April 08, 2009
Waist Circumference Seen As Heart Attack Risk Factor

You can be at higher risk of heart failure even if your body mass index (BMI) is in a normal range. The type of fat you have is as important as the total amount of fat you have.

The researchers examined two Swedish population-based studies, the Swedish Mammography Cohort (made up of 36,873 women aged 48 to 83) and the Cohort of Swedish Men (43,487 men aged 45 to 79) who responded to questionnaires asking for information about their height, weight and waist circumference. Over a seven-year period between January 1998 and December 2004 the researchers reported 382 first-time heart-failure events among the women (including 357 hospital admissions and 25 deaths) and 718 first-time heart-failure events among men (accounting for 679 hospital admissions and 39 deaths.)

Their analysis found that based on the answers provided by the study participants, 34 percent of the women were overweight and 11 percent were obese, while 46 percent of the men were overweight and 10 percent were obese.

“By any measure – BMI, waist circumference, waist to hip ratio or waist to height ratio –our findings showed that excess body weight was associated with higher rates of heart failure,” explains Levitan.

Further breakdown of the numbers showed that among the women with a BMI of 25 (within the normal range), a 10-centimeter higher waist measurement was associated with a 15 percent higher heart failure rate; women with a BMI of 30 had an 18 percent increased heart failure rate. In men with a BMI of 25, a 10-centimeter higher waist circumference was associated with a 16 percent higher heart failure rate; the rate increased to 18 percent when men’s BMI increased to 30.

So fat on your waist is a bigger threat than fat on, say, your hips. So then does liposuction of stomach fat reduce heart attack risk?

Share |      Randall Parker, 2009 April 08 11:13 PM  Aging Diet Weight Studies

Jake said at April 9, 2009 12:13 AM:

High waist circumference is not the cause of heart disease. It is a symptom of a defective blood sugar/insulin control mechanism. High blood sugar and the resulting high insulin is very inflammatory to the body. That inflammation causes heart disease. High insulin levels cause
high waist circumference and diabetes.

You can change your defective food sugar/insulin control mechanism by eating a low carb, high fat, moderate protein diet and staying with the diet the rest of your life. The reduction in inflammation will help prevent heart disease. And who knows, you might lose some weight in the process.

Rafal Smigrodzki said at April 9, 2009 1:50 AM:

Liposuction removes only subcutaneous fat which is less relevant to cardiac health - it is the deep visceral fat that matters. But, even if you started liposuction on the visceral fat, you most likely wouldn't improve metabolism, since fat is most likely only a symptom of caloric overload, rather than the cause of dysfunction. And of course mucking around with a big sucking needle deep in your belly would be a recipe for disaster anyway. The way to avoid problems is to cut back on calories, and this could be perhaps achieved by switching to a low-carb diet.

Brett Bellmore said at April 9, 2009 3:53 AM:

I'm not sure that fat deep in the body is just a symptom, it actually does apply pressure to organs, including the heart and lungs. This could make a difference in survival during heart attacks, be the final insult that does you in.

This seems to be an issue of *where* fat deposits in your body, not how much. That could be a marker for some metabolic factor, or not.

bbartlog said at April 9, 2009 8:39 AM:

To some extent, I view this as just one more piece of evidence that BMI is a crappy metric.

Looking at the details of the study (the graphics on the final two pages especially), you can see something that's not evident from the article: for women, waist size is a *far* better predictor of hazard than BMI; in fact, for women with the smallest waists in their groupings (70cm), the association between BMI and risk of heart failure was negative! Presumably this is due to the slight association between height and HF risk (height would drive down the BMI for these women at the same time that it increased their risk).

For men it isn't so clear; increasing your waist size will increase your risk faster than increasing your BMI, but for a given individual these aren't really independent quantities, even if you can treat them separately in a population. More or less my conclusion would be to not worry about BMI; academics use it because it uses easy-to-get statistics, but anyone who is concerned about their health can easily get more relevant and important measures of their own body.

I also believe that they made either a labeling error or a statistical one in using the same groupings (70cm, 80cm, 90cm, 100cm) for men's waist sizes as they did for women's (80, 90, 100, 110 would make more sense) and have sent Levitan an email.

Lono said at April 9, 2009 8:44 AM:

Anyone who is significantly overweight - in this day and age - is as ignorant and self destructive as any tobacco smoker.

I have always been impressed, Randall, on how you provide us here on Future Pundit with such a wealth of excellent, cutting edge, information on these health issues.

That being said - I have 50lbs to lose by 2010 - better get on the ball before the Globalist's finish their bloodless coup...


David Govett said at April 9, 2009 9:51 PM:

Until we get real-time monitoring of our body's various markers and our overall systemic metabolism, we'll be stumbling in the dark, from answer to answer, from cure to cure. We're just plain ignorant at present, and ignorance has its price.

cathy said at April 10, 2009 4:06 AM:

Lono -why do you want to loose weight before the bloodless coup? If you're going Galt, won't you need your fat reserves?

Lono said at April 10, 2009 8:37 AM:


Oh I'm not going Galt per se - but one needs to be in good shape to Refresh the Tree of Liberty!


(This country is in real trouble - England is ALREADY an Orwellian Dystopia - never thought I'd see such a thing in my lifetime)

Randall Parker said at April 10, 2009 3:45 PM:


Rudolph Leibel at Columbia U and some other fat researchers claim that fat cells excrete a lot of hormones. So I find the argument that fat itself is the problem to be fairly persuasive. There's an obvious mechanism for how the fat can cause the damage.

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