Apple or pear? Excess fat -- no matter where --is bad

Any excess fat — whether it's distributed throughout your body or concentrated at your waistline — is bad for your heart health, according to a new review of studies.

The results show that a high body mass index (BMI) can predict heart risks just as well as a large waist, the review said.

The findings challenge previous work that has shown that abdominal obesity is better at predicting heart disease than overall obesity.

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"This study shows that [belly fat] is just the same as other fat" when analyzing heart disease risks, said study researcher Dr. Emanuele Di Angelantonio, a lecturer in medical screening at the University of Cambridge in England.

The study was published online today (March 10) in the journal Lancet.

Similar predictors
Researchers analyzed health data gathered in 58 previous studies including 221,934 people who were monitored for 10 or more years. By the end of those studies, 14,297 participants had had a heart attack or stroke, the study said.

The study found that waist circumference, waist-to-hip ratio and BMI measurements were all similar in their ability to predict a person's risk of developing heart disease or stroke.

This shows that "whether you carry weight around your waist, or any other way, it doesn’t matter. Whatever way you carry your fat is bad," Di Angelantonio said.

Even though any measure of obesity — BMI, waist circumference or hip-to-waist ratio — seems to equally predict heart risks for doctors, being "apple-shaped" may still spur more heart problems than being "pear-shaped," said Rachel Huxley, an associate professor of epidemiology at the University of Minnesota School of Public Health, who wrote an editorial that accompanied the study.

Some studies have shown that belly fat is more strongly associated with metabolic problems, such as insulin resistance and Type 2 diabetes, than fat in other parts of the body, Huxley said.

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That's why "measures of central obesity were considered to be more informative than BMI, in terms of predicting later cardiovascular risk," which the new study showed to not be true, Huxley told MyHealthNewsDaily.

A different kind of fat
When people gain weight in their thighs, new fat cells are created that function normally. But when people gain weight in their bellies, existing fat cells expand, and lose their ability to store and release fat properly, said Dr. Michael Jenson, an endocrinologist at the Mayo Clinic who published a study on the subject last year in the journal Proceedings of the National Academy of Sciences.

A potential explanation for the new finding is that waist circumference and waist-to-hip ratio can sometimes be calculated differently across studies, whereas BMI is universally calculated the same way, Jenson said.

Therefore, waist circumference "won't pop out as being that helpful," Jenson told MyHealthNewsDaily.

Still, being mindful of waist size is a good way for the average person to keep track of his or her health, he said.

"People are afraid to step on the scale, but they do have to put their pants on every day," Jenson said.

Pass it on: Measuring any sort of obesity, not just the fat around your mid-section, equally well predicts your heart disease risks, a new study suggests.

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Follow MyHealthNewsDaily staff writer Amanda Chan on Twitter @ AmandaLChan.