The stubborn fat lying around one’s midsection is not only unsightly and annoying but is also a health risk.

According to a new study, people with a normal body mass index or BMI but carry excess weight around their middle have the highest death risk from any cause, compared with the overweight or obese who carry weight somewhere else.

BMI Versus Hip-To-Waist Ratio

A team from Loughborough University in the United Kingdom tracked over 42,000 participants every year for a decade based on the annual Health Survey for England, and Scotland’s Health Survey.

They set out to see if a large-scale data analysis would confirm earlier findings from smaller studies, which noted that normal-weight people with stomach fat fared worst even against the overweight with the same central obesity.

In the past, researchers argued that BMI is no longer the most reliable way to predict one’s health risks. They came up with something potentially more telling, namely the waist-to-hip ratio or one’s waist measurement divided by hip measurement.

A resulting high ratio is deemed troublesome, even if one’s weight is within normal range.

In 2011, a study from the Mayo Clinic discovered that excess weight carried in one’s midsection could result in diabetes, stroke, and cardiovascular conditions.

Study Findings

Based on BMI as well as waist-to-hip ratio, the new study categorized the subjects into different groups: normal weight; normal weight with fat in midsection; overweight; overweight with fat in midsection; obese; and obese with fat in midsection.

Compared with normal-weight subjects without central obesity, only normal weight and obese subjects with central obesity had the greater risk for so-called “all-cause mortality.” Never mind what their BMI was — all subjects with tummy fat had increased risk for cardiovascular death.

"It is yet further evidence that even if you are within a 'healthy' BMI range but you carry weight around your stomach your health is still at risk,” said study author and professor Mark Hamer in a statement, calling for those with central obesity to start taking steps toward fat reduction.

The findings were discussed in the journal Annals of Internal Medicine.

Obesity remains the leading cause of premature death among Americans, despite the general scope of advanced treatment. It steals 47 percent more life-years than tobacco when compared with other conditions, a new study stated.

In recent years, however, researchers have been more critical of belly fat, especially that which is stored inside the abdominal cavity. A study from last year, for instance, showed that the density of stomach fat is as significant as how much fat is present around someone’s midsection.

"What's really interesting is that we show that an increase in the amount of stomach fat and a lower density fat is associated with worse heart disease risk factors — even after accounting for how much weight was gained," said lead researcher Dr. Caroline Fox, who is also former senior investigator for the National Heart Lung and Blood Institute.

While both levels of fat under skin and fat accumulated inside the abdominal cavity adversely affected heart health, the latter — also known as visceral adipose fat — increased cardiovascular risk even worse.