HealthDay News — Individuals with central obesity but of normal weight according to body mass index (BMI) have a higher risk of premature mortality than overweight or obese people, according to research published online Nov. 10 in the Annals of Internal Medicine.

For the study, a team led by Francisco Lopez-Jimenez, MD, a professor of medicine at the Mayo Clinic in Rochester, Minn., used data from a national survey to compare the risk of premature death among 15,184 adults. The mean follow-up time was 14 years. The researchers looked at BMI and waist-to-hip ratios.

The researchers found that a normal-weight male with more fat around the waist had an 87% increased risk of death during the study period compared to a man who was normal weight without central obesity. Compared to overweight or obese men (as measured solely by BMI, without specific waist size information), a normal-weight man with central obesity had more than twice the risk of dying early. Normal-weight women with central obesity had nearly a 50% increased risk of death during the study period versus a normal-weight woman whose weight was more equally distributed throughout her body. Compared to obese women (measured by BMI only), the normal-weight women with abdominal fat had a 32% higher risk of early death.

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“These new data provide evidence that clinicians should look beyond BMI. Although assessing for total fat mass with BMI to identify patients at greater cardiovascular risk is a good start, it is not sufficient,” writes the author of an accompanying editorial.


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  2. Poirier P. The many paradoxes of our modern world: is there really an obesity paradox or is it only a matter of adiposity assessment? Ann Intern Med. 2015; doi: 10.7326/M15-2435