body shape

Your wise grandma may have told you never to judge a book by its cover, but when it comes to heart disease, you should rethink that advice. According to research from Intermountain Medical Center Heart Institute and Johns Hopkins University, a person’s body shape may be a better predictor of future heart disease than either body weight or body mass index.

Scientists looked at 200 patients with type 1 or type 2 diabetes—chosen because they had a high proclivity for developing left ventricular dysfunction—and assessed heart disease risk based on whether each patient carried more weight on the hips or in the abdomen. Subjects underwent CT screenings and echocardiography to measure global systolic longitudinal strain, which is an index of left ventricular function.

So, for a lower risk of heart disease, is it better to resemble an apple or a pear?

The researchers found that greater waist circumference was associated with “progressively worse global strain.” They could not find similar findings with other commonly used measures.

“After including either weight or BMI in the regression model, only waist circumference remained an independent predictor of global [strain], while weight and BMI became non-significant,” the authors wrote.

One of the report’s authors, Brent Muhlestein, MD, concluded, “This study confirms that having an apple-shaped body—or a high waist circumference—can lead to heart disease, and that reducing your waist size can reduce your risks.”

This information was presented at the American College of Cardiology 2016 Scientific Session in Chicago. An abstract appeared in the Journal of the American College of Cardiology (2016; 67 [13_S], 1609).