Coronary artery disease patients who have even a modest beer belly or muffin top are at higher risk for death than people whose fat collects elsewhere, according to a new study.
The effect was observed even in patients with a normal BMI.
Researchers at the Mayo Clinic analyzed data from 15,923 people with coronary artery disease involved in five studies from around the world, according to
The study provides some new evidence to support the so-called "obesity paradox"--a cluster of findings suggesting that once diagnosed with heart disease, the patient who is overweight or obese is less likely to die than one who is at normal weight or below. "The association between fatness and mortality might rely more on measures of fat distribution than on the amount of body fat," the authors wrote.
But most with a high BMI should not take too much comfort from the study. Mayo Clinic cardiologist Thais Coutinho, the lead author of the study, said the study demonstrated that BMI is a poor bellwether of a cardiovascular patient's prognosis, in that even patients with BMIs in the normal healthy range were at high risk of dying if they had a spare tire. So, relying too heavily on BMI misses a lot of people who should whittle their waists to improve their health,
"Our data suggest waist circumference and hip-waist-ratio to be more reliable than body mass index in stratifying mortality risk in coronary artery disease patients," Dr. Thais Coutinho, the study's lead author and a cardiology fellow at Mayo Clinic and her co-authors concluded.
"These findings might have significant implications for clinical practice, because it is generally accepted that, if body mass index is normal, no further measures of obesity are necessary, and no lifestyle modifications to induce weight loss might be recommended,"