The findings are in line with other research that has shown a link between excess abdominal fat in normal-weight people and an increased risk of chronic disease.

Older women with a “normal” body mass index (BMI) are still at high risk of early death if they carry extra fat around their bellies, according to a study published online this week in JAMA Network Open.

Specifically, the study found that women aged 50 and older who were considered of normal weight (a BMI of 18.4 to 24.9) but who also had central obesity (a waist circumference of more than 34.6 inches) were a third more likely to die within a two-decade period than normal-weight women without central obesity.

That raised risk was almost identical to what was observed among women who had both obesity (a BMI of 30 or higher) and central obesity — the group considered at highest risk.

Those results underscore that waist size is too often overlooked when determining weight-related health risks, the study’s authors say.

This is the largest study so far to find that normal-weight people with central obesity are at increased risk of early death, according to its authors. It’s an observational study, however, so it can’t prove that body shape is a direct cause of that increased risk.

The study also included only older women, and so its findings may not be applicable to younger women or to men.