A major new analysis challenges the long-held idea that obese people who carry their extra weight mainly around the middle — those with an “apple” shape — are at greater risk for heart disease than “pears,” whose fat tends to cluster on their thighs and buttocks.
The new report, published online on Friday in The Lancet, pooled data from 58 studies about more than 220,000 people, with a mean age of 58. During the time they were followed, more than 14,000 suffered a heart attack or stroke.
Conventional risk factors like blood pressure, cholesterol, diabetes and smoking were accurate predictors of a heart attack or stroke, but additional information about weight or body shape (ascertained by measuring waist circumference or waist-to-hip ratio) did not improve the ability to predict risk.
“Whatever your shape is doesn’t really matter,” said Dr. Emanuele Di Angelantonio, a lecturer at the University of Cambridge and a member of the Emerging Risk Factors Collaboration, which carried out the study.
He emphasized that being overweight or obese is one of the main modifiable risk factors for cardiovascular disease, and is often an early sign of future risk. But he said, “Whatever form of obesity or overweight you have is all the same.”
