Belly Fat Doubles Death Risk
Increase in Death Risk Not Limited to Overweight, Obese
Nov. 12, 2008 -- Belly fat has been linked to an increased risk of heart disease and diabetes. Now an important new
study links belly fat to early death.
Researchers followed about 360,000 Europeans enrolled in one of the largest,
longest health studies in the world.
They found that people with the most belly fat had about double the risk of
dying prematurely as people with the least amount of belly fat.
Death risk increased with waist circumference, whether the participants were
overweight or not.
The study provides some of the strongest evidence yet linking belly fat to
early death, says lead author Tobias Pischon, MD, MPH. It appears in the Nov.
12 issue of TheNew EnglandJournal of Medicine.
"Our study shows that accumulating excess fat around your middle can put
your health at risk even if your weight is normal," he says.
"There aren't many simple individual characteristics that can increase a
person's risk of premature death to this extent, independent of smoking and drinking."
Belly Fat Research
It has long been recognized that people who carry their excess weight around
their middles -- those who are apple-shaped instead of pear-shaped -- have a
higher risk for heart attacks and strokes.
Recent research also suggests a link between belly fat and a range of other
diseases, including diabetes, some cancers, and even age-related dementias.
But it has not been clear whether the increase in death risk associated with
abdominal obesity occurs independently of recognized risk factors like general
obesity, Pischon says.
The researchers used two measures of abdominal obesity -- waist
circumference and waist-to-hip ratio -- in their attempt to better understand
the role of belly fat in early death.
They examined data on 359,387 European adults followed for nearly 10 years
who were enrolled in the larger, ongoing European Prospective Investigation
into Cancer and Nutrition (EPIC) health study.
During the follow-up period, 14,723 of the study participants died.
After adjusting for overweight and obesity, as measured by body mass index (BMI), waist
circumference and waist-to-hip measurements were both independently associated
with an increased risk for early death.
- Men and women with the largest waists (more than 40 inches for men and 35
inches for women) had roughly double the risk of premature death as men and
women with the smallest waists (less than 34 inches for men and 28 for
- Each 2-inch increase in waist circumference was associated with close to a
17% increase in mortality in men and a 13% increase in women.
- Waist-to-hip ratio also strongly predicted mortality.
"The most important result of our study is the finding that not just
being overweight, but also the distribution of body fat, affects the risk of
premature death," Pischon says.
The findings come as no surprise to University of Michigan cardiologist and
research scientist Daniel Eitzman, MD.
Work by Eitzman and colleagues in mice found that belly fat -- also known as
visceral fat -- produces more inflammation than fat found in other areas of the
Inflammation is thought to play a key role in heart disease and a host of
other chronic diseases.
Eitzman tells WebMD that measurement of waist circumference or waist-to-hip
ratio are important for assessing the risk of inflammation-driven disease.
"Studies like this focus attention on the importance of measuring
visceral fat, which is not now routinely done in clinical practice," he