Large waistline - A cause for worry

Large waist size in middle-aged people puts them at the risk of developing artery-clogging plaques, even if their weight is within the normal range. Calcium is a component of the plaques that mark atherosclerosis, a hardening and narrowing of the arteries that can trigger cardiovascular events, such as heart attack and stroke. People with larger waist size in relation to their hips are at a greater risk of calcium build-up in their arteries, resulting in atherosclerosis. Doctors can measure coronary artery calcium using non-invasive imaging; to check whether atherosclerosis is present and how severe it is. Previous studies too have linked excess fat in the abdomen, with the risk of developing heart attacks. Researchers at the University of Texas Southwestern Medical Center studied 2,744 middle-aged adults, and evaluated their body mass index (BMI), waist circumference, waist-to-hip ratio, CT scan for calcium in the coronary arteries and MRI scans to study atherosclerotic plaque in the largest artery of the body. They found that the waist-to-hip ratio was more closely associated with calcium scores and the risk of atherosclerosis than was BMI. Calculated as the ratio of weight to height, BMI is often used to determine if a person is over- or under-weight. But waist-to-hip ratio is more precise than BMI in predicting heart risks, as the latter may not accurately reflect a person's amount of body fat. A muscular man, for example, may have a high BMI but not a high percentage of body fat. The findings showed that abdominal fat might be key in the early stages of heart disease, when people have plaque in their arteries but no chest pain or other symptoms. This implies that one important way by which larger waist-to-hip ratio confers risk is through plaque build-up. In fact, a potbelly seems to raise this risk even when a person's overall weight is normal. Thus, less fat in the abdomen is better. However, waist-to-hip ratio was also more closely associated with atherosclerosis than a simple measure of waist circumference. People with large hips were found to have lower odds of some heart disease risk factors. This could be explained by the fact that excess fat in the hips and thighs may actually be protective against heart disease, as long as the waistline remains trim. Thus, people need to maintain a healthy diet and exercise regularly throughout life.