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Healthy Recipe Doctor

with Elaine Magee, MPH, RD

Elaine Magee's blog has now been retired. We appreciate all the wisdom and support she has brought to the WebMD community throughout the years.

Friday, November 13, 2009

Belly Fat Is the Worst for Your Heart

You’ve heard of apple and pear body shapes, right? Well, it’s the apple shape — with the extra weight mostly being stored around the waist — that is most associated with heart disease and other diseases like metabolic syndrome and type 2 diabetes. This abdominal fat seems to be more biologically active, potentially secreting inflammatory proteins that contribute to atherosclerosis plaque.

The bigger your waist, the higher your risk of developing heart failure — a condition where the heart isn’t pumping enough blood out, and fluid and blood back up into the lungs and/or pool in the feet and legs.

According to a recent animal study:

  • Belly fat brought on the most inflammation.
  • Belly fat was linked to the worst atherosclerosis (hardening of the arteries).

[Circulation online Jan. 22, 2008]

In adults at the lower end of the “overweight” range in body mass index, an increase in waist circumference of 10 centimeters was associated with a 15% higher risk of heart failure for women and 16% higher for men. [Circulation online April 7.2009]

Putting a Number to Your Waist

Measure your natural waist circumference (just above the navel) with a tape measure. If your body mass index (BMI) is 25 kg/m2 or greater (which is most of us), your goal for waist circumference, according to the American Heart Association, is:

Men: less than 40 inches
Women: less than 35 inches

But there is more to the belly fat story…

Waist-to-Hip Ratio May Be the Best Way to Measure Risk

Here’s where it gets interesting. If you want to get the most accurate measure of potential risk from belly fat, measure your hips and calculate your waist-to-hip ratio. Fat around your hips doesn’t appear to increase risk of heart disease at all. In fact, it may have a protective effect. Having a big waist with comparably big hips does not appear to be as troublesome as a big waist with small hips.

All of this is why I personally put more value on the waist measurement – and even better is the waist-to-hip ratio – than I do pounds on a scale. Pounds don’t take into account your muscle or bone mass or where you tend to deposit extra body fat.

To get your waist-to-hip ratio, measure your waist circumference in inches and divide it by your hip circumference. An abnormal ratio is thought to be:

For women: 0.85 and above
For men: 1.0 and above

It takes exercise and a healthy diet to lose the belly fat. But given the risks, it’s healthier to eat an apple than to be one.


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Posted by: Elaine Magee, RD at 7:15 am

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