Heart Risk Linked to Pot Belly
Banish the belly, not just the pounds: That is the heart-healthy advice from a new study published in the Journal of the American College of Cardiology that finds that "pot" bellies may be a big indicator of future heart disease.
"What we're seeing is a quite strong association between the pot-belly, apple shape among a relatively young group of people and the build-up of plaque in the arteries," says study co-author Dr. James A. de Lemos at the University of Texas Southwestern Medical Center.
"Ten to 15 years down the road, this can lead to major cardiac problems, such as a heart attack," he says.
According to the American Heart Association, more than 870,000 Americans die from heart disease each year, making it the leading killer of both men and women.
Cardiovascular disease has long been associated with obesity, and approximately one-third of American adults are considered clinically obese, the researchers note.
But are some forms of overweight worse than others?
Dr. de Lemos' team compared various ways of measuring obesity to detect signs of heart disease. They looked specifically at atherosclerosis, in which blood vessel walls become thick and stiff. This affect on the blood vessel walls can be caused by a build-up of calcium and plaque, which is composed of cholesterol and triglyceride fats.
The researchers focused on data collected between 2000 and 2002 on more than 2,700 men and women between the ages of 30 and 65, who were participating in the larger, multi-ethnic Dallas Heart Study.
Blood and urine samples were taken from all the participants following completion of a general health survey.
A subsequent clinical exam calculated both weight and body mass index (BMI) - a common obesity measurement based on weight-to-height ratios - as well as waist and hip circumference.
All the men and women then underwent non-invasive imaging tests, including magnetic resonance imaging (MRI) to assess atherosclerosis and/or electron beam computed tomography (EBCT) that specifically looked at arterial calcium deposits in the heart. EBCT is also called ultrafast CT.
Such calcium deposits, Dr. de Lemos and his colleagues note, collect years before the onset of chest pains or a heart attack.
Detectable coronary artery calcium was found in just over 20 percent (583) of the men and women tested. Almost 40 percent of those who underwent an MRI (976) were found to have detectable aortic plaque.
After factoring out differences in blood pressure, diabetes, age, smoking, or cholesterol status, body shape was a much better indicator of either calcium or plaque status than either simple weight or BMI numbers.
For men and women both, the bigger the belly in relation to the hips - otherwise called the waist-to-hip ratio (WHR) - the greater the likelihood of arterial calcium in the heart.
After dividing the participants into five groups ranging from those with the smallest to the largest WHRs, the authors specifically observed that those with the largest were almost twice as likely to have coronary calcium as those with the smallest.
Even if your belt buckled somewhere between flat and fat, you were not home-free, the researchers say. That is because even incremental increases in waist-to-hip-ratio translated into small but steady increases in calcium deposits.
Those with the largest waist-to-hip ratios were also three times as likely to have atherosclerotic plaque as those in the smallest waist-to-hip group, the researchers note.
Although higher BMI and waist circumference readings alone were also associated with signs of atherosclerosis, waist-to-hip ratios were found to be much stronger indicators of either calcium or plaque build-up.
Dr. de Lemos and his team noted that BMI, in particular, does not gauge body composition, because it fails to account for the fact that abdominal fat - as opposed to fat around the hips - may be much less healthy.
Abdominal fat appears to trigger a chain of inflammatory activities that translates into harmful metabolic changes, plaque build-up, and, ultimately, heart disease.
"The good news for patients is that it's not an 'all or nothing' situation," says Dr. de Lemos. "Even little improvements in your body shape are going to prove beneficial, with the goal being the smallest waist relative to your hips that you can have - without becoming anorexic, obviously."
"It's not rocket science," he adds. "It's the kind of thing you work on by incorporating regular routine exercise into everyday living.
“Nothing heroic, mind you,” he says. “Just some exercise, and by developing good eating habits. And most of that revolves around moderation.
"It's not about crash diets. It's about learning portion control, notes Dr. de Lemos. "So the best thing we can do is unlearn everything our parents taught us. Meaning, we should definitely not finish everything on our plate."
Cardiologist Dr. Curtis M. Rimmerman at the Cleveland Clinic describes Dr. de Lemos' work as a "start in the right direction" toward refining heart disease screening methods.
"I wouldn't say this finding is surprising," says Dr. Rimmerman.
"But it is certainly a reasonable assertion to suggest, given limited health care resources, that health care advisors focus on central-weight distribution rather than weight alone.
He says this can be a more precise way to identify at-risk patients in need of aggressive treatment and follow-up.
"In that sense, this is a valuable step forward," concludes Dr. Rimmerman.
Always consult your physician for more information.
Overweight and obesity together represent the second leading preventable cause of death in the US.
Obesity is a serious, chronic disease that can inflict substantial harm to a person’s health.
Over weight and obesity are not the same, rather, they are different points on a continuum of weight ranging from being underweight to being morbidly obese.
The percentage of people who fit into these two categories, overweight and obese, is determined by Body Mass Index (BMI).
The US Surgeon General has declared that overweight and obesity have reached epidemic proportions in this country.
Over 9 million children between the ages of six and 19 are overweight. Public health officials say physical inactivity and poor diet are catching up to tobacco as a significant threat to health.
Currently, about 33 percent of women and 28 percent of men are considered seriously overweight.
BMI is a measure of weight proportionate to height. BMI is considered a useful measurement of the amount of body fat. Occasionally, some very muscular people may have a BMI in the overweight range.
However, these people are not considered overweight because muscle tissue weighs more than fat tissue.
Generally, BMI can be considered an effective way to evaluate whether a person is overweight or obese.
According to the National Heart, Lung, and Blood Institute (NHLBI), a BMI from 18.5 to 24.9 is considered normal while a BMI of more than 25 is considered overweight.
A person is considered obese if the BMI is greater than 30 and morbidly obese if the BMI is 40 or greater.
In general, after the age of 50, a man's weight stabilizes and even drops slightly between the ages of 60 and 74.
However, a woman's weight continues to increase until age 60 and then begins to drop.
Another measure of obesity is the waist-to-hip ratio (WHR). The WHR is a measurement tool that looks at the proportion of fat stored on the waist, and hips and buttocks.
The waist circumference indicates abdominal fat. A waist circumference over 40 inches in men and over 35 inches in women may increase the risk for heart disease and other diseases associated with being overweight.
Consult your physician with questions regarding healthy body weight.
In many ways, obesity is a puzzling disease. How the body regulates weight and body fat is not well understood.
On one hand, the cause appears to be simple in that if a person consumes more calories than he or she expends as energy, then he or she will gain weight.
However, the risk factors that determine obesity can be a complex combination of genetics, socioeconomic factors, metabolic factors, and lifestyle choices, as well as other factors.
Some endocrine disorders, diseases, and medications may also exert a powerful influence on an individual's weight.
Factors which may influence the occurrence of obesity include, but are not limited to, the following:
- genetics - studies have shown that a predisposition toward obesity can be inherited.
- metabolic factors - how a particular person expends energy is different from how someone else's body uses energy. Both metabolic and hormonal factors are not the same for everyone, but these factors play a role in determining weight gain.
- socioeconomic factors - there is a strong relationship between economic status and obesity, especially among women.
- lifestyle choices - overeating, along with a sedentary lifestyle, contributes to obesity. These are lifestyle choices that can be affected by behavior change.
Eating a diet in which a high percentage of calories come from sugary, high-fat, refined foods promotes weight gain. And, as more US families eat on the go, high-calorie foods and beverages are often selected.
Lack of regular exercise contributes to obesity in adults and makes it difficult to maintain weight loss. In children, inactivity, such as watching television or sitting at a computer, contributes to obesity.
Always consult your physician for more information.