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Belly fat linked with repeat heart attacks
The authors recommend using waist circumference in clinical settings to identify first-time heart attack patients at increased risk of recurrent events.
Heart attack survivors who carry excess fat around their waist are at increased risk of another heart attack, according to research published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).
Prior studies have shown that abdominal obesity is an important risk factor for having a first heart attack. But until now, the association between abdominal obesity and the risk of a subsequent heart attack or stroke was unknown.
“Patients are typically put on a stringent medical treatment regimen after their first attack to prevent second events (called secondary prevention),” said study author Dr. Hanieh Mohammadi of the Karolinska Institute, Stockholm, Sweden. “Secondary prevention works through reducing risk factors associated with heart attack and stroke such as high blood sugar, lipids and blood pressure. It was previously unknown whether abdominal obesity is a risk factor for recurrent events among patients on secondary prevention treatments.”
The study, the largest and most definitive ever conducted on this topic, followed more than 22,000 patients after their first heart attack and investigated the relation between abdominal obesity (measured by waist circumference) and the risk for recurrent cardiovascular disease events. The researchers specifically looked at events caused by clogged arteries, such as fatal and non-fatal heart attack and stroke. Patients were recruited from the nationwide SWEDEHEART registry and followed for a median of 3.8 years.
Most patients – 78% of men and 90% of women – had abdominal obesity (waist circumference 94 cm or above for men and 80 cm or above for women).
Increasing abdominal obesity was independently associated with fatal and non-fatal heart attacks and strokes, regardless of other risk factors (such as smoking, diabetes, hypertension, blood pressure, blood lipids and body mass index [BMI]) and secondary prevention treatments. Waist circumference was a more important marker of recurrent events than overall obesity.
Dr. Mohammadi said: “The reason abdominal obesity is very common in patients with a first heart attack is that it is closely linked with conditions that accelerate the clogging of arteries through atherosclerosis. These conditions include increased blood pressure, high blood sugar and insulin resistance (diabetes) as well as raised blood lipid levels.”
“Our results, however, suggest that there may be other negative mechanisms associated with abdominal obesity that are independent of these risk factors and remain unrecognised,” she added. “In our study, patients with increasing levels of abdominal obesity still had a raised risk for recurrent events despite being on therapies that lower traditional risk factors connected with abdominal obesity – such as anti-hypertensives, diabetes medication and lipid lowering drugs.”
This was the first study of its kind to analyse men and women together and separately. The relationship between waist circumference and recurrent events was stronger and more linear in men. In women the relationship was U-shaped, meaning that the mid-range waist circumference (rather than the lowest) was the least risky. It must be noted that the mid-range waist circumference for women included in the study was above the cut-off traditionally recognised for abdominal obesity (80 cm).
Dr. Mohammadi noted: “There were three times as many men in the study compared to women, contributing to less statistical power in the female group. Therefore, more studies are needed before definite conclusions can be drawn according to gender, but this is a start.”
Regarding possible reasons for the different results between sexes, she said: “Some studies have suggested that abdominal obesity may be more directly associated with the evil visceral fat (fat that sits around your organs) in men compared to women. In women it is thought that a greater portion of the abdominal fat is constituted by subcutaneous fat which is relatively harmless.”
Dr. Mohammadi concluded: “Abdominal obesity not only increases your risk for a first heart attack or stroke, but also the risk for recurrent events after the first misfortune. Maintaining a healthy waist circumference is important for preventing future heart attacks and strokes regardless of how many drugs you may be taking or how healthy your blood tests are. Abdominal obesity can be tackled by eating a healthy and balanced diet and regular physical activity.”
The authors recommend using waist circumference in clinical settings to identify first-time heart attack patients at increased risk of recurrent events.
NewsMakers
Stress more strongly linked to poorer quality of life among adults with multiple chronic conditions
We should consider both the clarity of health information and the need to address sensitivity to stress when supporting people managing several long-term chronic health conditions.
Perceived stress is more strongly associated with poorer health-related quality of life among adults living with two or more chronic conditions than among those without chronic conditions, according to a study from the University of Eastern Finland.
The study also found that adults who found it easier to access, understand and use health information also tended to report less stress. The study suggests that we should consider both the clarity of health information and the need to address sensitivity to stress when supporting people managing several long-term chronic health conditions.
Stress and quality of life are more closely linked among people with several chronic conditions
Participants reported whether they had any of 21 long-term conditions, including common health problems such as high blood pressure, high cholesterol, migraine and back problems. Among survey respondents, nearly three in four reported at least one condition, and almost half reported two or more.
Perceived stress describes how unpredictable, difficult to control or overwhelming people felt their lives had been during the previous month. Health-related quality of life was assessed with the EQ-5D-5L instrument through five aspects of everyday health: mobility, self-care, usual activities, pain or discomfort and anxiety or depression.
The researchers compared three groups of adults, those with no chronic conditions, those with one condition and those with two or more conditions. In all three groups, higher stress was associated with poorer quality of life, even after accounting for age, gender, education, employment and financial strain. The association became progressively stronger with increasing chronic disease burden. It was strongest among people with two or more conditions, for whom a given increase in perceived stress was associated with an approximately twofold larger decline in quality of life compared with people without chronic conditions. This comparison describes a statistical association, not a causal effect.
“Living with several conditions can mean managing appointments, medication routines and information from different services. Our findings suggest that stress deserves particular attention when considering quality of life among people facing these demands,” says Postdoctoral Researcher Jing Zhou from the University of Eastern Finland.
Better health literacy linked to lower stress
Health literacy refers to people’s ability to find, understand, evaluate and use health information when making everyday health decisions. Adults with higher health literacy tended to report less stress, and this association was similar across all three groups.
The main difference between the groups emerged in how closely stress was associated with quality of life, rather than in the relationship between health literacy and stress. In the overall statistical analysis, much of the observed association between health literacy and quality of life was linked to perceived stress.
The findings draw attention to the potential value of addressing health information needs, practical demands and stress together. Clear communication, help navigating services and better coordination of care may be particularly relevant for people managing multiple conditions, although the study did not test the effectiveness of these approaches.
“From a health policy perspective, making health information easier to understand is important, but people managing several conditions may also face substantial practical demands. In future, we need to search for effective solutions to better coordinate care, provide easier access to support and focus more attention on stress, as these efforts together can help to improve the well-being of people with chronic conditions,” says Professor Tomi Mäki-Opas of the University of Eastern Finland.
The researchers emphasise that the study cannot establish cause and effect because health literacy, perceived stress and quality of life were measured at a single point in time. Poorer health may increase stress, while stress may also contribute to poorer quality of life. Longitudinal and intervention studies are needed in future to determine which approaches combining accessible health information, coordinated services and stress-sensitive support can effectively improve quality of life.
The study, published in Health Promotion International, used data from the PROM 2024 online survey of 4,003 adults aged 19 to 79 living in Finland. Data collection was funded by NextGenerationEU and the research by YUFE (Zhou) and the Research Council of Finland (Mäki-Opas).
NewsMakers
A longevity diet is not just about eating less—it is what, when, and for whom
Choose high-quality carbohydrate sources, partially replace red and processed meat with plant proteins, favor unsaturated fats, eat enough fiber—and treat diet as one strand of a life woven together with sleep, circadian rhythm, exercise, and social connection.
“Eat less, live longer” has a firm footing in the laboratory: dietary restriction extends lifespan across species, from yeast to mammals. But a review published in The Innovation Nutrition argues that the slogan travels badly to the dinner table—and that what people eat may matter at least as much as how much.
Drawing on more than thirty large prospective cohorts and meta-analyses, the authors—Jintao Huang, Dejian Huang, and corresponding author Ziyun Wu of Shanghai Jiao Tong University—assemble a case for “precision diets”: optimizing macronutrient quality, sources, and proportions rather than cutting total energy.
Severe restriction, they note, is hard to sustain and carries risks including reproductive impairment, menstrual irregularities, osteoporotic fractures, and cardiac arrhythmias.
The evidence is organized around four nutrients. Carbohydrates follow a U-shaped curve: in several populations, moderate intake—about 50 to 55 percent of energy—is associated with lower all-cause mortality, with whole grains, legumes, vegetables, and whole fruits consistently outperforming refined grains and sugar-sweetened beverages.
Protein shifts with age: in midlife, higher intake of animal protein correlates with higher mortality risk, whereas plant protein shows favorable associations; after 65, when sarcopenia and frailty take over, the recommendation flips toward moderately more high-quality protein from fish, legumes, and other sources.
For fats, type beats quantity—unsaturated fats from nuts, olive oil, and fish are linked to better cardiovascular outcomes, while industrial trans fats should be limited. Dietary fiber, at roughly 25 to 29 grams per day, shows one of the most stable associations with lower mortality, likely mediated through short-chain fatty acids produced by gut microbes.
The authors caution repeatedly against overreach. Cohort studies show associations, not causation. Clinical ketogenic diets are not ordinary low-carb diets and belong, they argue, in medically supervised, time-limited treatment rather than everyday longevity practice.
The framework’s age-stratified ratios—19 to 35, 36 to 64, and 65 onward—are research scaffolding, not validated prescriptions.
The review’s most forward-looking section is a feedback loop: because postprandial glucose, insulin, and triglyceride responses can differ up to tenfold between individuals eating identical meals, precision nutrition should mean continuous assessment—continuous glucose monitors, microbiome and multi-omics profiling, wearables, and artificial-intelligence-assisted diet design—rather than one personalized menu generated once.
Time-restricted eating adds a temporal dimension. Early personalized-nutrition trials have improved short-term metabolic markers, but the authors stress that no tool has yet demonstrated longer healthspan; that will take multi-year randomized trials, enriched for adults over 75, non-European genetic backgrounds, and low- and middle-income regions.
The public-health message that survives the caveats is deliberately unglamorous: choose high-quality carbohydrate sources, partially replace red and processed meat with plant proteins, favor unsaturated fats, eat enough fiber—and treat diet as one strand of a life woven together with sleep, circadian rhythm, exercise, and social connection.
NewsMakers
Dance training influences how the brain processes facial emotions
Dance expertise shapes both the visual and embodied perception of emotions, providing new evidence of how specialised motor and artistic training can influence human perception.
Dance training can influence how we perceive not only movement but also everyday emotional expressions, according to new research from the Centre for Cognition and Neuroscience at City St George’s, University of London.
The study, published in the journal Cerebral Cortex, found that dance expertise influences the brain’s early visual and somatosensory responses when observing emotional facial expressions.
The findings build on Professor Beatriz Calvo-Merino’s previous research, which showed for the first time that motor training, such as dance expertise, can modulate how we perceive actions. This latest study broadens that understanding, suggesting that the effects of dance training extend beyond familiar, dance-specific movements to influence the perception of emotions in other people’s faces.
Professor Calvo-Merino, Professor of Cognitive Neuroscience at City St George’s, said: “The impact of dance expertise goes beyond movement and taps into social perception mechanisms, such as face processing and emotions. This is fascinating as it provides direct evidence for the impact of the arts on social cognition.”
To investigate the relationship between dance expertise and emotion processing, the researchers recruited 26 professional or trainee ballet dancers from dance schools across London, alongside 26 people without dance experience.
The team, formed by Dr Vasiliki Meletaki, Professor Bettina Forster and Professor Calvo-Merino, recorded participants’ brain activity using specialised equipment as they completed a task involving the identification of emotions and whether faces were perceived as male or female. Participants were shown images of happy, afraid and neutral facial expressions.
Professor Forster developed the EEG analysis approach used to examine when and where brain responses to emotional expressions differed between dancers and non-dancers, allowing the researchers to investigate how dance expertise influences both visual and somatosensory processing.
The results revealed distinct patterns of brain activity between dancers and non-dancers, indicating that dance expertise influences how emotional expressions are processed through both visual and somatosensory systems.
In particular, dancers showed early differences in their brain responses to neutral and emotional faces, suggesting a distinctive way of processing emotional expressions. They also demonstrated early somatosensory responses to facial emotions, particularly neutral and afraid faces.
By contrast, non-dancers showed emotional effects primarily at later stages of emotional processing compared to dancers.
As a result, the findings suggest that dance expertise shapes both the visual and embodied perception of emotions, providing new evidence of how specialised motor and artistic training can influence human perception.
Professor Bettina Forster said: “What is particularly interesting is that dance expertise appears to influence how the somatosensory cortex responds to emotions expressed by others. This suggests that our own bodily experiences can shape how the brain processes other people’s emotions, providing further evidence for the embodied nature of emotion perception.”
Dr Vasiliki Meletaki added: “It was exciting for us to find empirical evidence for the profound impact professional dance training has on how dancers perceive not only their bodies and dance movements but also other people’s emotional expressions.”
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