Overweight or obese has long been known as one risk factor for heart disease. Doctors often take into account in assessing a person's risk of obesity with heart disease.
Obesity among them can be known by measuring BMI (body mass index). This is a simple measurement by dividing the height value to the size of a raised weight. The greater the person's BMI score, the more likely fall into the category of obesity.
Numerous studies have indicated, the high score of BMI associated with lower risk of dying from heart disease or chronic disease. This is a mysterious phenomenon known by the term "obesity paradox"
According to the analysis of experts who published the Journal of the American College of Cardiology, this paradox seems to be explained by the simple fact that BMI is not accurate enough to measure the risks associated with heart disease. Waist size, experts said, it can give a more accurate guide in predicting risk of death due to heart attack patients at a young age or any other cause.
In a study of experts at the Mayo Clinic Rochester, Minnesota USA, patients with heart disease by waist size larger than 35 inches in women or 40 inches in men, has 70 percent greater risk of dying sooner than those for a smaller waistline. The size of a large waist circumference combined with high BMI score even make much greater risk of death.
"The most important thing than the other possibility is the distribution of fat," says researcher Francisco Lopez-Jimenez, MD, a researcher who is also a cardiologist at the Mayo Clinic Rochester.
This latest study provides further evidence that BMI had many limitations in assessing the risk of heart disease, said Jean-Pierre Despres, Ph.D., director of research at the Quebec Heart and Lung Institute, Laval University, Quebec City.
"If you measure your BMI, you'll assess your body shape, you do not see fat distribution," said Despres, who wrote an editorial accompanying the research report.
"I'm not saying that the BMI is not useful. However, we need more than that. BMI is total cholesterol in the fat. We know that there is good cholesterol and bad cholesterol, there are bad fats and good fats."
In addition, continued Despres, BMI also can not distinguish between fat and muscle. Patients who underwent heart or a sedentary lifestyle is less active may record a low BMI because they lose muscle mass, he said, while cardiac patients who have active lifestyles are likely to experience weight gain and increased BMI because they add lean muscle.
These findings also led to debate about the shape of the body and the risk of heart disease. Several other studies indicate, those who have an apple body with fat deposits in the abdominal area at greater risk of suffering from heart disease than those whose body was pear-shaped. But this theory into question by experts.
Lopez-Jimenez and his team analyzed data on about 16,000 heart patients who participated in one of four studies and cardiac rehabilitation program at Mayo Clinic. More than a third of registered patients died during the study, for periods ranging between six months to seven years.
The high BMI values associated with a 35 percent lower risk of death, but have a large waist circumference combined with high value of BMI increased the risk of death doubled.
Why belly fat is so bad? Researchers explain that belly fat is a sign of visceral fat or fat that gathered around the organs in the abdomen or belly. These fats can lead to insulin resistance and increasing the amount of bad cholesterol as well as to stimulate inflammation.
Genetic factors play a strong role in determining whether a person can accumulate fat around the waist, Despres said. He estimates about 30 percent of the population have a tendency to accumulate fat in places that are not desired.
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