The bigger your belly, the greater your risk of coronary heart disease

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Wednesday, October 18, 2006 3:01 am Email this article
The bigger your belly, the greater your risk of coronary heart disease according to a study from Kaiser Permanente of Northern California. This is true for both men and women. Men

Men with largest bellies 42% more likely to develop coronary heart disease

The one-fourth of men with the largest bellies were 42 percent more likely to develop coronary heart disease over the twelve years of the study than the one-fourth of men with the smallest bellies.

 

Women

Women with largest bellies 44% more likely to develop coronary heart disease

The one-fourth of women with the largest bellies were 44 percent more likely to develop coronary heart disease than the one-fourth of women with the smallest bellies.

 

Measuring Bellies

Bellies measured as distance from your back to your belly (sagittal abdominal diameter)

Bellies were measured as sagittal abdominal diameter. This is the distance from your back to the front of your belly while standing and after gently exhaling.

Another way to picture this is if you could push your back up against the wall—and I realize that some people have buttocks that would not allow them to do this, but if they could—it is the distance that your belly extends from the wall.

 

Men’s Risk According to Belly Size

Men : Risk increased by 13%, 22% and 42% for three quarters of men with the largest bellies

Compared to the one-fourth of men with the smallest bellies, whose bellies extend 7 inches or 17.9 centimeters from their back and had an average BMI of 23.1, the risk of coronary heart disease for other men was:

• 13 percent greater for the second lowest quarter of men with their average belly extending 8.3 inches or 21 centimeters from their back. Their average BMI was 24.8.
• 22 percent greater for the second highest quarter of men with their average belly extending 9.1 inches or 23.2 centimeters from their back. Their average BMI was 26.1.
• 42 percent greater for the highest quarter of men with their average belly extending 10.6 inches or 26.9 centimeters from their back. Their average BMI was 28.6.

 

Women’s Risk According to Belly Size

Women : Risk increased by 9%, 16% and 44% for three quarters of women with the largest bellies

For women, compared to the one-fourth of women with the smallest bellies, whose bellies extend 6.4 inches or 16.2 centimeters from their back and had an average BMI of 21.1, the risk of coronary heart disease for other women was:

• 9 percent greater for the second lowest quarter of women with their average belly extending 7.5 inches or 19 centimeters from their back. Their average BMI was 22.5.
• 16 percent greater for the second highest quarter of women with their average belly extending 8.4 inches or 21.3 centimeters from their back. Their average BMI was 24.3.
• 44 percent greater for the highest quarter of women with their average belly extending 10.1 inches or 25.7 centimeters from their back. Their average BMI was 28.6.

 

Belly Fat vs BMI

Belly fat better predictor than BMI alone

The study found that belly fat was a better predictor of coronary heart disease risk than BMI alone.

“Finally, we found clear evidence that consideration of standing [sagital abdominal diameter] at each level of BMI provided better risk stratification than use of BMI alone,” the study states.

Other studies have found that belly fat is a better predictor of insulin resistance and elevated insulin levels than measuring BMI, waist or waist-to-hip ratio.

 

Races

True for all races

The study also found that the increased risk associated with belly fat was true for all races.

“We found that standing [sagital abdominal diameter] to be equally predictive of [coronary heart disease] risk across racial groups,” the researchers noted.

 

Subjects

Subjects : 101,765 adults in Northern California

The study followed 101,765 adults in Northern California who were members of Kaiser Permanente of Northern California, a Health Maintenance Organization (HMO), who had checkups between 1965 and 1970, and who were then followed for twelve years.

 

Conclusion

Conclusion : Belly fat is a strong predictor of coronary heart disease and should be measured with BMI

“In summary, standing [sagital abdominal diameter], a marker of visceral obesity [belly fat], was a strong predictor of [coronary heart disease] independently of BMI in our study, and it added incremental [coronary heart disease] risk prediction at each level of BMI for men and women, for older and younger persons, and across racial groups,” the paper concludes.

“These findings suggest that BMI and a measure of visceral obesity [belly fat] such as standing [sagital abdominal diameter] should be considered together for optimal [coronary heart disease] risk assessment.”

 

Comments

Comment : Belly fat is the problem

It is interesting to note that the risk of coronary heart disease roughly doubled when going from the second quarter of men and women to the third quarter—increasing from 13 pecent to 22 percent in men, and 9 percent to 16 percent in women—and then roughly doubling again when going from the third quarter to the fourth quarter—increasing from 22 pecent to 42 percent in men, and 16 percent to 44 percent in women.

Comment : BMI in the highest quarter is not that high, but still increased risk

It should also be noted that

Comment : Belly fat increases other risk factors

The data also shows that every risk factor that they measured—total cholesterol, systolic blood pressure, diastolic blood pressure, history of hypertension, and history of diabetes—increased as bellies got bigger.

Comment : Belly fat poses a problem for women also

It should also be noted that the risk for men and women was very similar.

“Results for women were remarkably similar to the results observed for men,” the paper notes.

This suggests that belly fat is the problem.

REFERENCE

Iribarren C, Darbinian J, Lo J, Fireman BH, Go A. Value of the sagittal abdominal diameter in coronary heart disease risk assessment: Cohort study in a large, multiethnic population. Am J Epidemiol. 2006 Oct 13.

AUTHOR’S CORRESPONDENCE

Dr. Carlos Iribarren
Division of Research
Kaiser Permanente of Northern California
2000 Broadway, Oakland, CA 94612
USA
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