- A new study found that abdominal fat, or a “beer belly,” may be linked to harmful changes in heart structure, particularly in males.
- The researchers say that a high waist-to-hip ratio may be associated with more concerning cardiac remodeling than BMI scores alone.
- The study utilized advanced cardiac MRI imaging to identify subtle changes in heart tissue that wouldn’t otherwise be visible.
Abdominal obesity, often referred to as a “beer belly,” is an accumulation of visceral fat that is stored around the internal organs.
Visceral fat is a type of fat stored within the abdominal cavity that can accumulate in the arteries, contributing to the development of cardiovascular disease.
A new study found that abdominal obesity is not only linked to harmful changes in heart structure, but that these effects were more apparent among males.
The researchers used advanced cardiac MRIs to detect beer belly-associated heart changes that could signal early heart stress before the onset of cardiovascular disease or symptoms. The study, however, did not examine beer consumption among the subjects.
The findings were recently presented at the annual meeting of the Radiological Society of North America (RSNA), held from November 29 to December 3, in Chicago, IL. The study has not yet been published in a peer-reviewed scientific journal.
“Abdominal obesity, a high waist-to-hip ratio, is associated with more concerning cardiac remodeling patterns than high body mass index (BMI) alone,” lead study author Jennifer Erley, MD, a radiologist resident at the University Medical Center Hamburg-Eppendorf, Germany, said in a press release.
For the study, researchers examined MRI scans of 2,244 adults ages 46 to 78.
The study found that obesity, as measured by BMI scores, was more strongly associated with enlarged heart chambers across all participants, regardless of sex.
Abdominal obesity, or “beer belly,” was more associated with a thickening of the heart muscle and smaller heart chambers.
These abdominal obesity-related changes were more prominent in males, particularly in the right ventricle. The right ventricle pumps blood to the lungs.
The researchers suggested their findings may reflect early cardiac stress related to how abdominal fat affects breathing and lung pressure.
“It appears to lead to a potentially pathological form of cardiac remodeling, concentric hypertrophy, where the heart muscle thickens, but the overall size of the heart doesn’t increase, leading to smaller cardiac volumes,” Erley said in the press release.
“In fact, the inner chambers become smaller, so the heart holds and pumps less blood. This pattern impairs the heart’s ability to relax properly, which eventually can lead to heart failure,” she continued.
The researchers suggest that the more extensive heart damage seen in males may be an earlier onset of more severe abdominal obesity, but more research is needed ot confirm this theory.
Mir Ali, MD, medical director at MemorialCare Weight Loss Center in Long Beach, CA, who was not involved in the study, said the study’s findings reaffirm that abdominal obesity has a negative impact on cardiovascular disease. Ali wasn’t involved in the study.
“Though there is no one clear explanation for this, it is surmised that abdominal fat increases inflammation throughout the body, affects normal hormonal balance, and leads to insulin resistance, to name a few,” Ali told Healthline.
“All of these changes affect all organs, but the heart and blood vessels are particularly sensitive to these changes.”
Kevin Shah, MD, program director at MemorialCare Heart Failure Outreach in Long Beach, CA, who wasn’t involved in the study, echoed these remarks.
“Visceral fat drives inflammation, insulin resistance, and abnormal cholesterol patterns — all of which accelerate cardiovascular disease,” Shah told Healthline.
BMI is a calculation of a person’s weight in kilograms divided by the square of their height in meters. For adults ages 20 and older, a BMI of
Your waist-to-hip ratio can be calculated by dividing the measurement of your waist circumference at its narrowest point by the measurement of your hips at their widest point.
A ratio of 0.90 for males and 0.85 for females is an indicator of abdominal obesity and may be associated with an increased risk of cardiovascular disease.
BMI does not account for fat distribution in the body. The waist-to-hip ratio can better indicate any increase in abdominal fat. It may also be easier to calculate than BMI.
“Waist-to-hip ratio — and even simple waist circumference — adds important information that BMI alone misses. BMI cannot distinguish between muscle and fat, and it doesn’t capture fat distribution,” Shah said.
He added that the waist-to-hip ratio and waist circumference should be included in routine assessments. BMI, while useful, should not be the only measure guiding risk discussions.
Not only is visceral fat associated with cardiovascular disease, but it’s also linked to higher risks of other chronic conditions, including:
While it can be difficult to target abdominal obesity, there are some strategies that may help you lose weight and lower your risk of other chronic diseases.
“Doing abdominal exercises does not necessarily lead to weight loss in the abdomen,” Ali said. “Losing weight overall, whether it’s with diet, medications, or surgery, can lead to a reduction in abdominal fat.”
Shah emphasized the importance of nutrition quality, resistance training, and overall physical activity. He offered the following tips and suggestions:
- strength training 2 to 3 times per week
- adding 20–30 minutes of daily walking
- reducing refined carbohydrates and increasing protein intake
“Small, consistent lifestyle changes have a measurable impact on waist size and long-term heart health,” Shah said.
