Having an apple-shaped body predicts the risk of heart disease better than obesity and BMI

Waist circumference is a more accurate predictor of heart disease than weight or body mass index (BMI), scientists have said.

A new research from Intermountain Medical Center Heart Institute and Johns Hopkins University brings new evidence that having an apple-shaped body, with the weight centred around the abdomen, increases the risk of developing cardiac dysfunctions, in patients with type 1 and type 2 diabetes. Diabetes itself is an additional risk factor of heart disease.

In contrast, people with diabetes but a pear-shaped body — weight located around the hips— appear better protected against heart problems.

Ventricular dysfunction

While apple-shaped body had already been associated in the past to metabolic syndrome, heart failure and coronary artery disease, this study, presented at the 2016 American College of Cardiology Scientific Session, also highlights for the first time a risk of ventricular dysfunction.

"Our research examined patients with diabetes, who are considered high risk for developing heart disease already, and found that the shape of your body determined if you were at a greater risk to develop left ventricular dysfunction," explains co-author Brent Muhlestein.

Left ventricular dysfunction can lead to heart failure and sudden cardiac arrest, because the left ventricle is weakened, and might not successfully be able to pump blood around the body.

More than BMI

For this latest study, the scientists looked at 200 diabetes patients, without any symptoms of heart disease.

The patients went through CT scans and echocardiography, to assess their left ventricular function. Even without taking into account BMI or body weight, an apple-shaped body — also known as abdominal obesity — was linked to a higher risk of left ventricular dysfunction.

"We specifically found that waist circumference appears to be a stronger predictor for left ventricle dysfunction than total body weight or body mass index," confirms Boaz D. Rosen, the study's lead investigator.

The scientists say further research is needed to confirm these results, especially to follow up the apple-shaped patients, and see it they indeed develop heart diseases after a few years.

Meanwhile, a person who displays such morphology can still benefit from a fat reduction around the abdomen, to prevent potential complications in the long-term. "This study confirms that having an apple-shaped body — or a high waist circumference — can lead to heart disease, and that reducing your waist size can reduce your risks," concludes Dr Muhlestein.