Saturday November 15, 2008 (foodconsumer.org) -- Belly fat is a factor not only for increased risk of heart disease and diabetes, but also for premature death, according to a new study of about 360,000 Europeans.

Tobias Pischon, MD, MPH and colleagues at the Department of Epidemiology, German Institute of Human Nutrition reported their study in the Nov. 12 issue of The New England Journal of Medicine saying that people with the most belly fat were almost twice as likely to die prematurely as people with the least amount.

They found the increased risk was seen even in those who had a large waist circumstance, but no overweight. The finding again suggests that the body mass index may not be an adequate measure for assessing the risk of excess body weight.

It has been known for long that people with excess weight around their middles have a higher risk of heart attacks and strokes.   Recent research also has linked belly fat to a variety of other disease such as cancers, diabetes and age-related brain diseases.

For the study, Pischon and team followed 359,387 European men and women for nearly 10 years. During the follow-up, 14,723 of the participants died.

The researchers were able to associate waist circumference and waist-to-hip measurements with high risk of early death even after overweight and obesity as measured by BMI were adjusted.

They found men and women who had largest waists were twice as likely to die prematurely as those who had the smallest waists. Specifically, for each 2-inch increase in waist circumference, the death risk was increased by 17 percent in men and 13 percent in women.

The current study is not the first to find the association between belly fat and increased risk of early mortality.  One study by Koster A and colleagues from the National Institute on Aging in Bethesda, Maryland has already showed similar associations.

The study published in the June 2008 issue of American Journal of Epidemiology followed 154,776 men and 90,757 women age 51-72 entering the NIH-AARP Diet and Health Study in 1996 to 1997.

The researchers found men with largest waists were 22 percent more likely to die than those with small waists.   For women, the risk was increased by 28 percent.

Among women who had normal BMI, those with largest waist circumferences were 22 percent more likely to die than those with smallest waists and men with largest waists were 20 percent more likely to die prematurely than those with smallest waist circumference.

Another study published in the April 2008 issue of Circulation by Zhang C and colleagues from National Institute of Child Health and Human Development showed that the death risk increased by abdominal a diposity was much greater in those who had cardiovascular disease and cancer.

Men and women with largest abdominal a diposity were 79 percent more likely to die from all causes, 99 percent more likely to die from CVD and 63 percent more likely to die from cancer than those with smallest waists.

Additionally among women with normal weight, those with waist circumference > or = 88 cm were 3 times as likely to die as those with smallest waists and those with waist-to-hip ratio greater than 0.88 were 3.45 times as likely to die as those with smallest ratio.

The researchers concluded "Anthropometric measures of abdominal adiposity were strongly and positively associated with all-cause, CVD, and cancer mortality independently of body mass index. Elevated waist circumference was associated with significantly increased CVD mortality even among normal-weight women."