Hidden Belly Fat Can Trigger Heart Attacks Even in Healthy Individuals

New Delhi | September 23, 2025 Heart Attack in a Healthy Young Adult A 32-year-old researcher, who maintained a normal weight, did not smoke or drink, and played table tennis on weekends, recently suffered a heart attack. On the surface, he lacked traditional cardiovascular risk factors. However, frequent dining out had led to abdominal obesity, a hidden fat around the stomach and core organs, which proved to be a critical trigger for his heart attack. Understanding Abdominal Obesity Abdominal obesity, often called belly fat, is a major threat to cardiovascular health. Unlike typical white fat, which primarily stores energy, this type of fat is metabolically active. It releases inflammatory chemicals and hormones that can cause insulin resistance, high blood pressure, and elevated LDL (“bad”) cholesterol. These factors collectively damage artery walls, stiffen blood vessels, and increase the likelihood of a heart attack. Why Belly Fat Is Dangerous for the Heart A layer of fat called epicardial fat exists between the heart’s muscular wall (myocardium) and the pericardium, the membrane surrounding the heart. Excess epicardial fat releases inflammatory chemicals and oxidized LDL particles, promoting plaque deposition in the arteries. Chronic inflammation damages the endothelium—the inner lining of blood vessels—making LDL particles stickier. The heart also works harder to supply excess fat tissue with blood, increasing wall tension and stretching the chambers, which raises the risk of plaque rupture and clot formation. In severe cases, fat can infiltrate heart muscle, leading to structural changes and heart failure. Risk Factors for Abdominal Obesity Abdominal obesity is largely acquired and can result from a combination of sedentary lifestyle, poor dietary habits, stress, and genetics. Even individuals with normal BMI can carry excessive visceral fat—a condition sometimes referred to as “skinny fat”—that significantly elevates cardiovascular risk. Research Insights Research underscores the dangers of belly fat. A decade ago, a study at KMC Manipal showed that individuals with excess abdominal and epicardial fat had higher risk of coronary blockages. Similarly, a 2018 study published in the Journal of the American Heart Association tracked 500,000 women and found that waist-to-hip ratio was a stronger predictor of heart attacks than BMI. A 2020 study of 22,000 individuals confirmed that abdominal obesity increases the risk of first-time and recurrent heart attacks, as well as strokes. Reducing Abdominal Fat Addressing belly fat requires a balanced lifestyle rather than extreme measures. Regular physical activity, strength training, and a healthy, clean diet can help reduce visceral fat. Adequate sleep, avoiding processed foods, and limiting alcohol and tobacco also contribute. Strength training is particularly effective because increasing lean muscle mass boosts calorie burn, both at rest and during exercise. Key Takeaway Even in individuals who appear healthy and maintain a normal weight, abdominal obesity can silently increase the risk of heart disease. Awareness, lifestyle modifications, and regular monitoring of waist circumference can help prevent early heart attacks and protect cardiovascular health. Hidden Belly Fat: A Silent Heart Threat Even healthy-looking individuals with normal weight can be at risk for heart attacks due to hidden belly fat, also known as abdominal or visceral fat. This fat, surrounding the stomach and internal organs, releases inflammatory chemicals and bad cholesterol, which can damage arteries and strain the heart. A recent case of a 32-year-old non-smoker and active young adult highlights this danger. Experts recommend regular exercise, strength training, balanced nutrition, adequate sleep, and avoiding processed foods to reduce visceral fat. Monitoring waist size is as important as body weight for long-term heart health.