Being thin and carrying fat around the midsection more deadly than being obese

Abstract: http://www.annals.org/article.aspx?doi=10.7326/M14-2525
Editorial: http://www.annals.org/article.aspx?doi=10.7326/M15-2435

Normal-weight people who carry fat around their midsections have a greater mortality risk than those who are overweight or obese but have normal fat distribution, according to an article published in Annals of Internal Medicine.

Studies have shown that central obesity is associated with increased total and cardiovascular mortality. However, no studies have specifically focused on assessing the mortality risk in persons with normal body mass index (BMI) and central obesity compared with those who are overweight or obese according to BMI. Researchers examined data from a large cohort of Third National Health and Nutrition Examination Survey (NHANES III) participants to compare the total and cardiovascular mortality risks for persons with different combinations of body mass index (BMI) and waist-to-hip ratios (WHR). They found that normal-weight adults with central obesity have the worst long-term survival compared with any group, regardless of BMI. The data showed that a normal-weight person with central obesity had twice the mortality risk of participants who were overweight or obese according to BMI only.

The researchers conclude that persons with normal-weight central obesity may represent an important target population for lifestyle modification and other preventive strategies.