Heart disease due to a big belly

Fat distribution determines the risk of cardiovascular disease

08/28/2012

The waist circumference has a significant influence on the risk of cardiovascular disease. Not the overweight itself is crucial, but the fat distribution on the body, reported US scientists at the annual congress of the European Society of Cardiology (ESC) in Munich.

Numerous studies have already linked the risk of cardiovascular disease to existing overweight or obesity. Recently, however, have condensed the evidence that especially the belly fat has negative effects on health. The US scientists around Dr. Karine Sahakyan of the Mayo Clinic in Rochester (USA) came to the conclusion in her study that even normal weight people are at an increased risk of cardiovascular disease if they have an increased belly fat percentage.

Association between body fat and cardiovascular disease studied
"We knew from previous research that central obesity is bad, but the new thing about our research is that the distribution of fat has a major impact on the cardiovascular system, even in people of normal weight. Francisco Lopez-Jimenez, senior author of the current study. As part of their research, the researchers identified possible associations between fat distribution and risk of cardiovascular disease based on data from 12,785 US citizens from the third National Health and Nutrition Examination Survey. All subjects were 18 years or older, the average age was 44 years. The average observation period was 14.3 years. A total of 2,562 subjects died during the study, 1,138 from cardiovascular disease.

Waist-to-hip ratio and BMI are taken into account
The study covered body measurements such as height, weight, waist circumference and hip circumference, as well as socioeconomic status, comorbidities, physiological and laboratory measurements, according to the ESC press release. (Sahakyan divided the 12 785 subjects into three categories (normal weight, overweight, obese) based on their BMI, and established two subgroups based on the waist-hip ratio for each of these categories, as well as risk factors such as age, sex, and tobacco use. Diabetes or hypertension were corrected, and the researchers then examined how the cardiovascular deaths were distributed among the six groups of study participants.

Normal-weight people with big bellies have the highest cardiovascular risk
The result surprised. Of the 1,138 deaths attributable to cardiovascular disease, most were in the normal-weight category with big bellies (high waist-hip ratio). "This group had the highest mortality rate, even higher than those who were considered obese based on BMI," Dr. Francisco Lopez-Jimenez. "From the point of view of public health, this is an important insight," the expert continues. Thus, normal weight with increased fat deposits on the stomach is the most dangerous in terms of the risk of fatal cardiovascular disease. The BMI is thus only partially suitable as an indicator. In the future, "physicians should therefore also emphasize the importance of the waist circumference or the abdominal fat for the risk of cardiovascular disease," said the US scientists.

Protective hip fat, harmful belly fat?
According to the scientists, the particularly harmful effect of the abdominal fat is due to the increased release of messenger substances, which in turn cause chronic inflammation in the organism. These burden the heart or the metabolism and promote the occurrence of vascular calcifications. The visceral fat (abdominal fat) also causes unfavorable health effects such as insulin resistance. Karine Sahakyan and colleagues. The fat on hips and legs, which is missing in the normal weight, however, are attributed to "protective effects", the US scientists continue. (Fp)

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