Even if you have normal body weight, if you have coronary artery disease your risk of death is considerably greater if you have a slight beer belly, researchers from the Mayo Clinic revealed in the Journal of the American College of Cardiology.

Thais Coutinho, M.D. and team examined information from five studies around the world involving 15,923 patients who had coronary artery disease. They discovered that individuals with central obesity were twice as likely to die, compared to others – the kind of increased risk linked to smoking twenty cigarettes a day or having exceedingly high cholesterol levels.

This study’s findings contradict some others which have found that individuals with a higher BMI and chronic diseases have a better chance of surviving compared to patients with the same disease but who are of normal weight.

Dr. Coutinho said:

“We suspected that the obesity paradox was happening because BMI is not a good measure of body fatness and gives no insight into the distribution of fat. BMI is just a measure of weight in proportion to height. What seems to be more important is how the fat is distributed on the body.”

Francisco Lopez-Jimenez, M.D., said:

“Visceral fat has been found to be more metabolically active. It produces more changes in cholesterol, blood pressure and blood sugar. However, people who have fat mostly in other locations in the body, specifically, the legs and buttocks, don’t show this increased risk.”

Doctors should advise normal weight patients with coronary artery disease, but who have large waists to reduce their waist size.

Dr. Coutinho added:

“All it takes is a tape measure and one minute of a physician’s time to measure the perimeter of a patient’s waist and hip.”

Waist-hip ratio (WHR) or waist-to-hip ratio compares a person’s waist size to hip size.

WHR is commonly used to measure an individual’s health, as well as the likelihood of developing serious conditions or diseases. According to most studies, pear-shaped people tend to have lower risks of developing unhealthy conditions compared to apple-shaped individuals.

A 0.7 WHR among women and 0.9 among males is strongly associated with good general health and fertility.

WHR is seen by many as a better indicator of health than Body Mass Index (BMI).

Calculating your WHR – divide the circumference of your waist by that of your hips. Below are some measurement indicators:

  • Male – WHR Close to 0.9 – Ideal. Very low health risk.
  • Female – WHR Close to 0.7 – Ideal. Very low health risk.
  • Male – WHR 0.95 or less. Low health risk.
  • Female – WHR 0.90 or below. Low health risk.
  • Male – WHR 0.6 to 1.0. Moderate health risk.
  • Female – WHR 0.81 to 0.85. Moderate health risk.
  • Male – WHR 1+. High health risk.
  • Female – WHR 0.85+. High health risk.

“Central Obesity and Survival in Subjects With Coronary Artery Disease”
Thais Coutinho, MD, Kashish Goel, MD, Daniel Corrêa de Sá, MD, Charlotte Kragelund, MD, PhD, Alka M. Kanaya, MD, Marianne Zeller, PhD||, Jong-Seon Park, MD, Lars Kober, MD, PhD, Christian Torp-Pedersen, MD, PhD, Yves Cottin, MD, PhD, Luc Lorgis, MD, Sang-Hee Lee, MD, Young-Jo Kim, MD, Randal Thomas, MD, MSc, Véronique L. Roger, MD, MPH, Virend K. Somers, MD, PhD and Francisco Lopez-Jimenez, MD, MSc
J Am Coll Cardiol, 2011; 57:1877-1886, doi:10.1016/j.jacc.2010.11.058

Written by Christian Nordqvist