The six-year study of more than 1,000 adults found people with a "spare tire" in their midsection had a greater risk for heart disease compared to those with visible flab elsewhere under the skin—or "love handles." The study looked at abdominal fat quantity and quality.

The researchers cautioned, however, that the study only showed an association between belly fat and potential heart disease, not that belly fat causes heart disease.

The team collected data on 1,106 men and women, average age 45, who took part in the long-running Framingham Heart Study. All agreed to have their stomachs scanned to determine the amount of their belly fat.

Over six years, the researchers found that increases in the amount of fat and decreases in fat density were linked with changes in the risk for heart disease. Each additional pound of fat was associated with newly developed high blood pressure, high triglycerides and metabolic syndrome, which includes high cholesterol and increased odds of type 2 diabetes, the researchers said.

Although increased fat was linked to new and worsening heart disease risk factors overall, the risk was greater for fat inside the abdomen, compared with fat just under the skin, the researchers said.

People whose deep stomach fat increased had significant rises in high blood sugar, high triglycerides and low levels of HDL cholesterol, Fox's team said. These associations remained significant even after the researchers accounted for changes in weight and waist size.

The report was published in the Journal of the American College of Cardiology.

Some experts say identifying the location and type of body fat provides valuable information—perhaps better than that from body mass index (BMI), a current tool that calculates body fat based on weight and height.

Abdominal tissue scanning is emerging as a new way to assess heart disease risk and address many of the limitations of the simple BMI measurement, author said. "It may be time to retire the BMI in favor of these novel adipose tissue deposits in clinical and research practice," author added.

http://content.onlinejacc.org/article.aspx?articleid=2555924