Extra padding around the belly can spell trouble for the heart, even if you're not technically overweight.
While obesity can raise the odds of developing heart disease, not all body fat is the same, said Dr. Ruwanthi Titano, a cardiologist and assistant professor at Mount Sinai's Icahn School of Medicine in New York City.
"We used to think everything is about BMI," Titano said. "But BMI does not tell you where fat cells are in the body."
Titano, who was not involved in the AHA statement, was referring to body mass index, which is a measure of weight in relation to height. BMI is commonly used to put people into weight categories like "overweight" and "obese," but it is actually a crude gauge.
What matters more is body fat and where it's carried, Titano said.
Research has found that fat concentrated around the mid-section is particularly problematic. A larger waist size can signal more visceral fat — deep fat that wraps around the internal organs. And that type of fat is far from "inert," Titano said.
Visceral fat, she explained, appears to be more "metabolically active" than fat that accumulates under the skin of the hips and thighs. It releases cytokines and other substances that promote inflammation and can inflict damage on the blood vessels and organs.
Visceral fat is also associated with insulin resistance, Titano said. That's a loss of sensitivity to the blood-sugar-regulating hormone insulin, which can lead to type 2 diabetes, a major risk factor for heart disease and stroke.
According to the U.S. National Heart, Lung, and Blood Institute, the risk of heart disease rises when waist size expands beyond 35 inches for women and 40 inches for men.
As for exercise, the good news is that grueling workouts are not necessary.
Research suggests that moderate aerobic exercise, for 150 minutes a week, can do the job, Powell-Wiley said. And that includes activities like brisk walking.
Plus, she noted, exercise has many benefits beyond trimming waistlines. It improves cardiovascular fitness, which helps prevent heart disease, and makes daily tasks like stair-climbing easier.
source : medicinenet.com
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