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Heart Risk Linked to Pot Belly
Even so, focusing on the belly alone may not be the best way to address the risk
A new study published in the Journal of the American College of Cardiology underscores that “pot” bellies may be a big indicator of future heart disease. The researchers reported seeing a strong association
between the pot-belly or apple shape and atherosclerosis, or hardening of the arteries, among a relatively young group of
people.
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. They also took blood and urine samples 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 collect years before the onset of chest pains or a heart attack.
The researchers found detectable coronary artery calcium 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. Further, after dividing the participants into five groups ranging
from those with the smallest to the largest WHRs, the authors observed that those with the largest were almost twice as likely
to have coronary calcium as those with the smallest.
And even if your belt buckled somewhere between flat and fat, you weren’t home-free, the researchers say. That’s 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.
Interpreting the findings
Jefferson cardiologist Matthew V. DeCaro, MD, says this latest report isn’t surprising: “This study’s findings are clearly
supported by a wealth of literature and clinical experience.”
Even so, Dr. DeCaro says care should be taken in interpreting these findings.
“A person has no control over how fat is deposited in his or her body upon gaining weight. That’s genetically determined,”
he explains. “The same genetic factors that establish a pattern of belly fat also appear to be associated with atherosclerotic
risk. This indicates a predisposition to problems – and means that these individuals need to work even harder on the risk
factors they can potentially modify.”
Dr. DeCaro says those factors include elevated weight, sugar, blood pressure and cholesterol/lipids, as well as smoking and
lack of exercise.
“In addition to a large belly, these individuals often have metabolic syndrome and a pattern of high triglycerides, high LDL
(bad cholesterol), low HDL (good cholesterol), glucose intolerance and high blood pressure,” he notes.
Sit-ups: Not necessarily the ‘cure’
Dr. DeCaro points out that there are no interventions that focally decrease weight.
“Sit-ups don’t get rid of belly fat,” he says. “They only tone abdominal muscles, but in burning calories, can help with overall
weight loss.”
He adds that just as genetics determine where we gain weight, genetics also affect where we lose it: “Quite simply, no intervention has been shown to get rid of this belly in isolation.”
Above all, Dr. DeCaro says patients shouldn’t fixate only on the belly: “It’s a genetic risk factor just like a family history
of early coronary artery disease. The treatment isn’t to focus on the belly, just like we can’t disown our parents to alleviate
a bad family history.”
The correct approach, he says, is to lose weight overall with a healthy diet, stop smoking and take medications if necessary
to control blood pressure, lipids and sugar.
“The whole package is important. It’s often easy to take a pill, but the lifestyle changes are equally, if not more, important
– yet infinitely more difficult to achieve,” he concludes.
For more information
Make an appointment with a Jefferson physician online or by calling 1-800-JEFF-NOW.
