FROM high cholesterol to heart failure, being fat has long been associated with poor heart health.
But having a “beer belly” alone can cause more damage to your heart than being generally overweight, researchers now warn.
Abdominal obesity was found to be more harmful for heart health than just being overweightCredit: Getty
Using advanced imaging, German scientists found abdominal , which is often referred to as a “beer belly”, is linked with more harmful changes in the heart’s structure than overall body weight – especially in men.
But there are proactive measures doctors and patients can take to identify potential risks and protect the heart, the findings of their study suggest.
These include preventing abdominal fat accumulation through regular exercise and sticking to a balanced diet.
Study lead author Dr Jennifer Erley said: “Abdominal obesity, a high waist-to-hip ratio, is associated with more concerning cardiac remodelling patterns than high alone.
“It appears to lead to a potentially pathological form of cardiac remodelling, concentric hypertrophy, where the heart muscle thickens but the overall size of the heart doesn’t increase, leading to smaller cardiac volumes.
“In fact, the inner chambers become smaller, so the heart holds and pumps less blood.
“This pattern impairs the heart’s ability to relax properly, which eventually can lead to heart failure.”
Taking into account BMI, a measure of general obesity calculated from a person’s weight and height, and waist-to-hip ratio (WHR), a measure of abdominal obesity, the researchers studied cardiovascular MRI images of 2,244 German men and women, aged 46 to 78, without known cardiovascular disease.
Dr Erley explained abdominal obesity reflects an accumulation of visceral fat, which is stored deep around internal organs and strongly linked to harmful cardiovascular effects.
Using BMI, 69 per cent of men and 56 per cent of women in the study were overweight or obese.
According to WHR, 91 per cent of the men and 64 per cent of the women met the World Health Organisation (WHO) criteria for obesity.
Dr Erley, radiology resident at University Medical Centre Hamburg-Eppendorf, said: “General obesity based on BMI was more often linked to enlarged heart chambers across all participants.
“Abdominal obesity was associated with thickening of the heart muscle and smaller heart chamber volumes.
“These changes were more prominent in men, particularly in the right ventricle, which pumps blood to the lungs.
“This may reflect early cardiac stress on the heart related to how abdominal fat affects breathing and lung pressure.”
Obesity was also linked to “subtle” heart tissue changes in men, detectable only with advanced cardiac MRI, potentially signalling early heart stress before symptoms or diagnosable disease.
The associations persisted even after accounting for other cardiovascular risk factors, including high blood pressure, , and .
How to get rid of a beer belly
DOING aerobic exercise while eating a healthy diet is the best way to lose belly fat and overall body fat.
This will help to create a calorie deficit (where you use more calories than you consume), which promotes fat loss over time.
Aerobic exercise includes any activity that raises your heart rate such as walking, dancing, running or swimming.
This can also include doing housework, gardening and playing with your children. Other types of exercise such as strength training, Pilates and yoga can also help you lose belly fat.
Seated exercise can be an effective way to burn calories and increase your aerobic fitness levels if you find walking or standing difficult.
NHS guidelines suggest aiming for at least 150 minutes of moderate intensity activity per week.
Aim to exercise at a level where you become a little out of breath but can still speak in full sentences.
Take time to warm up before and to cool down after exercise. If you begin to feel more breathless, slow down and rest.
If you are new to exercise, start slowly and build up gradually. You don’t need to exercise at a high intensity to burn calories.
Stress and lack of sleep can also affect fat loss, because they can lead to increases in the stress hormone cortisol, affecting appetite.
Stress-relieving and good sleep-promoting activities can include mindfulness, breathing techniques, and gentle exercise like tai chi and yoga.
Source: British Heart Foundation
Dr Erley said: “The sex-specific differences suggest that male patients may be more vulnerable to the structural effects of obesity on the heart, a finding not widely reported in earlier studies.
“Rather than focusing on reducing overall weight, middle-aged adults should focus on preventing abdominal fat accumulation through regular exercise, a balanced diet and timely medical intervention, if necessary.”
She said the more extensive heart damage seen in men could be due to an earlier onset of more severe abdominal obesity, or the cardioprotective effect of oestrogen in women, although more research is needed.
Dr Erley says people can use a tape measure to calculate their WHR at home by dividing their waist circumference at its narrowest point by their hip circumference at its widest point.
A ratio above 0.90 for men and 0.85 for women is an indicator of abdominal obesity and is associated with increased risk of cardiovascular disease, according to the WHO.
The research team also encouraged doctors to be proactive in checking and flagging abdominal obesity as early as possible.
Dr Erley added: “From the perspective of a radiologist, when we see this cardiac remodelling pattern, we currently think of cardiomyopathy, hypertensive or some other form of disease, but we don’t clinically draw the line to obesity in our reports.
“This study should alert radiologists and cardiologists to be more aware that this remodelling could be attributed independently to obesity.”
Eze Chidiebere Paul
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