A major new study using advanced imaging techniques has found that abdominal obesity – known as a “beer belly” – has a greater impact on the heart than simply being overweight. These changes are especially noticeable in men. The findings, presented at the annual meeting of the Radiological Society of North America (RSNA), highlight the need for early risk identification and timely intervention.
The researchers looked at two key indicators: BMI, which measures overall obesity, and waist-to-hip ratio (WHR), which measures the amount of fat in the abdominal area. Based on these data, they examined cardiac MRI images of 2,244 adults aged 46-78 years (43% women) without diagnosed heart disease. Abdominal obesity is associated with the accumulation of visceral fat deep in the abdominal cavity around the internal organs, which is considered a particularly dangerous factor for the cardiovascular system. All participants were part of the long-term German study Hamburg City Health Study. Based on BMI, 69% of men and 56% of women were found to be overweight or obese. In terms of WHR, the picture was even more pronounced: 91% of men and 64% of women met WHO obesity criteria.
BMI was more likely to correlate with increased cardiac chamber size in all participants. However, abdominal obesity was associated with thickening of the heart wall and a decrease in the volume of the chambers. Similar changes were observed to a greater extent in men – especially in the right ventricle, which is responsible for transporting blood to the lungs. Researchers speculate that this may be due to additional stress on the heart due to the effect of visceral fat on respiratory function and pressure in the lungs.
In addition, the obese men showed subtle changes in cardiac tissue that were only noticeable through advanced MRI techniques. They may indicate early heart damage that does not yet show symptoms. This association persisted after adjusting for common risk factors such as high blood pressure, smoking, diabetes and cholesterol levels.
You can determine your WHR at home: just measure your waist at the narrowest point and your hips at the widest, and then divide one value by the other. According to WHO criteria, values above 0.90 in men and above 0.85 in women indicate abdominal obesity and an increased risk of heart disease. The researchers emphasize that it is important for doctors to proactively identify abdominal obesity at an early stage to improve prevention and treatment.