Kaiser Permanente, Oakland, CA-
In the past six weeks there have been 4 major studies all telling us what we already know. This belly fat is going to be the death of us, yet!
No exaggeration here. That jiggly poochy stuff that appears around our middles in midlife is now blamed for strokes in women ages 35-54, increased dementia in later life, dying earlier from cancer or heart disease, increasing your risk of metabolic syndrome and type-2 diabetes. And you don't have to be overweight for it to cause you trouble!
So what's so special about belly fat & why does it do so much damage? This was news to me and I heard a great explanation from Dr. Erminia Guarneri, who is the co-founder & medical director of the Scripps Center of Integrative Medicine & an attending cardiologist at the Scripps Clinic in La Jolla, CA.
Belly fat is completely different from the subcutaneous fat that surrounds our bodies. It's called omentum, and it acts just like an organ, secreting its own chemicals and hormones like adipokines that produce angiotensin II, that raises blood pressure. It also secretes tumor necrosis factor, interleukin 6, and C-reactive protein which lead to high blood pressure, insulin resistance, high cholesterol and inflammation that damages our brains & blood vessels.
Inflammation, high blood pressure & high cholesterol are all associated with heart disease, aging, Alzheimer's, stroke and cognitive decline. Big surprise! And I almost forgot to mention--the belly fat puts mechanical pressure on the kidneys, further raising blood pressure.
STUDY 1. Belly fat & stroke. Dr. Amytis Towfighi, Assistant Professor of Neurology at the University of Southern California, reported at the February 2008 International Stroke Conference that there has been a tripling of stroke in middle-aged women age 35-54 in recent years. Her research group compared two studies - one conducted from 1988-1994 and one conducted from 1999-2004.
Her group controlled for all the usual suspects, when it comes to stroke, like diabetes, cholesterol, & high blood pressure, and Dr. Towfighi said, "The one thing that was driving this increase in stroke risk was the waist circumference and body mass index."
- Women are heavier on average than they were even a decade ago.
- Our waist sizes have increased by almost 2 inches as compared to a decade ago.
- Stroke prevalence tripled in middle-aged women, double the prevalence of men.
- Even if you're just moderately overweight, you increase your stroke risk.
STUDY 2. Just a Little Belly fat & heart disease/metabolic syndrome & type 2 diabetes. Dr. Francisco Lopez-Jimenez, a cardiologist with the Mayo Clinic reported at the April 2008 American College of Cardiology meeting on his findings that more than half of us with normal weight, are in fact part of the "NORMAL WEIGHT OBESE". You may look "just right", and your doctor might say "your weight is fine", but if your body fat is over 20% for a man, or over 30% for a woman, you're not all right.
Don't confuse body fat with your Body Mass Index (BMI). To find your body fat you would need to be checked on a special scale, or have your waist measured with fat calipers. This is best done at a reputable gym or doctor's office. So why is a higher fat percentage a problem? Same old story. It puts you at risk for heart disease, type-2 diabetes and other metabolic disorders. That little bit of extra fat just changes your blood chemistry, upping your cholesterol and leptin, the hormone that regulates your appetite.
If you tend to put that fat on in the middle (belly fat) watch out! Dr. David Katz, the Yale University nutrition expert says, "Even a small amount of extra fat where it matters most can wreak havoc. Excess body fat in the belly is a menace, whatever your weight."
And by the way, a fit muscular woman could have a high body weight, but if her fat content is low, she's perfectly healthy. It's not about the weight - it's all about the fat, especially in your belly.
STUDY 3. Belly fat & dementia. Rachel Whitmer, a research scientist at Kaiser Permanente in Oakland, California, reported in the March 26 online issue of Neurology on her study that followed 6,583 Kaiser Health Plan members. The study began in the late 1960s and early 1970s and measured the abdominal fat of this large group of 40 and 45 year olds. She followed up with them between 1994 and 2006 when they had reached their 70s and beyond.
Back in 2005 Whitmer had previously reported that senior citizens who were overweight at middle age were 74 percent more likely to develop dementia. This new study specifically looked at whether belly fat was the culprit.
- Those people who were obese and had the most belly fat in their 40s were 3.6 times more likely to develop dementia than those with the least amount of belly fat.
- Those who were overweight--a step below obese--and had large bellies in their 40s, were 2.3 times more likely to develop dementia.
- 21 percent of those with high levels of belly fat developed dementia.
- The belly fat dementia connection persisted, even when researchers adjusted their statistics to take into account the effect of stroke & diabetes.
STUDY 4. Belly fat & death from cancer & heart disease. Dr. Cuilin Zhang, of NIH's Kennedy-Shriver National Institute of Child Health & Human Development, published his study online April 7th, in Circulation. This was one of the largest extended (16 years) investigations of abdominal fat, following 44,000 women in the Nurses Health Study. The NIH press release said:
"Women who carry excess fat around their waists were at a greater risk of dying early from cancer or heart disease than were women with smaller waistlines, even if they were of normal weight."
- Waist size equal or greater than 35 inches doubled the risk of premature death by heart disease compared to women with a waist size less than 28 inches.
- Waist size equal or greater than 35 inches doubled the risk of premature death by cancer as compared to women with a waist size less than 28 inches.
- Women who were obese (a BMI over 30) & had a greater waist circumference were at the greatest risk.
- Women are advised to maintain a waist size of 30 inches or less, and a Body Mass Index between 18.5-24.9.
I can think of about 4 women over 50 who have flat bellies. Most of them are vegetarians who eat fish, vegans, and dedicated exercisers. In case you think getting your waist measurement under 30 inches in middle age is easy, the measurement is around the belly-button which can add an inch or two to what you think your waist is. Isn't it interesting that we're likely to be given a prescription for high blood pressure and high cholesterol without coaching & direction to reduce belly & body fat, the main drivers of inflammation and many of our chronic diseases?
Recap on the goal numbers for women: Waist size of 30" or less, Body Mass Index 18.5-24.9, Body Fat 30% or under.
Most people would think my weight is just right, I eat mostly veg, and I'm definitely a dedicated exerciser, but after reading these studies, I now know I have some serious whittling to do around my waistline! I'm motivated! Is anyone else surprised by their measurements?