‘Beer belly’ fat linked to early heart damage, with greater risks seen in men

A build-up of fat around the abdomen, commonly referred to as a “beer belly”, may be linked to early signs of heart damage, with men appearing to be at greater risk than women, according to new research.

The study suggests that abdominal obesity may cause more harmful changes to heart structure than overall body weight alone, raising further questions about the reliance on body mass index (BMI) as the main measure of obesity-related risk.

Researchers used advanced cardiac magnetic resonance imaging to examine subtle changes in heart tissue that are not typically detected during routine tests. These changes may represent early cardiac stress, occurring before symptoms of cardiovascular disease develop.

The findings were presented at the annual meeting of the Radiological Society of North America, held in Chicago between 29 November and 3 December, and have not yet been published in a peer-reviewed journal.

The research analysed MRI scans from 2,244 adults aged between 46 and 78. While higher BMI was linked to enlarged heart chambers across both men and women, a high waist-to-hip ratio, an indicator of visceral or abdominal fat, was associated with thickening of the heart muscle and smaller internal chambers.

These changes were particularly pronounced in men and were most evident in the right ventricle, which is responsible for pumping blood from the heart to the lungs. Researchers suggested this pattern could reflect early cardiac strain linked to the mechanical and metabolic effects of abdominal fat.

Lead author Dr Jennifer Erley, a radiology resident at University Medical Center Hamburg-Eppendorf in Germany, said abdominal obesity appears to drive a potentially pathological form of cardiac remodelling.

She explained that this involves thickening of the heart muscle without an increase in overall heart size, meaning the chambers become smaller and hold less blood. Over time, this can impair the heart’s ability to relax properly and may eventually contribute to heart failure.

The study did not examine alcohol intake, despite the use of the term “beer belly”, and researchers stressed that the findings relate to fat distribution rather than drinking habits.

The researchers suggested the more extensive heart changes seen in men may be due to an earlier onset or greater severity of abdominal obesity, although further research is needed to confirm this.

Independent experts said the findings add to existing evidence that visceral fat has a particularly damaging effect on cardiovascular health. Dr Mir Ali, medical director at the MemorialCare Weight Loss Center in California, said abdominal fat is known to increase inflammation throughout the body, disrupt hormone balance and lead to insulin resistance, all of which place strain on the heart and blood vessels.

Dr Kevin Shah, programme director for heart failure outreach at MemorialCare in Long Beach, said visceral fat drives inflammation, insulin resistance and abnormal cholesterol patterns, accelerating the development of cardiovascular disease.

The research adds to growing calls for clinicians to look beyond BMI when assessing obesity-related health risks, particularly as rates of abdominal obesity continue to rise among middle-aged and older adults.