Here's more reason to dislike that beer belly or muffin top. New research suggests that carrying even modest amounts of extra fat around your middle can raise your risk of dying early if you have heart disease—even if you're at a normal weight.

The researchers looked at five large studies on heart disease that measured people's waist, their waist-to-hip ratio (how large a person's waist is in relation to their hips), or both. They then pooled these studies' findings to see what conclusions they might draw about people's risk of dying, based on their belly fat. The studies followed participants from six months to 16 years.

Overall, people with extra fat around their middle were nearly twice as likely to die during the studies as those with normal waistlines. The researchers likened this increase in risk to the effects of smoking a pack of cigarettes a day or having very high cholesterol.

They also looked separately at people who were judged to have a healthy weight because of their low body mass index (BMI). Even among this group, those with extra belly fat—even a small amount—had a higher risk of dying.

These findings should be fairly reliable, as they took into account several factors that also might have affected people's risk of dying during the studies, including their age, whether they smoked, and whether they had diabetes or another condition that could have worsened their heart problems.

The researchers say their study helps explain the "obesity paradox"—a puzzling finding of some research suggesting that people with a higher BMI tend to live longer with heart disease. The researchers argue that studies behind the paradox are misleading, because a person's BMI is not an accurate measure of their body fat, as it simply relates their weight to their height. Looking at where people carry their fat can provide more useful information, particularly in light of other studies linking belly fat to harmful changes in cholesterol, blood pressure, and blood sugar—all factors that can raise the risk of potentially fatal heart problems.

Bottom line. If you have heart disease, the fat around your waistline may provide more insight into your health outlook than your BMI, particularly if your BMI puts you at a healthy weight.

However, keep in mind that belly fat is just one of several factors that may influence your risk of dying earlier if you have heart disease. The good news is that many of these factors are under your control, such as how much you exercise, whether you smoke, and how well you follow your treatment plan. Reducing your belly fat by losing weight may also help, although studies still need to explore this.

Source
Central obesity and survival in subjects with coronary artery disease [Journal of the American College of Cardiology]

—Sophie Ramsey, BMJ Group

ConsumerReportsHealth.org has partnered with The BMJ Group to monitor the latest medical research and assess the evidence to help you decide which news you should use.