Your Neck Size Can Reveal Your Risk for Heart Disease, Stroke, and Diabetes
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STORY AT-A-GLANCE
A thick neck is more than a cosmetic issue — it’s one of the clearest physical signs of metabolic stress, indicating higher risks for diabetes, heart disease, and stroke
Research shows neck circumference predicts disease risk more accurately than BMI or waist size because it reflects harmful visceral fat stored around vital organs
Fat around the neck and upper torso releases inflammatory chemicals and stress hormones that disrupt blood sugar, blood pressure, and heart rhythm
Visible changes in your neck, such as swelling, lumps, bulging veins, or sagging tissue, offer early clues about thyroid dysfunction, heart strain, or oxygen deprivation during sleep
Tracking your neck size each month is an easy, no-cost way to monitor your metabolic health, helping you take early action before serious conditions develop
When it comes to fat accumulation, most people are concerned about the flab around their waist or the numbers on the scale and how it affects their risk of disease. But did you know that there’s another area of your body that could also serve as a warning sign of illness? It’s your neck.
According to a growing body of research, the circumference of your neck could be an indicator of a higher likelihood of serious metabolic diseases, including heart disease, diabetes, and sleep disorders. Another troubling fact is that even if your body mass index (BMI) index is healthy, just how large your neck is could still be a determining factor in your predisposition to developing these conditions.
Neck Fat Is a Hidden Metabolic Warning Signal
Although a thick neck often gives the impression of strength, especially in athletes, research shows it can also signal underlying health problems that aren’t visible on the surface. A 2022 longitudinal study published in Nutrition, Metabolism & Cardiovascular Diseases journal provided insights on this. A team of researchers from Shanghai found that a simple measure of the fat stored around the upper body, specifically the fat around the neck, may help predict a person’s likelihood of cardiovascular events.1
The study participants — The researchers followed 1,435 adults aged 50 to 80 years old living in Shanghai between 2013 and 2022. Participants were free from cardiovascular or cerebrovascular disease at the start of the study and underwent extensive health evaluations, including body measurements, blood tests, and lifestyle assessments.
The researchers looked at the neck circumference of the participants — They defined the parameters of a “high” neck circumference, namely 38.5 centimeters (cm) or higher for men and 34.5 cm or higher for women.
Over nearly eight years of follow-up, 148 cardiovascular events occurred — These included 62 cases of ischemic heart disease and 86 cerebrovascular events. Men were notably more affected, with a 13.3% incidence compared to 8% in women.
Bigger necks, bigger risks — The researchers noted that with every 1 standard deviation increase in neck circumference, there was an associated 45% higher risk of cardiovascular events. When comparing individuals with high vs. low NC, they found that the risk of heart disease rose by 59% overall.
Men with bigger necks have a nearly doubled risk — In women, however, the association was weaker and not statistically significant. Further analysis revealed that neck size was particularly predictive of ischemic heart disease (IHD), such as heart attack and coronary artery blockage, but was not strongly linked to strokes.
This pioneering research underscores that neck circumference is more than a body measurement — it’s a potential biomarker for cardiovascular health. Most importantly, the predictive ability of NC was found to be comparable to traditional measures like BMI and waist circumference, both of which are standard tools for evaluating obesity-related health risks. As the researchers concluded:
“The identification of other simple measures that reflect obesity and fat distribution may help to better predict the occurrence of CV events in more dimensions.
<label class="hide-text" contenteditable="false">Text within this block will maintain its original spacing when published</label>NC is a new measurement index that is simple, saves time, has little variability, and can reflect upper-body fat content. Emerging evidence has supported the link between NC and multiple CV risk factors such as diabetes, hypertension, and subclinical atherosclerosis.”2
So Why Does Neck Size Matter?
Many people think that neck fat is just a cosmetic issue, but apparently, it can tell so much more about your health. This is because the fat stored in the upper body, especially around the neck, may be metabolically active and closely tied to the body’s inflammatory and hormonal systems.
The researchers believe that neck fat acts like perivascular adipose tissue — This is the type of fat that surrounds blood vessels. When this tissue becomes dysfunctional, it can trigger a cascade of inflammatory signals and oxidative stress, damage the vascular lining, and accelerate the development of atherosclerosis, or the buildup of plaque in arteries.
<label class="hide-text" contenteditable="false">Text within this block will maintain its original spacing when published</label>In short, excess fat in the neck region may be a visible marker of internal metabolic stress that contributes to cardiovascular disease.3
Neck circumference also helps identify visceral fat — This is the type of fat wrapped around your internal organs. Visceral fat is far more harmful than fat carried in the lower body, because it’s highly active, constantly releasing fatty acids, stress hormones, and inflammatory chemicals into your bloodstream.
<label class="hide-text" contenteditable="false">Text within this block will maintain its original spacing when published</label>Over time, this overactivity drives up blood sugar and inflammation, making it harder for your cells to respond to insulin. The result is a steady progression toward metabolic syndrome, a condition that dramatically increases your risk for heart disease and stroke.4
In contrast, BMI only estimates body fat based on height and weight — This is why it often misses the full story. A fit, muscular person might
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