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'Apple shape' heart risk U-turn

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Being overweight and “apple-shaped” might not be as unhealthy as previously thought, medical experts have concluded.

Researchers have performed a U-turn which casts doubt over warnings that carrying a few extra pounds can be especially damaging to the heart.

The study, which was carried out by a consortium of 200 scientists from 17 countries, with funding from the Medical Research Council (MRC) and British Heart Foundation (BHF), concluded that fat concentrated around the waist did not increase the risk of heart attacks and strokes any more than general obesity.

Their findings, which were published in The Lancet medical journal, contradict previous evidence that obese individuals with “apple-shaped” bodies are three times more likely to suffer a heart attack than those with other kinds of fat distribution.

The authors of the new research argue that earlier studies had delivered a misleading message because of design flaws. Experts said the results should help end confusion over different international guidelines.

However, recent research suggested that being fat around the middle is especially bad, increasing the risk over and above that resulting from having a high body mass index (BMI). Some experts have even challenged the usefulness of BMI as an assessment tool, arguing in favour of the tape measure instead.

The new investigation involved examining data from 58 studies which collectively monitored more than 220,000 adults for almost a decade. During this period, more than 14,000 participants suffered a heart attack or stroke.

The authors, led by Cambridge University professor John Danesh, wrote: “Whether assessed singly or in combination, body-mass index, waist circumference, and waist-to-hip ratio do not improve prediction of first-onset cardiovascular disease when additional information exists on blood pressure, history of diabetes, and cholesterol measures.. This finding applies to a wide range of circumstances and clinically relevant subgroups.”

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