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Fat Alone, Not Where It Sits, May Be Key to Heart Problems
Date:3/11/2011

1 in The Lancet.

To explore the predictive power of various heart disease risk factors, the researchers examined data from 58 studies that included more than 222,000 men and women from 17 countries.

None of the study participants had a history of heart disease. Data for most people included BMI readings, waist circumference measurements, waist-to-hip ratios, age, gender, smoking history, blood pressure readings, diabetes history and cholesterol measurements. For nearly 64,000 people, fat deposit assessments were conducted periodically for a number of years.

Over about a decade, more than 14,000 participants had a heart attack or a stroke.

The study concluded that being obese certainly raises the overall risk for heart disease, but that those who carry much of their excess fat in the stomach region do not appear to face a particularly higher risk, compared with those whose fat deposits are distributed differently.

They also found that tracking a person's blood pressure and cholesterol levels, as well as monitoring their history of diabetes, appeared to be best way to assess heart disease risk. When such indicators were readily available, they noted, adding in BMI and waist measurement information did not improve risk diagnosis.

The team was quick to emphasize, however, that being obese should not be deemed any less of a problem when it comes to heart disease. Excess weight, they said, remains a key culprit in the onset of medical conditions that boost the risk for cardiovascular illness.

Because of that, they suggested, calculations of weight, waist circumference and BMI might continue to be of value because the patient portrait they create can help health-care providers promote better diets and lifestyle choices that ultimately reduce risk. An editorial accompanying the study in The Lancet agreed, noting that BMI measurements can still serve as an early warning signal, especially in teens, young adults and
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