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How do weight and body shape affect women’s risk of heart disease?

Dr. Michael W. Gen, MD
Cardiologist (Heart Specialist)

Weight itself is not specifically a risk for heart disease. It’s how women gain weight that is a risk of heart disease. Part of it is the way fat deposits shape the body. A pear-shaped body is always better than an apple-shaped body, where fat is centered in the stomach. An apple-shaped body is also known as central obesity and a pear shape is peripheral obesity. Women with pear-shaped bodies have a lower risk of heart disease. High cholesterol, high blood pressure and, indirectly, weight are correlated with heart disease.

Being overweight is a known risk factor for heart disease. But it is not just your weight that matters: where you carry weight is important as well.

Try this exercise for your heart health. Find your waistline. If you cannot identify a clear waistline because your middle is as big as or bigger than your hips, you are at increased risk for heart disease. The good news is that losing as few as 10 pounds can make a difference. You will also want to measure your body mass index (BMI) - a measure of body fat - to make sure it is where it should be (under 25). You can either talk with your doctor about measuring your BMI or there are helpful tools online.

Think apples and pears. Women shaped like apples are storing more fat around their middles. Pear-shaped women are bigger through their hips, thighs, and bottoms. Recent studies indicate that people shaped like apples are more at risk for heart disease, high blood pressure, and diabetes.

To a certain extent, you can blame your shape on genetics, but you can reduce your risk of heart disease by maintaining a healthy weight no matter what your shape. This is especially critical if your father had a heart attack before age 50 or your mother before 60.

It is a good idea to measure your waist from time to time to make sure it is less than half your height. The risk begins to increase at 31.5 inches with a significant jump at 37 inches. You can also calculate your waist to hip ratio. Divide your waist measurement by the measurement of the widest part of your lower body. If the ratio is less than 0.80 you are a pear. If it is more, you are an apple.

If you are a pear, you are not necessarily in the clear. Carrying more weight in the lower half of your body may offer some protection against heart disease but not if you are overweight. And pears can become apples, too, especially after menopause. There is also some evidence that pear-shaped women are more at risk for other problems, such as ovarian cancer, breast cysts and endometriosis.

If your BMI or body shape is not what it should be, the advice is simple: eat less and exercise more. Doing it is the difficult part. Your doctor can help. You can also visit your local library or surf the Internet for free information, tools and support.

Too much body fat, especially around your middle, increases your risk for heart disease and other serious diseases and conditions, including high blood pressure and diabetes. "Apple-shaped" women with extra fat at the waistline may have a higher risk than "pear-shaped" women with heavy hips and thighs. If your waist is nearly as large as, or larger than, the size of your hips, you may have a higher risk for coronary heart disease.

Federal exercise guidelines now recommend 60 minutes of moderate-activity exercise on most days to avoid gaining weight. If 60 minutes sounds entirely out of the question, then use the Take 10 approach. Be creative and grab an extra 10 minutes of physical activity wherever you can throughout your day.

Belly dancing, shooting hoops, swimming, walking your dog, gardening -- whatever physical activity you enjoy, do it. Your heart will thank you.

Depending on your body type, whether you are apple- or pear-shaped, you may be more likely to develop heart disease. The Nurses' Health Study at Brigham and Women's Hospital found that middle-aged and older women who are apple-shaped are at greater risk for heart disease. According to the study, women with a 38-inch waist or greater are three times more likely to develop coronary heart disease than women with waistlines of 28 inches or less.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.