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Heart Disease Health Center

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Pot Belly May Signal Diseased Arteries

Waist-to-Hip Ratio May Be More Telling Than BMI, Study Shows
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 13, 2007 -- The tape measure may beat the scale as a low-tech indicator of atherosclerosis, new research shows.

Atherosclerosis means the hardening of the arteries, which makes heart attacks and stroke more likely.

Doctors have sophisticated tools to search for signs of atherosclerosis. But a tape measure may give you a rough idea of your risk -- and if you've got a pot belly, watch out.

So say James de Lemos, MD, FACC, and colleagues at the University of Texas Southwestern Medical Center at Dallas.

"We think the key message for people is to prevent accumulation of central fat early on in their lives," de Lemos says in a news release. "To do so, they will need to develop lifelong dietary and exercise habits that prevent the development of the 'pot belly.'"

Pot Belly or Flat Abs?

The new study included 2,744 Dallas residents who were in their mid-40s, on average (age range: 30-65).

Participants got noninvasive scans to check for evidence of atherosclerosis, which can start years before a heart attack or stroke. They also got their height, weight, waist circumference, and hip circumference measured.

Based on those measurements, de Lemos and colleagues calculated participants' BMI (which relates height to weight) and waist-to-hip ratio (waist circumference divided by hip circumference).

BMI vs. Waist-to-Hip Ratio

BMI (body mass index) is often used to gauge obesity. But BMI can be misleading.

BMI can't tell muscle from flab. It also doesn't show where body fat is located. Carrying extra fat around your waist may be unhealthier than having extra fat around your hips.

Because of BMI's drawbacks, some experts prefer the waist-to-hip ratio to gauge obesity.

In the Dallas study, waist-to-hip ratio trumped BMI as a marker of atherosclerosis.

That is, participants' waist-to-hip ratio was more sensitive than BMI at indicating who had scans showing evidence of atherosclerosis.

Abdominal fat may play an active role in promoting heart disease, warn de Lemos and colleagues.

Their study, published in next week's edition of the Journal of the American College of Cardiology, didn't directly test that theory.

Looking to lose a pot belly? Your doctor can give you pointers on doing so safely -- and on maintaining your progress.

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