Men often ignore their pot bellies, imagining that a little beer belly is nothing to worry about.
Not so - in fact, having a beer belly carries a greater risk of death than being overweight or obese, a study found.
Adults who have a normal weight, but a ‘spare tyre’ of fat (known as central obesity) have double the risk of mortality as people who are fat all over.
The study assessed 15,184 people aged 18 to 90 in terms of weight distribution and death rates.
People with weight concentrated in their stomach tend to have low muscle mass, which is also linked to high mortality, the researchers said.
Dr Lopez-Jimenez said: 'Normal-weight central obesity defined by WHR is associated with higher mortality than BMI-defined obesity, particularly in the absence of central fat distribution.
'Future studies should focus on identifying factors associated with the development of normal-weight central obesity and better understanding the effect of normal-weight central obesity on health outcomes.
'Until such data are available, the use of BMI with measures of central obesity may provide better adiposity-related risk factor stratification cal practice than either method alone.'
'Obesity defined by BMI or measures of central obesity, such as waist-to-hip ratio (WHR) and waist circumference, is associated with increased total and cardiovascular mortality,' said Dr Francisco Lopez-Jimenez, a cardiologist at the Mayo Clinic, Minnesota.
'However, a recent meta-analysis showed that being overweight according to BMI was actually associated with lower total mortality, challenging the paradigm that BMI is linked to increased mortality.