Normal BMI but central obesity increases CVD risk
Belly fat, even in people who are not otherwise overweight, is bad for the heart, according to results from the Mayo Clinic presented at the recent EuroPrevent 2018 congress.
Measuring body mass index (BMI) does not account for the amount and distribution of fat and muscle. This new study tested the hypothesis that people with normal weight and central obesity would have more cardiovascular problems than people with normal weight and normal fat distribution.
The study enrolled 1692 aged 45 years or older between 1997-2000. Participants underwent a clinical examination and measurement of weight, height, waist circumference and hip circumference. Central obesity was defined as a ratio dividing the waist circumference by the hip circumference of 0.90 or above for men and 0.85 or above for women. Patients were followed-up from 2000-2016 for the occurrence of major adverse cardiovascular events (MACE) using linked medical records from the Rochester Epidemiology Project.
Participants with a normal BMI (18.5–24.9 kg/m2) and central obesity had an approximately two-fold higher long-term risk of MACE compared to participants without central obesity, regardless of their BMI (HR 2.4 [95% CI 1.48-3.82]). Participants with a normal BMI and central obesity also had a higher risk of MACE than overweight and obese participants with central obesity. Study author Dr Medina-Inojosa (Mayo Clinic, Rochester, Minnesota) said that overweight and obese people with central obesity might also have more muscle mass which could be protective.
He concluded, “If you have fat around your belly and it’s greater than the size of your hips, visit your doctor to assess your cardiovascular health and fat distribution. If you have central obesity the target will be waist loss rather than weight loss. Exercise more, decrease sedentary time by taking the stairs or getting off the train one stop early and walking, increase your muscle mass with strength and resistance training, and cut out refined carbohydrates.”
- The study shows that healthcare professionals should measure central obesity to assess cardiovascular risk – even in patients with normal BMI.
- Medina-Inojosa J et al. Normal-weight central obesity and long-term cardiovascular events: a prospective population-based cohort study. Presented at EuroPrevent 2018 congress, Abstract 380