A large research study has found that carrying extra fat around the belly—often called a “beer belly”—may be more harmful to the heart than simply being overweight in general.
This is especially true for men. The study was presented at the annual meeting of the Radiological Society of North America (RSNA).
The researchers used advanced heart imaging to look at how belly fat affects heart structure. They found that a high waist-to-hip ratio, which measures how much fat is stored around the abdomen, was linked to more serious changes in the heart than a high body mass index (BMI), which measures overall body weight based on height and weight.
Dr. Jennifer Erley, the study’s lead author and a radiology resident in Germany, explained that belly fat seems to lead to a condition called “concentric hypertrophy.”
In this condition, the heart muscle becomes thicker, but the inside chambers of the heart become smaller. This means the heart holds and pumps less blood, and over time, it becomes harder for the heart to relax properly. This can eventually lead to heart failure.
The researchers studied MRI scans of the hearts of 2,244 adults between the ages of 46 and 78. None of the participants had been diagnosed with heart disease. The study is part of the ongoing Hamburg City Health Study in Germany.
They found that while general obesity (measured by BMI) was often linked to larger heart chambers, abdominal obesity (measured by waist-to-hip ratio, or WHR) was linked to thicker heart muscle and smaller chambers.
This pattern was seen more often in men, especially in the right side of the heart, which sends blood to the lungs. This may be because belly fat can affect breathing and pressure in the lungs, putting more stress on the heart.
Belly fat also appeared to cause early signs of heart tissue changes in men. These changes were only visible with advanced imaging and might be signs of early heart problems, even before symptoms begin.
These results remained the same even when researchers considered other risk factors like high blood pressure, smoking, diabetes, and high cholesterol.
Dr. Erley said that men might be more sensitive to the effects of belly fat on the heart than women. This could be because men develop belly fat earlier or because women may have some protection from estrogen.
Instead of just trying to lose weight in general, adults—especially middle-aged men—should focus on keeping belly fat under control. This can be done through regular physical activity, eating a balanced diet, and seeing a doctor when needed.
You can check your waist-to-hip ratio at home using a tape measure. Measure your waist at its narrowest point and your hips at the widest point. Then divide the waist number by the hip number. A ratio above 0.90 for men and 0.85 for women means abdominal obesity and a higher risk for heart disease, according to the World Health Organization.
The researchers also want doctors to pay more attention to belly fat when checking for heart problems. Radiologists, who look at medical images, should consider that certain heart changes may be caused by obesity, even if they don’t yet see signs of heart disease.
This study is a strong reminder that where fat is stored on the body matters. Paying attention to belly fat could help doctors find and treat heart issues earlier, leading to better health outcomes.
If you care about heart health, please read studies about blood thinners that may not prevent stroke in people with heartbeat problems and this diabetes drug may protect heart health in older veterans.
If you care about heart health, please read studies about why light-to-moderate drinking is linked to better heart health and reconsidering the long-term use of high blood pressure beta blockers after a heart attack.
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