Carrying a few extra inches around your stomach area may mean more than it's time to go on a diet. New research has shown that several additional inches added to the waist -- even if weight is still within the normal range -- could increase the risk of unhealthy plaque build-up in the arteries of he heart, as well as the rest of the body.

According to studies conducted at the University of Texas Southwestern Medical Center in Dallas that appeared in the August 21, 2007 Journal of the American College of Cardiology (JACC), the relationship of the waist measurement to the hip measurement was very closely tied to early, hidden signs of heart disease -- more so than other common measures of obesity, such as body mass index (BMI) or the waist circumference alone.

One of the key investigators of the study, Dr. James de Lemos, associate professor of internal medicine stated that the study shows that people who develop fat around the middle have more atherosclerotic plaque than those who have smaller waist-to-hip ratios. He went on to say that BMI was used as the primary measure of obesity rather than alternative measures such as waist circumference or waist-to-hip ratio, and the latter measures have demonstrated stronger correlations for cardiovascular risk than BMI.

The study involved approximately 3,000 men and women between the ages of 18 and 65. Researchers found that people with the largest waist-to-hip (WHR) ratio had a twofold increase in the incidence of calcium deposits -- a strong indication that future cardiovascular ailments including heart attacks may occur.

Dr. Raimund Erbel of the West German Heart Center Essen said that the WHR can be easily measured, taking only a few minutes and giving more precise information on the presence of coronary artery calcium than BMI or waist circumference. He added that although BMI is used more often, it does not identify patients with central obesity, which seems to be related to metabolic syndrome, insulin resistance and abnormal cholesterol levels; more important is that other measures of obesity did not discriminate beyond traditional risk factors whereas WHR did.

Dr Erbel said the results are astonishing and may be influenced by the age distribution of the study. "During life, the likelihood of coronary artery calcium increases more in men than in women. It may be that in an older population, in which the duration of risk factor exposure is longer and the likelihood of coronary artery calcium is higher, the association between obesity as measured by BMI and waist circumference and signs of early atherosclerosis is stronger," he said.

This research was conducted as part of the Dallas Heart Study, a multiethnic, population-based study of more than 6,000 patients in Dallas County designed to examine cardiovascular disease. The multiyear study aims to gather information to help improve the diagnosis, prevention and treatment of heart disease.

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