Researchers have warned that having a “beer belly” or tummy fat alone can cause more damage to the heart than being generally overweight.

Using advanced imaging, German scientists found that abdominal obesity, which is often referred to as a “beer belly”, is linked with more harmful changes in the heart’s structure than overall body weight, especially in men.

The findings, presented at the annual meeting of the Radiological Society of North America (RSNA), also point to actions patients and doctors can take to identify potential risks and intervene earlier to protect the heart.

Taking into account BMI, a measure of general obesity calculated from a person’s weight and height, and waist-to-hip ratio (WHR), a measure of abdominal obesity, the researchers studied cardiovascular MRI images of 2,244 adults aged 46 to 78 (43% female) who did not have cardiovascular disease.

Abdominal obesity reflects an accumulation of visceral fat, which is stored deep around internal organs and strongly linked to harmful cardiovascular effects. All of the study participants are part of the ongoing Hamburg City Health Study, a long-term population study in Germany.

According to BMI, 69% of males and 56% of females in the study were overweight or obese. Using WHR, 91% of the males and 64% of the females met the World Health Organisation (WHO) criteria for obesity.

General obesity based on BMI was more often linked to enlarged heart chambers across all participants. Abdominal obesity was associated with thickening of the heart muscle and smaller heart chamber volumes.

These changes were more prominent in men, particularly in the right ventricle, which pumps blood to the lungs. This may reflect early cardiac stress on the heart related to how abdominal fat affects breathing and lung pressure.

Obesity was also linked to subtle heart tissue changes in men, detectable only with advanced cardiac MRI, potentially signalling early heart stress before symptoms or diagnosable disease. These associations persisted even after accounting for other cardiovascular risk factors, including high blood pressure, smoking, diabetes and cholesterol.

Study lead author Jennifer Erley, M.D., radiology resident at University Medical Centre Hamburg-Eppendorf, Germany, stated that abdominal obesity appears to lead to a remodelling of the heart, with the heart muscle thickening and the inner chambers becoming smaller, reducing the amount of blood it can pump and potentially leading to heart failure.

“Rather than focusing on reducing overall weight, middle-aged adults should focus on preventing abdominal fat accumulation through regular exercise, a balanced diet and timely medical intervention, if necessary,” he declared.

Naveed Sattar, professor of Metabolic Medicine at the University of Glasgow, told The Independent: “Men put their fat in their tummies faster than women, which means men have a higher risk of type 2 diabetes, heart disease and heart failure than women.

“Women have a better capacity to store fat in their skin, arms, and legs, and that fat is locked up. Whereas when you start putting fat in the tummy, you are also putting fat into organs where it shouldn’t be, such as the liver, muscle, pancreas and heart. Therefore, men’s buffering capacity for weight is not as good as women’s.” (Nigerian Tribune)

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