People with heart disease who are at a normal weight but who have fat around their bellies are at greater risk of death compared to people whose fat is concentrated elsewhere, a new study found.
Carrying more weight around the belly is as significant a risk factor as smoking 20 cigarettes a day or having very high blood cholesterol, researchers say. The risk is greater for men.
A spare tyre around the waist 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.
The study, published in the Journal of the American College of Cardiology, looked at data involving almost 16 000 people from around the world with coronary artery disease. The risk of death was nearly double for people with coronary artery disease and central obesity, which was determined by waist circumference and waist-to-hip ratio.
"Visceral (belly) fat has been found to be more metabolically active," says Dr Francisco Lopez-Jimenez, the study's lead investigator. "It produces more changes in cholesterol, blood pressure and blood sugar. However, people who have fat mostly in other locations of the body, specifically the legs and buttocks, don't show this increased risk."
Doctors should look beyond BMI and advise those with a large waist or a high waist-to-hip ratio to lose weight, the study said.
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