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Excess Weight Ups Risk of Death, No Matter Where It Collects

But too much abdominal fat poses a bigger threat, study finds,,,,

WEDNESDAY, Nov. 12 (HealthDay News) -- Whether you're shaped like an apple or a pear, if you're overweight, you have a higher risk of dying than someone of normal weight, a new European study says.

But, those who tend to collect their weight around the middle -- apple-shaped -- face an even higher risk of death than those whose excess weight tends to settle in their hips and thighs -- pear-shaped.

"We found that a large waist circumference is related to a higher risk of death even for individuals who have the same BMI [body mass index, a ratio of weight to height]," said the study's lead author, Dr. Tobias Pischon, of the German Institute of Human Nutrition. "Therefore, you could say that adipose [fat] accumulation in the abdominal region is even more detrimental than just having an elevated BMI level," he added.

Previous research had linked abdominal fat with a higher risk of chronic diseases. But past research generally hadn't assessed the risk of death in those who were overweight and those who were overweight with more abdominal fat, according to background information in the study.

The new research, published in the Nov. 13 issue of the New England Journal of Medicine, included almost 360,000 people from nine European countries who were part of the European Prospective Investigation into Cancer and Nutrition (EPIC).

In addition to weight information and whether or not the study participants had died, the researchers also adjusted the data for education level, smoking status, alcohol consumption, physical activity and height.

During a follow-up period of almost 10 years, slightly less than 15,000 people enrolled in the study had died.

Those with the lowest risk of death were men with a BMI of 25.3 and women with a BMI of 24.3. A body mass index between 25 and 29.9 is considered overweight, and a BMI over 30 is considered obese, according to the U.S. National Heart, Lung, and Blood Institute.

Men with a BMI between 30 and 35 had a 24 percent increased risk of death compared to normal weight men. And women with a BMI between 30 and 35 had a 17 percent increased risk of death compared to their slimmer counterparts, Pischon said.

When the researchers factored in abdominal fat, they found that men with the largest waist circumference had more than double the risk of death, and women with the largest waist circumference increased their risk of death by 78 percent.

"Having a large waist circumference is related to a higher risk of death. This is even true for people who -- in terms of BMI -- would be considered as being normal weight," Pischon said.

Dr. Marc Siegel, an internist at New York University Langone Medical Center in New York City, said, "Fat is a problem. Obesity of all kinds correlates with heart disease, stroke, diabetes, and more. But, abdominal fat is a more rudimentary indicator of risk.

"The bottom line is, if you want to live a long and healthy life, eat right, exercise and reduce stress. Fat is bad for you, period," Siegel added.

More information

To learn more about the health risks of too much weight, visit the Weight-control Information Network.

SOURCES: Tobias Pischon, M.D., M.P.H., German Institute of Human Nutrition, Nuthetal, Germany; Marc Siegel, M.D., internist, New York University Langone Medical Center, and associate professor, New York University School of Medicine, New York City; Nov. 13, 2008, New England Journal of Medicine

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