A number of people who feel that they are healthy at their current weight typically know that their belly or gut is where they may store the bulk of their fat. Visceral fat surrounds body organs and is much more dangerous than subcutaneous fat, which may hang off our belt buckles or upper arms. Having a "beer belly," however, seems to serve as a good marker for people with high amounts of visceral fat based on studies using CT/MRI.

New research now confirms just how dangerous these areas (central abdominal fat/love handles) may be for our health: Those individuals who are at their normal weight, but who have concentrated "central" obesity were more than 50% likely to die from all causes compared to those who were obese, according to results of a 14 year study recently.

In this study, researchers reviewed data on over 12,785 patients over a 14 year period, evaluating body mass index (BMI) and waist to hip ratios (WHR- a circumference of your belly in relation to your hips) as measures of cardiac risk.

Researchers divided study participants into three categories of BMI: normal, overweight, and obese. The participants were also divided into 2 categories of waist to hip ratios (WHR): normal and high. (Normal WHR was designated as less than 0.85 in women and 0.90 in men and high as greater 0.85 in women and 0.90 in men).

There were 2,652 deaths of people in the study at the end of the 14 year period. Upon sub group analysis, those with a normal BMI but excessive belly fat (High WHR), had the highest chance of dying based on the six subgroups assessed. This was the case even after accounting for risk factors for early mortality such as sex, age, race, smoking, diabetes and hypertension. What was most striking was that the normal BMI/high central obesity had a higher risk of death than all obese participants, regardless of their waist to hip ratios.

The risk of dying for participants with a normal BMI but high WHR was 2.1 times those with a normal BMI and WHR. For patients who were obese, the risk of dying was still about 1.4 times higher compared to normal controls.

Dr. Lopez Jimenez, the lead author of this study, stated that, what was most striking is that the "the level of risk attributed to normal weight but central obesity appears to be similar to smoking a pack a day."

Visceral or belly fat is highly active metabolically, and can be a contributing factor in development of insulin resistance.

Fat concentrated in the legs and buttocks leads to a safer metabolic profile: lower blood sugar, triglycerides, cholesterol, and insulin levels.

Presented at the European Society of Cardiology on August 27, 2012.

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