What you need to know about body shape

Bummed your body has more padding around the hips and thighs? Don’t be.

New research is showing that those of normal weight who stow a little more in this area (a pear shape) may be at a lower risk of heart disease and diabetes than those who carry fat elsewhere, like the stomach or the back (an apple shape).

The German study, published August 1 in the journal Cell Metabolism, focused on those who are lean, with a body mass index (BMI) in the normal range, but have at least two risk factors for heart disease and diabetes. This makes this group of people “metabolically unhealthy,” which affects about 20 percent of normal weight people, according to the researchers.

“Metabolic syndrome is defined as having three of the following five risk factors: central (abdominal) obesity, high blood pressure, elevated fasting blood sugar, high triglycerides and/or low levels of “good” cholesterol (HDL),” says Dr. Ambar Andrade, a heart failure cardiologist with The Advocate Heart Institute at Christ Medical Center in Oak Lawn, Ill.

The researchers pointed out that past studies have shown metabolically unhealthy people are at a higher risk for heart disease, diabetes and early death than some obese people. Obese people without risk factors for heart disease and diabetes are about 25 percent more likely to have heart problems or die an early death than metabolically unhealthy people. And the metabolically unhealthy have a 300 percent higher risk for heart problems or early death compared to normal-weight people with a BMI of 18.5 to 24.9 who don’t have risk factors for heart disease and diabetes – meaning they are metabolically healthy.

Nearly 1,000 people (including normal weight, overweight and obese people) participated in this study. Each participant was at increased risk of heart disease or diabetes, based on their weight, a family history of diabetes or higher-than-typical glucose levels. They underwent tests to determine their precise body fat mass and fat distribution for the new analysis.

When analyzing information from all of these participants, the researchers found that, among normal-weight people, the biggest predictor of unhealthy metabolism was not storing extra fat in the lower body. Storing excess fat in the lower body appeared to be protective against metabolic problems for normal-weight people.

Researchers said that this may be because when fat is stored in the lower body, it stays put; but fat stored elsewhere in the body could end up in more “dangerous” places, such as around the heart or other organs.

“This study reinforces what we have known for quite some time; metabolic syndrome without obesity is associated with a risk of cardiovascular disease; however, obesity without metabolic syndrome does not necessarily result in an increased cardiovascular risk,” says Dr. Andrade.

Dr. Andrade cautions that the German population may have important genetic or environmental differences compared to an average American and therefore, we may not completely be able to conclude the same percentages for our patients.

“Staying healthy is more than focusing on a specific body type, because let’s face it, we are not in control of where our bodies decide to store fat,” says Dr. Andrade. “We should all aim to live a healthy lifestyle. At the very least, try to follow a heart healthy diet and exercise 30-45 minutes three to four times a week to prevent key modifiable risk factors such as obesity, diabetes and hypertension.”

“Once certain disease processes have developed, we cannot prevent the negative consequences of these risk factors; we can only try to keep them from progressing,” she states.

Dr. Andrade says that recognition of a health risk is the first step, and that your cardiologist can be your biggest ally and cheerleader in combating these deadly risk factors. “I am very aggressive about helping my patients meet with nutritionists, enroll in cardiac rehab and/or refer them to appropriate sub-specialists who can help provide medical care in a multi-disciplinary setting.”

“I do believe that once patients recognize the burden these risk factors can have on their quality of life and longevity, they find the will to make the necessary lifestyle changes for a happy and healthy life,” says Dr. Andrade.

Find out your risk for heart disease by taking our simple and easy Heart Risk Assessment.