Many people know that being overweight increases their risk of heart disease, but a new study suggests that it’s the location of body fat that matters most.
The study of nearly 700 post-menopausal women revealed that fat deposited around around the waist represents carries a greater risk of coronary artery disease (CAD) than an overall high body mass index (BMI).
Coronary heart disease is the number one cause of death in the UK, affecting around 73,000 per year, according to the charity Heart UK.
Obesity, defined as a BMI greater than 30, has long been known as a risk factor for CAD, and is often accompanied by other cardiovascular risk factors, such as hypertension and diabetes.
However, BMI does not take into account where our body fat is stored; two people of the same height can both have a BMI of 29, for example, yet have completely different compositions.
One could be a bodybuilder, possessing a large amount of muscle mass, whereas the other could be overweight due to unhealthy eating, likely having a large degree of visceral body fat – the dangerous type, typically stored around the abdomen.
The study of nearly 700 Korean women showed that the risk of CAD was significantly higher in women whose waists measured at least 85cm (33.5inches) than those who were generally overweight, with a BMI of over 25.
“Not all fat is the same, and central obesity is particularly dangerous because it is associated with risk for heart disease, the number one killer of women,” said Dr. Stephanie Faubion, NAMS medical director.
These results are especially relevant for postmenopausal women, who tend to have an increased abdominal fat disposition.
This is because estrogen protects women’s cardiovascular systems before menopause, but women’s estrogen levels decline during and after menopause, increasing the risk of CAD.
“Identifying women with excess abdominal fat, even with a normal BMI, is important so that lifestyle interventions can be implemented,” said Dr. Faubion.
The good news is CAD is largely preventable through the lifestyle habits we undertake.
According to the Mayo Clinic, lack of physical activity, being overweight and smoking are among some of the primary behaviours associated with an increased risk of CAD.
The findings of the study are published online today in Menopause, the journal of The North American Menopause Society (NAMS).
The findings also back up a previous 2018 NHS report indicating that very high waist circumferences (above 102cm for men and 88cm for women) increases the likelihood of heart disease in those aged 35 or over.