Researchers have found that neck circumference may be a strong indicator of heart disease risk, even among those with a normal weight.
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The researchers explained that those with wider necks were more likely to show early signs of insulin resistance, a metabolic condition linked to an increased risk of type 2 diabetes, heart attacks, and strokes.
The results suggest that where the body stores fat may be just as important as the weight itself in the long run.
Doctors typically rely on body mass index (BMI), calculated from height and weight. A BMI of 25 or higher is considered overweight, while 30 or higher is classified as obese. However, previous research has suggested that fat distribution may be a better indicator of certain health risks than weight alone, meaning that even those with a healthy BMI may still be at risk.
The study, presented at the American Heart Association's Scientific Sessions in Chicago, analyzed health data from 197 healthy adults recruited from a hospital in Philadelphia. Researchers measured the participants' neck and waist circumference before testing them for insulin resistance, a condition in which the body's cells become less responsive to the hormone insulin, which regulates blood sugar.
Insulin resistance is linked to metabolic syndrome, a cluster of conditions including high blood pressure, high blood sugar, and unhealthy cholesterol levels, which can damage blood vessels. Previous research has found that people with metabolic syndrome are nearly twice as likely to have a heart attack or stroke compared to those without. Importantly, these problems can develop even in people who are not overweight, meaning they may be unaware of the risk.
Dr. Cynthia Cheng, the lead author of the study, said that while neck circumference is not usually measured in healthcare, it is a quick, accurate, and convenient measurement that reflects upper body fat, and a practical and standardized alternative to body mass index or waist circumference, and can be easily measured by the patients themselves.
She added that neglecting to look at fat stored around the neck could mean missing early warning signs of metabolic problems and delaying opportunities to prevent cardiovascular disease, explaining that routine measurement could facilitate early identification of patients at increased risk and support effective preventive cardiac care.
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