The Body Mass Index (BMI) has long been the standard tool for assessing weight status and health risk. The BMI is often used to calculate your height taking into account your height and weight as it is a quick, easy and inexpensive measuring tool. However, there is a lack of assessment of how much fat a person has or how it is distributed in the body. Both are key indicators of metabolic health. A recently published study in The BMJ analyzed various measures of body shape – particularly central or abdominal fat – to determine which measures best predicted premature death.
Belly fat associated with higher risk of death
The researchers for this study analyzed the following measurements of central fatness: waist, hip, and thigh circumference; Belly to hip circumference; Ratio of waist to height; Waist to thigh ratio; Body obesity index (taking into account hip circumference and height); and a body shape index (calculated from waist circumference, BMI and height).
They found that having a larger hip and thigh circumference (sometimes called a pear shape) was associated with a lower risk of death for all reasons. All other measures that indicated centrally located fat (sometimes called the apple shape) were associated with a higher risk of death. That said, the more belly fat a person has, the higher their risk of dying for any reason.
What do these results mean?
These results show that not only does the total amount of body fat determine the health risk, but also the position of that fat on a person’s body. Previous research has shown that abdominal obesity is more strongly associated with cardiovascular risk factors such as increased blood pressure, increased blood triglyceride levels, and type 2 diabetes than general obesity. Studies have shown that it is even related to dementia, asthma, and some cancers.
Fat around the abdomen, especially visceral fat that surrounds the liver and internal organs, is highly inflammatory and metabolically disruptive: it releases inflammatory molecules that contribute to insulin resistance, type 2 diabetes, and ultimately cardiovascular disease. In contrast, fat protects the hips and thighs. These protective effects include an association with lower total cholesterol, LDL (or bad) cholesterol, triglycerides, arterial calcification, blood pressure, blood sugar and insulin levels, and higher sensitivity to insulin.
Taken together, these results show the importance of using BMI along with measurements of belly fat to fully assess health risk.
What was missing from this analysis?
Researchers in the BMJ The study examined the data from different angles, breaking the results down by different categories such as gender, geographic location, smoking status, BMI, physical activity, and the presence of diseases such as diabetes and high blood pressure.
In particular, they did not analyze the relationship between abdominal obesity and mortality between different races or races. A 2005 study showed that waist size is a better indicator of risk of cardiovascular disease than BMI, and suggested different waist size limits that vary based on race / ethnicity and gender around it To be able to assess the risk more precisely.
More recently, a 2015 American Heart Association statement warned of misclassification of obesity (and cardiovascular risk) across races and ethnic groups. In particular, current threshold values can lead to the risk in Asian population groups being underestimated and the risk in black population groups being overestimated. As a result, people in these groups may misperceive their weight status and doctors may not offer appropriate treatment options.
What can you do to reduce your risk?
The question that everyone wants to know the answer to is how can you reduce belly fat? Well, there is bad news and good news. An older study looking at fat distribution between identical and fraternal twins found the bad news that the way your body stores fat is largely genetics.
The good news is that belly fat responds to the same behavioral habits and strategies recommended for overall health and overall body fat loss. These strategies include the following:
- Eat a healthy diet with lean protein, fruits, vegetables, and whole grains.
- Limit processed carbohydrates and especially added sugars that aren’t naturally found in foods.
- Get enough physical activity, at least 150 minutes per week of moderate to vigorous physical activity.
- Get enough restful sleep: For most adults, that means seven to eight hours a night.
- Limit stress as it is correlated with the release of the hormone cortisol, which has been linked to weight gain in the abdomen.
Racism and socio-economic factors make it difficult for some to lose fat
While individuals have some control over the above lifestyle factors, we must acknowledge that there are system-level factors that affect a person’s ability to access healthy foods, exercise regularly, get adequate sleep, and reduce stress levels. These access imbalances have long been linked to healthcare disparities.
This is especially important as we enter 2021 – amid the coronavirus pandemic and exacerbated by social and political unrest in the United States. As a nation, we must face these challenges and find system-wide solutions to break down socio-economic barriers and remove racism in order to improve individual freedom of choice and the ability to lead healthier lives.