A new international study funded by the Medical Research Council (MRC) and the British Heart Foundation (BHF) challenges the idea that obese people with an apple shape (fat deposition on the middle of the body) are at higher risk of heart attacks and strokes than obese people with other types of fat distribution.
The Emerging Risk Factors Collaboration, a consortium of 200 scientists from 17 countries led by the University of Cambridge, monitored the health of over 220,000 adults for almost a decade. The researchers found that although obesity is clearly a major indicator of heart disease in itself, body mass index (BMI), waist circumference, and waist-to-hip ratio each had a similar impact on the risk of heart attack and strokes. This finding contradicts earlier studies which have suggested that those with “central obesity” (as assessed by the ratio of the waist to hip circumference, or “waist-to-hip” ratio) have 3 time greater risk of heart attack than people with general obesity (as assessed by the “body mass index”, or the weight divided by the height squared).
The study reveals that when information on a patient’s blood pressure, history of diabetes and fat levels are available, additional measures of BMI, waist circumference, and waist-to-hip ratio do not add to the picture when predicting their risk of developing cardiovascular disease.
Researchers, from the Cardiovascular Epidemiology Unit at the University of Cambridge, said:
“This study shows that measuring your waist is no better for calculating your cardiovascular risk than calculating your BMI. Excess fat levels remain the main risk factor for heart disease which can of course be influenced by lifestyle choices.
The study underlines the value of GPs continuing to measure cholesterol and blood pressure levels, irrespective of body shape. The findings should help guide medical practice worldwide because national and international guidelines have provided differing recommendations about the value of measures of obesity for prediction of heart disease risk.”
Professor Stephen Holgate chair of the MRC’s Population and Systems Medicine Board said:
“The main concern with obesity is that it leads on to other illnesses. Around three-fifths of type 2 diabetes and one-fifth of heart disease cases are attributable to excess body fat. Six cancers are also linked to obesity. The percentage of UK adults who are obese has increased by 50 per cent in the last decade, and obesity in children continues to grow at an alarming rate. MRC scientists have been working on obesity for more than two decades and by funding this kind of gold standard research, we hope to help arm doctors and patients with the best possible evidence to help prevent diagnose treat diseases associated with obesity.”
The findings of this study do not, of course, alter the key message that fat levels remain the main risk factor for cardiovascular disease which can be influenced by personal lifestyle choices.
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Notes to Editors
The study ‘Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies’ is published on Friday, March 11 in the journal The Lancet.
For almost 100 years the Medical Research Council has improved the health of people in the UK and around the world by supporting the highest quality science. The MRC invests in world-class scientists. It has produced 29 Nobel Prize winners and sustains a flourishing environment for internationally recognised research. The MRC focuses on making an impact and provides the financial muscle and scientific expertise behind medical breakthroughs, including one of the first antibiotics penicillin, the structure of DNA and the lethal link between smoking and cancer. Today MRC funded scientists tackle research into the major health challenges of the 21st century. www.mrc.ac.uk.
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