Key Takeaway:
- Belly Fat and Heart Disease may be linked more closely than BMI alone suggests.
- High waist circumference or waist-to-hip ratio was linked to 15%-50% higher cardiovascular risk.
- Experts recommend combining BMI with waist measurements, healthy eating, and regular exercise.
A new study published Aug. 11 finds that abdominal fat measures may better identify future Belly Fat and Heart Disease risk than body mass index alone, particularly among people with normal or overweight BMI.
Study Links Abdominal Fat To Higher Cardiovascular Risk
Researchers analyzed health data from nearly 260,000 people who had measurements for waist circumference or waist-to-hip ratio and tracked cardiovascular outcomes including heart attack, stroke, heart failure, atrial fibrillation and cardiovascular death.
People who had a clinically high waist circumference or waist-to-hip ratio despite having a healthy-weight or overweight BMI faced a 15% to 50% higher risk of some cardiovascular outcomes, according to the study. The findings highlight the potential connection between Belly Fat and Heart Disease.
The findings add to evidence that BMI, which uses height and weight to estimate body size, does not fully capture where fat is stored. Current cardiovascular guidance also recommends assessing BMI and waist circumference because the measures provide complementary information about health risk.
“BMI is not a great measure of abdominal or visceral fat,” said Michael J. Blaha, the study’s senior author and director of the Cardiometabolic Clinic at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease.
Visceral Fat Can Affect Metabolic Health
Visceral fat is stored around abdominal organs and is metabolically active. Blaha said people without obesity based on BMI can still have substantial abdominal fat that may increase their metabolic and cardiovascular risk, making Belly Fat and Heart Disease an important health consideration.
Cheng-Han Chen, a cardiologist who was not involved in the study, said visceral fat can release substances that contribute to inflammation and interfere with blood sugar, blood pressure, and cholesterol regulation.
The findings are consistent with broader cardiovascular research showing that central adiposity can provide risk information that BMI alone may miss. A 2026 JACC meta-analysis also found that measures of central adiposity were associated with coronary artery calcium and its progression.
“Patients with normal weight or overweight can still have high metabolic and cardiovascular risk,” Blaha said, adding that newer approaches increasingly consider abdominal fat alongside BMI when assessing Belly Fat and Heart Disease risk.
Experts Recommend Measuring Waist Correctly
Doctors say waist circumference can provide useful information, but measurements must be taken consistently. Mir Ali, a bariatric surgeon and weight-loss specialist who was not involved in the study, said people may obtain different results when measuring at different points around the abdomen.
“Talking to [their] primary doctor to show them the correct way to measure their waist circumference is a way to start,” Ali said.
Ali also cautioned that targeted exercises such as sit-ups do not specifically remove visceral fat. Overall weight loss can reduce abdominal fat, while Chen recommends a balanced diet low in saturated fat and added sugar, regular physical activity, adequate sleep, and stress management.
The study does not mean BMI has no value. Rather, the findings support using BMI together with measures such as waist circumference to provide a more complete assessment of cardiovascular and metabolic risk, including the potential risks associated with Belly Fat and Heart Disease.
