Body mass index, or BMI, has long been the standard tool for assessing weight status and health risks. Calculating your height that takes into account your height and weight, BMI is frequently used because it is a quick, easy and inexpensive measuring tool. Yet, there is no assessment of how much fat a person has or how it is distributed throughout the body, both of which are key indicators of metabolic health. A recent study Posted in The BMJ analyzed different measures of body shape – specifically, core or abdominal fat – to determine which measures were the most predictive of premature death.
Abdominal fat associated with a higher risk of death
The researchers in this study analyzed the following measures of central fat: waist, hip and thigh circumference; waist / hip ratio; size / height ratio; waist-to-thigh ratio; body fat index (which incorporates the circumference and height of the hip); and a body shape index (calculated from waist circumference, BMI and height).
They found that a larger hip and thigh circumference (sometimes called a pear shape) was associated with a lower risk of death from all causes. All other measurements, which indicated centrally located fat (sometimes referred to as an apple shape), were associated with a higher risk of death. In other words, the more belly fat a person has, the higher their risk of dying from any cause.
What do these results mean?
These results tell us that not only does the total amount of body fat determine the health risk, but also the location of that fat on a person’s body. Previous research has shown that abdominal obesity is more strongly associated than overall obesity with cardiovascular risk factors such as increased blood pressure, high blood triglyceride levels and type 2 diabetes. Studies have shown that ‘it was even linked to dementia, asthma and some cancers.
The fat located around the abdomen, in particular the visceral fat surrounding the liver and internal organs, is highly inflammatory and metabolically disruptive: it releases inflammatory molecules that contribute to insulin resistance, type 2 diabetes and , finally, to cardiovascular disease. On the other hand, the fat located in the hips and thighs is protective. These protective effects include an association with lowered total cholesterol, LDL (or bad cholesterol), triglycerides, arterial calcification, blood pressure, blood glucose and insulin levels, and increased sensitivity to blood glucose. ‘insulin.
Taken together, these results demonstrate the importance of using BMI with measurements of belly fat to fully assess health risks.
What was missing from this analysis?
Researchers in the BMJ The study looked at the data from several angles, disaggregating the results by different categories such as gender, geographic location, smoking, BMI, physical activity, and the presence of diseases such as diabetes and arterial hypertension.
Notably, they did not analyze the relationship between abdominal obesity and mortality among different races or ethnicities. A 2005 study demonstrated that waist circumference was a better indicator of cardiovascular disease risk than BMI, and proposed different waist circumference thresholds varying by race / ethnicity and gender to more accurately assess this risk.
More recently, a Declaration 2015 of the American Heart Association cautioned against misclassifying obesity (and cardiovascular risk) into different racial and ethnic groups. Specifically, the current thresholds may lead to underestimating the risk in Asian populations and overestimating the risk in black populations. As a result, people in these groups may misperceive their weight and doctors may not offer appropriate treatment options.
What can you do to reduce your risk?
The question everyone wants to know the answer to is: How to reduce belly fat? Well, there is bad news and there is good news. An older study Studying the distribution of fat between identical and fraternal twins has revealed the bad news – that the way your body stores fat is largely determined by genetics.
The good news is, belly fat responds to the same habits and behavioral strategies recommended for overall health and total body fat loss. These strategies include the following:
- Eat a healthy diet that includes lean protein, fruits, vegetables, and whole grains.
- Limit processed carbohydrates, and especially added sugars, which are sugars that are not naturally found in foods.
- Get adequate physical activity, at least 150 minutes per week of moderate to vigorous physical activity.
- Get adequate, restful sleep: For most adults, that means seven to eight hours a night.
- Limit stress, because it is correlated with the release of the hormone cortisol, which is linked to abdominal weight gain.
Racism and Socio-Economic Factors Make Fat Loss More Difficult for Some
While individuals have some control over the above lifestyle factors, we must recognize that there are systems level factors that affect a person’s ability to access healthy foods, participate in regular physical activity, get enough sleep and reduce stress levels. These access imbalances have long been linked to health disparities.
This is particularly relevant as we move into 2021 – amid the coronavirus pandemic and exacerbated by social and political unrest in the United States. As a nation, we must meet these challenges and find system-wide solutions to reduce socio-economic barriers and eliminate racism, in order to improve the ability of everyone to lead healthier lives.
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