Having a fat belly doubles heart attack risk

Having a fat belly doubles your heart attack risk even if you aren't obese, a study has found.

Those of normal weight but a bigger belly have more chance of heart problems than those who are obese but not carrying their excess weight round the waist.

Researchers 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.

It comes after body mass index (BMI), which is weight relative to height and used to categorise adults as underweight, normal weight, overweight or obese, fails to account for the amount and distribution of fat and muscle.

In 1997 to 2000 the study enrolled 1,692 American residents of Olmsted County, Minnesota, aged 45 years or older. The sample was representative of the county population for age and sex.

Participants underwent a clinical examination and measurements were taken of weight, height, waist circumference and hip circumference.

They were then followed-up from 2000 to 2016 for the occurrence of major adverse cardiovascular events, such as heart attacks, using linked medical records from the Rochester Epidemiology Project.

It emerged that participants with a normal BMI and central obesity had an approximately two-fold higher long-term risk of suffering a major adverse cardiovascular event compared to participants without central obesity, regardless of their BMI.

"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.

Dr Medina-Inojosa continued: "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.

"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."

Dr Medina-Inojosa says that overweight and obese people with central obesity might also have more muscle mass which could be protective.

The findings are due to be presented at the annual congress of the European Association of Preventive Cardiology (EAPC) in Slovenia.