Women who are ‘pear-shaped’ may be healthier than ‘apple-shaped’

All these postmenopausal women fell within the normal range of Body Mass Index.

This is the first study to look at where fat is stored in the body and its association with risk of CVD in postmenopausal women with normal BMI (18.5 to less than 25 kg/m2).

The study involved 2,683 women who were part of the Women's Health Initiative in the US, which recruited almost 162,000 postmenopausal women between 1993 and 1998 and followed them until February 2017. There was a median of 17.9 years of follow-up.

Research by New York's Albert Einstein College of Medicine observed 2,683 women who weren't overweight and had already gone through the menopause to show that those with waists that were wider than their hips - typically increasing body fat - were three times as likely to have a heart attack or stroke.

And the top quarter of pear-shaped women were 40 per cent less likely to get heart disease than people who store little fat in their legs.

Women who had the most pronounced "pear" shape, with more fat on their thighs, were 38 percent less likely to develop heart disease during the study than women with the least amount of fat on their upper legs.

While being overweight has always been linked to a higher risk of heart disease, the risks associated with excess fat for people with a body mass index (BMI) in the healthy range aren't as clear, researchers note in the European Heart Journal.

"Whether the pattern of the associations could be generalizable to younger women and to men who had relatively lower regional body fat remains unknown", Dr. Qui said.

The scientists said "apple-shaped" women should try to lose belly fat and become more "pear-shaped".

Among 1000 women who kept their fat around the middle constant but increased their leg fat from less than 42 per cent to more than 49 per cent, approximately three CVD cases could be avoided each year.

"In routine clinical practice, BMI is a common approach to assessing a person's risk of cardiovascular disease".

It's also not clear what dietary or exercise changes might help women shed fat specifically around their belly or shift where their body stores fat to transform their shape from an "apple" to a "pear", Qi said.

The authors of the new study conclude that their findings "highlight the importance of fat distribution beyond overall fat mass in the development of cardiovascular disease". "These are important research directions for future population studies".

They were all taking part in a major USA study, the Women's Health Initiative, which began in the mid-1990s, and had regular scans to check fat, muscle and bone density.

However, the researchers stress that the findings only show that where body fat is stored is associated with the risk of CVD, not a causal relationship. In addition, the distribution of body fat is determined by both genetics and exposure to environmental factors, such as diet and exercise. The researchers ascertained incident CVD events (coronary heart disease, and stroke).

The reason leg fat might be protective is not well understood, but it is not causing problems elsewhere in the body.

Importantly, the new study suggests that leg fat may have a positive effect on atherosclerosis risk, they wrote, adding that this needs to be studied in-depth.



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