The Grapevine

Your Muffin Top Could Turn Lethal: Large Waist To Hip Ratio Linked To Sudden Cardiac Death

belly fat
People with the highest waist to hip ratio have double the risk of sudden cardiac death compared to people with a normal ratio. Photo courtesy of Shutterstock.

The invincible Dr. Oz has been talking about the dangers of belly fat — women refer to it as a muffin top — since his guest hosting days on Oprah. Now, a new study from Veterans Affairs Medical Center in Minneapolis supports his dire warnings. People with the highest waist to hip ratio, the findings indicate, have double the risk of sudden cardiac death (SCD) compared to people with a normal ratio. 

“Abdominal obesity, measured by waist-to-hip ratio, appears to be directly associated with increased risk of sudden cardiac death,” wrote Dr. Selcuk Adabag, Division of Cardiology, and his co-authors in the conclusion of their study.

Sudden cardiac death kills around 300,000 people in the United States every year. It is distinct from a heart attack, though it similarly may occur without warning. SCD is caused by a sudden and unexpected loss of heart function, which rapidly reduces blood flow throughout the body, including to the brain. While general obesity has been linked to SCD, the researchers of the current study wanted to find out if midriff bulge might carry a greater risk of SCD. After all, belly fat often includes, or is the manifestation of visceral fat, which clogs the spaces between our abdominal organs. This is key to its ability to ruin our health.

Real World Evidence

To understand the relationship between abdominal fat and SCD, Adabag and his co-researchers studied almost 15,000 middle aged men and women, all participants in the Atherosclerosis Risk in Communities (ARIC) study. The participants include more women (55 percent) than men and slightly more than a quarter (26 percent) were African-American. Since 1987, ARIC has been tracking the causes of artery narrowing in middle aged Americans. All the participants underwent a detailed health assessment in 1987-9, with follow-up examinations in four waves, most recently during 2011-13. These included measurements of weight, height, waist circumference, and the waist to hip ratio.

During the monitoring period, 253 sudden cardiac deaths occurred, with those who died being in their mid-50s, on average. Unsurprisingly, they all tended to have a higher prevalence of known risk factors for cardiovascular disease, such as high blood pressure and high cholesterol, with one in every three being female and four out of 10 being of African-American heritage. Those who died also had a higher BMI (body mass index), larger waist circumference, and a larger waist to hip ratio — an indicator of central obesity or visceral fat — than participants who did not die of SCD.

Of these obesity measures, waist to hip ratio was the most strongly associated with SCD risk. Importantly, unlike BMI and waist circumference, the link between waist to hip ratio and SCD was independent of existing coronary heart disease, diabetes, or high blood pressure and other known risk factors.

Source: Adabag S, Huxley RR, Lopez FL, et al. Obesity related risk of sudden cardiac death in the atherosclerosis risk in communities study. BMJ. 2014.

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