Abdominal Adiposity and Risk of Heart Disease—Reply

In Reply: As Drs Seidell and Bouchard suggest, increased abdominal adiposity may be due to factors such as hyperandrogenism. However, recognizing that individuals with abdominal adiposity are at higher risk of heart disease is important, whether or not the underlying etiologic factors can be treated. Dietary changes, weight loss, and/or physical activity have been shown to decrease abdominal adiposity^1- 2; however, most interventions that reduce abdominal adiposity also have an effect on weight. Data on whether change in WHR will improve cardiovascular outcomes is scant. One 3-year study of a dietary modification and modest exercise program vs a standard low-fat diet achieved a significant reduction in WHR with a moderate decrease in weight. Cardiovascular risk profiles improved and incidence of cardiac events, as well as all-cause mortality, was significantly reduced in the intervention group.³