In a new statement from NIH, researchers say that people with excess fat around the body’s midsection and organs have a higher risk of heart disease even if they are not obese.
A greater understanding of obesity and its impact on cardiovascular health highlights abdominal obesity, sometimes referred to as visceral adipose tissue, or VAT, as a heart disease risk marker.
VAT is commonly determined by waist circumference, the ratio of waist circumference to height (taking body size into account) or waist-to-hip ratio, which has been shown to predict heart death independent of BMI.
Experts recommend both abdominal measurements and BMI be assessed during regular health care visits because of a high waist circumference or low waist-to-hip ratio, even in healthy-weight individuals.
Abdominal obesity is also linked to fat accumulation around the liver that often leads to non-alcoholic fatty liver disease, which adds to heart disease risk.
The risk-inducing power of abdominal obesity is so strong that in people who are overweight or have obesity based on BMI, low levels of fat tissue around their midsection and organs could still indicate lower heart disease risks.
For this statement, experts evaluated research on managing and treating obesity, particularly abdominal obesity.
They reported that reducing calories can reduce abdominal fat, and the most beneficial physical activity to reduce abdominal obesity is aerobic exercise.
Their analysis found that meeting the current recommendations of 150 min/week of physical activity may be sufficient to reduce abdominal fat, with no additional loss from longer activity times.
Exercise or a combination of dietary change and physical activity has been shown in some instances to reduce abdominal obesity even without weight loss.
Lifestyle changes and subsequent weight loss improve blood sugar, blood pressure, triglyceride and cholesterol levels – a cluster of factors referred to as metabolic syndrome – and reduce inflammation, improve blood vessel function and treat non-alcoholic fatty liver disease.
However, studies of lifestyle change programs have not shown a reduction in coronary artery disease events (such as heart attack or chest pain).
In contrast, bariatric surgery for weight loss treatment is associated with a reduction in coronary artery disease risk compared to non-surgical weight loss.
This difference may be attributed to the larger amount of weight loss and the resultant changes in metabolism that are typical after bariatric surgery.
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The study is published in Circulation. One author of the study is Tiffany M. Powell-Wiley, M.D., M.P.H., FAHA.
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