ROCHESTER, Minn. -- People who are of normal weight but have fat concentrated in their bellies have a higher death risk than those who are obese, according to Mayo Clinic research presented today at the European Society of Cardiology Congress in Munich. Those studied who had a normal body mass index but central obesity -- a high waist-to-hip ratio -- had the highest cardiovascular death risk and the highest death risk from all causes, the analysis found.
"We knew from previous research that central obesity is bad, but what is new in this research is that the distribution of the fat is very important even in people with a normal weight," says senior author Francisco Lopez-Jimenez, M.D., a cardiologist at Mayo Clinic in Rochester. "This group has the highest death rate, even higher than those who are considered obese based on body mass index. From a public health perspective, this is a significant finding."
The study included 12,785 people 18 and older from the Third National Health and Nutrition Examination Survey, a representative sample of the U.S. population. The survey recorded body measurements such as height, weight, waist circumference and hip circumference, as well as socioeconomic status, comorbidities, and physiological and laboratory measurements. Baseline data were matched to the National Death Index to assess deaths at follow-up.
Those studied were divided by body mass index into three categories (normal: 18.5-24.9 kg/m2; overweight: 25.0-29.9 kg/m2; and obese: >30 kg/m2) and two categories of waist-to-hip ratio (normal: <0.85 in women and <0.90 in men; and high: ≥0.85 in women and ≥0.90 in men). Analyses were adjusted for age, sex, race, smoking, hypertension, diabetes, dyslipidemia and baseline body mass index. People with chronic obstructive pulmonary disease and cancer were excluded.
The mean age was 44; 47.4 percent were men. The median follow-up period was 14.3 years. There were 2,562 deaths, o
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