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Having too much belly fat or abdominal obesity may put you at a higher risk of premature death from all causes, a new study suggests.

The study led by Tobias Pischon, MD, MPH and colleagues at the Department of Epidemiology, German Institute of Human Nutrition showed that people with the most belly fat were almost twice as likely to die prematurely as people with the least amount.

For the study reported in the Nov. 12, 2008 issue of The New England Journal of Medicine, 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, indicators of abdominal obesity, with a higher 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.

It has been known for long that people with excess weight around their middles have a higher risk of heart disease and diabetes.    But increased risk of premature death in those with large amounts of belly fat should be understandable.

One previous study reported in the October 15, 2006 issue of the journal Cancer Epidemiology Biomarkers & Prevention suggests that women with excess abdominal fat may face a higher risk of dying from breast cancer.

For the study, researchers at the University of North Carolina at Chapel Hill looked at data for 1,254 women ages 20 to 54, who were diagnosed with invasive breast cancer between 1990 and 1992, to determine how abdominal fat may affect the chance of survival from breast cancer in women.

The researchers found that women whose waist-to-hip ratios were greater than 0.80 were 52 percent more likely to die from the cancer than women with normal ratios. A high waist to hip ratio indicates a high amount of abdominal fat.

Additionally, they said that obesity seems to have an overall adverse effect on surviving cancer. Women with a body mass index greater than 30, indicative of obesity, had a 48 percent greater chance of dying from breast cancer than women with a normal BMI that is below 30.

For those who had both a high BMI (higher than 25) and a high waist to hip ratio (higher than 0.8), their risk of dying from breast cancer increased by 92 percent, according to the study.

Another study reported in the May, 2005 issue of the journal, Stroke suggests that the amount of abdominal fat is a stronger indicator of stroke risk. The study found that men with lots of abdominal fat are at a higher risk of a fetal stroke.

The study researchers at Tel-Aviv University and the Chami Sheba Medical Center in Tel-Hashomer, Israel followed more than 9,100 Israeli men aged 40 years or older for 23 years. By the end of the study, 316 study participants had died of a stroke.

The study found that men with excess abdominal fat, regardless of their body mass index (BMI), were more likely to die of a stroke compared with those with their body fat evenly distributed.

Overall, a higher BMI indicated a higher risk of having a fatal stroke. However, the amount of abdominal fat was a stronger indicator of stroke risk.

(Also contributed by Diana Simms and John Roberts)