‘Apple shape’ heart risk doubts

Doubts have been raised over the idea that being overweight and “apple shaped” increases heart attack risk.A study in the Lancet found the risk of heart attack was not increased by fat being concentrated around the waist.

It contradicts previous work that found overweight people with “apple shaped” bodies were three times as likely to suffer heart attacks than those with more generally distributed fat.

But experts warned obesity was bad for the heart, no matter where the fat was.The authors of the study say that obesity is still a major risk factor for heart disease, but they argue there is confusion about the best way to measure it.

One well known measure is the Body Mass Index (BMI) which relates weight to height.But previous research had also suggested that people with fat deposits in the middle of their body – known as an “apple shape” – were at much greater risk.

This method uses the “waist-to-hip” ratio and compares the distance around the hips and waist to measure what is known as central obesity.It can tell if someone is “apple shaped – with a bulging middle – or “pear shaped”, with a narrower waist and fatter hips and bottom.

Others have suggested concentrating on a measurement of the waist alone.But this new study, which looked at 220,000 people over almost 10 years, found that all three measures indicated risk of heart attack or stroke.

The study was led by Professor John Danesh from Cambridge University and concluded that none of the measures on their own improved the prediction of heart disease, especially when doctors could also assess other warning signs like blood pressure and cholesterol levels.

Writing in the Lancet, Professor Danesh said: “Whether assessed singly or in combination, body-mass index, waist circumference, and waist-to-hip ratio do not improve prediction of first-onset cardiovascular disease when additional information exists on blood pressure, history of diabetes, and cholesterol measures.”

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