It is not the weight that one carries, but where one carries it, according to new research, which warns that the paunch – the bane of many in middle age – is responsible for hundreds of thousands of deaths globally each year.
However, the cause is not a straightforward heart attack, but rather one where the heart suffers a sudden, often fatal malfunction of its electrical circuitry, according to the research published in the medical journal Heart.
Known as sudden cardiac death (SCD), it occurs without warning, and is caused by a sudden unexpected loss of heart function, which rapidly reduces blood flow around the body, including to the brain.
"It is distinct from a heart attack, and kills around 300,000 people in the USA every year," according to the research led by cardiologist Dr Selcuk Adabag, Veterans Affairs Medical Centre, Minneapolis, in Minnesota. "Those with the highest waist-to-hip ratio had double the risk of SCD of those with a normal ratio," the paper, published by Heart – which is one of the stable of journals published by the British Medical Journal – says.
Obesity has long been known to play a role in cardiac diseases, including SCD, but the evidence now suggests it is the distribution of weight into “a persistent midriff bulge” that is the most dangerous factor.
Midriff fat is believed to be more critical than fat stored elsewhere, because of its influence on inflammation. “Those with the largest waists and hips combined are twice as likely to be affected,” the paper says.
Noting obesity has long been associated with unfavourable changes in cardiovascular health, including SCD, researchers sought to discover whether the location of that weight in the body carried particular risks.
Some 15,000 middle-aged American men and women aged 45-64 were examined as part of the atherosclerosis risk in communities study, which has tracked the rcauses of artery narrowing for 35 years.
The participants were examined in 1987, then again in 1990-92, 1993-5, 1996-8, and 2011-13, where their weight, height and waist and waist-to-hip ratio numbers were recorded. In all, 235 suffered sudden cardiac death. One in three was female.
Most displayed other risk signs, such as high blood pressure and high cholesterol, but they also had a higher BMI (body mass index), larger waist circumference, and a larger waist-to-hip ratio – an indicator of central obesity – than those who did not suffer SCD.
