Body fat locations to warn of a heartattack

Body shape - whether fat was distributed on the abdomen or on the thighs and hips - proved a better predictor. Women with smaller waists and heavy thighs who are severely obese are no more likely to die from heart disease than less obese women with large waists and narrow thighs.

A study of more than 17 thousand obese men and women in North America found that in both sexes cardiovascular risk rose as obesity increased - but only to a point in women.

Doctors have examined data on several indicators of cardiovascular risk. They found that in all of the women, death caused by cardiovascular disease increased steadily once they passed a body mass index, or BMI, of 25 and until they reached a BMI of 30, at which point it leveled off. BMI is a measure of weight in kilograms divided by height in metres squared, report

According to the amount of body fat you carry around does not predict heart disease as well as its location does, a new study claims. The findings should call into question the practice of recommending bariatric surgery solely on obesity rather than other heart disease risk factors, Dr. Edward Harry Livingston, chairman of gastrointestinal and endocrine surgery at UT Southwestern Medical Center, said April 20 at the Experimental Biology 2004 meeting in Washington, D.C.

The finding applies especially to women, said Livingston, who performs the surgery. There are several types of bariatric surgery to treat severe obesity, the most common of which involves making the stomach smaller.

In his analysis, he found death from heart disease did not increase in a totally linear fashion the fatter people became. And he found distribution of body fat, rather than overall weight, is a better predictor of heart disease risk, with fat on the abdomen more unhealthy than that on the thighs and hips.

Fat distribution was key to heart disease death risk, he also found. There was a negative correlation with the buttock or thigh fat and a positive correlation with waist diameter.

It's the apple-pear story that's been told before: those who collect fat around their middles and are apple-shaped are less heart-healthy than the pears, who collect fat around the buttocks and thighs. Some who store fat in their lower bodies don't experience an increase in cholesterol, as do some who store it around their middle and become very obese with a rise in heart disease risk.

The worst combination of cardiovascular risk factors, irrespective of weight, was found in people with large waists and narrow thighs. Seriously obese individuals without this body type had a better cardiovascular risk profile than individuals with this body type who were smaller.

Dr. Livingston says these findings do NOT indicate that being obese is without risk, as the elevated death rates indicate.

But the findings do call into question whether moving from one level of overweight/obesity to a higher one always increases the risk of dying from heart disease. The findings also reinforce the importance of body shape.

Some very obese individuals appear to have the ability to store fat in their lower bodies without causing an increase in cholesterol as occurs in those who store fat in their abdomen, allowing them to become massively obese without a corresponding rise in cardiovascular risks, report

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