Times of India
12 March 2011
By Kounteya Sinha
New Delhi, India

Belly Fat As Bad As General Obesity: Study; Indians May Be Exception: Doctors
An apple, it now seems, is as bad as a pear.
Going by popular wisdom, those with an appleshaped body (fat around belly) were three to four times more prone to heart attacks than those with a pearshaped one (fat build–up around hips and bottom). Now, turning this theory on its head, an international consortium of 200 scientists from 17 countries has found that belly fat is as bad as general obesity. While fat concentrated around waist did not increase the risk of heart attacks and strokes anymore than fat anywhere else.

Publishing their findings in the Lancet on Friday, researchers who studied 220,000 adults over a decade – conducted as many as 58 studies – confirmed that though obesity is a major determinant of cardiovascular disease, body mass index (BMI), waist circumference and waist–to–hip ratio each had a similar impact on the risk of subsequent heart attack and strokes.

BMI, waist circumference and waist–to–hip ratio, whether assessed singly or in combination, do not improve cardiovascular disease risk prediction when additional information is available for systolic blood pressure, history of diabetes and lipids, researchers added.

However, according to Indian experts, the study might not apply to the local population.
Dr Anoop Mishra from Fortis Hospital said, "These findings may not apply to Indians, whose risk of heart disease is higher than their Western counterparts. Heart risk is driven predominantly by high body fat and abdominal obesity."

Dr Mishra added, "Moreover, it is easier to predict risk in a resource constrained country like India by measuring weight and waist girth than by blood pressure and lipids where apparatus, trained personnel and relatively expensive blood tests are required."

Dr Ambrish Mittal from Medanta Medicity said, "Essentially, it is intra–abdominal or visceral fat that is the culprit for all cardiac events and not tummy fat. In India, this kind of fat is high among people. It is common knowledge that abdominal fat is in no way better or worse that fat anywhere else."

The new study found that really powerful indicators were not body weight or shape, but what was going on in the blood. Once blood pressure, a history of diabetes and cholesterol level was taken into account, neither body weight nor shape added much in terms of predicting a cardiovascular event.

"Some earlier studies claimed that people with central obesity have three times greater risk of heart attack than people with general obesity. However, these earlier studies had major design limitations," the researchers claimed.