-- HealthDay Staff
MONDAY, May 2 (HealthDay News) -- Even normal-weight people with
belly fat and heart disease have an increased risk of death
compared to folks whose fat is concentrated elsewhere, a large, new
A "beer belly" or "muffin top" is as significant a risk factor
as smoking a pack of cigarettes a day or having very high blood
cholesterol, the study said. And the risk is greater for men.
That spare tire is even more significant than your overall body
mass index (BMI, a ratio of weight to height) in predicting risk of
death, the researchers said, noting their findings discount a
puzzling theory known as the "obesity paradox." That surprising
finding from earlier studies linked a higher BMI and coronary
artery disease with better survival chances than normal-weight
"We suspected that the obesity paradox was happening because BMI is not a good measure of body fatness and gives no insight into the distribution of fat," said study lead author Dr. Thais Coutinho, a cardiology fellow at the Mayo Clinic in Rochester, Minn.
"BMI is just a measure of weight in proportion to height. What seems to be more important is how the fat is distributed on the body," she said in a clinic
The study is published in the May 10 issue of the
Journal of the American College of Cardiology.
The researchers looked at data from five studies conducted
around the world, involving almost 16,000 people with coronary
artery disease. The risk of death was nearly doubled for people
with coronary artery disease and central obesity, which was
determined by waist circumference and waist-to-hip ratio, the study
What exactly is the difference between belly fat and thigh fat,
"Visceral [belly] fat has been found to be more metabolically active," Dr. Francisco Lopez-Jimenez, the study's lead investigator and director of Mayo's Cardiometabolic Program, explained in the news release. "It produces more changes in cholesterol, blood pressure and blood sugar. However, people who have fat mostly in other locations in the body, specifically the legs and buttocks, don't show this increased risk."
Doctors should look beyond BMI in assessing patients' health
risks and advise those with a large waist or a high waist-to-hip
ratio to lose weight, even if they have normal BMIs, the study
authors said. A BMI of between 18.5 and 25 is considered normal;
between 25 and 29.9 is overweight; and a BMI of 30 or more is
"All it takes is a tape measure and one minute of a physician's time to measure the perimeter of a patient's waist and hip," Coutinho said.
The study participants came from the United States, Denmark,
France and Korea, and that diversity gives real-world applicability
to the findings, Coutinho said.
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