and resistance training, and cut out refined carbohydrates.’
Medina-Inojosa warned that it is important for doctors not to assume that people with a normal BMI are not at risk of heart problems or that their fat distribution is normal.
He added: “Our study provides evidence that doctors should also measure central obesity to get a better picture of whether a patient is at risk.”
The findings are due to be presented at the annual congress of the European Association of Preventive Cardiology (EAPC) in Slovenia.
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