For those of us with expansive waistlines and worries about our brain health, getting rid of excess abdominal fat should be a major priority. Abdominal fat, also called belly fat or visceral fat, is one component of metabolic syndrome, a cluster of five risk factors that increase risk for stroke, depression, and dementia, among other conditions. New research suggests that Americans are making progress in addressing three of the five factors—high blood pressure, high triglycerides, and low “good” HDL cholesterol—but rates of abdominal obesity and poor blood sugar control, other risk factors that are associated with brain problems, have actually increased.
Researchers who reviewed 10 years’ worth of data from national health and nutrition sur-veys found that rates of abdominal obesity, or belly fat, increased from 45.4 percent to 56.1 percent in the entire study population, and from 53.5 percent to 65.4 percent among female participants. High blood sugar rates among study participants rose from 12.9 percent to 19.9 percent over the same 10-year period, according to a paper published online in the June 18, 2013 issue of the Journal of the American College of Cardiology.
“The improvements in blood pressure, HDL, and triglycerides suggested by this research are probably the result of the wider availability of effective medications for high blood pressure and lipid abnormalities,” says Paul L. Huang, MD, PhD, Director of the MGH Cardiac Metabolic Syndrome Program. “The two remaining metabolic syndrome risk factors, excess belly fat and poor blood sugar control, are related primarily to the problem of obesity.
“Individuals with metabolic syndrome have to address the mismatch between energy intake in the form of calories from food and beverages, and energy expenditure from physical activity. Any energy that isn’t used is stored as fat. Because we have not yet developed effective medications to address the issue of obesity, we must convince our patients to make lifestyle changes that involve increasing physical activity, reducing stress, and consuming a healthier diet.”
WHAT YOU CAN DO
Use your computer or smart phone to chart your calorie intake and/or physical activities on these free Websites.
An unhealthy fat
Belly fat, which is found at the waist and above, is a sort of disease-generating organism, with harmful effects derived in part from qualities that distinguish it from fat cells in the hips and thighs. Visceral fat lodged around the abdominal organs is more likely than other types of fat to break down and release chemicals that increase risk for a cascade of health problems—including stroke and heart attack, type 2 diabetes, cancer, and kidney disease—many of which directly affect the brain.
“The properties of visceral fat are different from those of subcutaneous fat,” explains Dr. Huang. “Rather than simply storing excess energy, visceral fat produces proteins, stress hormones, and chemicals that increase resistance to insulin and promote inflammatory processes.”
Research suggests that unhealthy visceral fat spells particular trouble for the brain. Among other negative effects, it is linked to increased risk for cerebrovascular problems; damage to the brain’s white matter (the communications network that links brain cells to one another); small-er total brain volume and atrophy of the hippocampus, an important memory region of the brain; and inflammation thought to increase brain aging and heighten risk for cognitive decline, Parkinson’s disease and Alzheimer’s disease. Insulin resistance linked to belly fat, with its high insulin and blood sugar levels, is associated with worsening memory and cognition.
Getting rid of belly fat
A simple measurement can help you determine whether you have too much abdominal fat, Dr. Huang says. Using a measuring tape, circle your waist at a point about two inches above the hip bones, passing the tape over your navel. Do not pull your stomach in. A waist size of more than 40 inches for men and more than 35 inches for women is associated with increased health risks.
Fortunately, fat that accumulates at the waist and above may actually be more responsive to weight loss efforts than fat distributed elsewhere. To keep your waist trim and your body and brain in good order, eat a sensible low-calorie, low-fat diet with plenty of fruits and vegetables, fish, lean meats, and nutrient-dense, fiber-rich legumes, nuts, and whole grains. Limit fats, alcohol, and refined foods, and avoid the simple sugars found in sweet desserts, sodas and candies.
“With your doctor’s approval, make an effort to increase your physical activity,” suggests Dr. Huang. “Try to exercise at moderate intensity for 150 minutes a week—at least 30 minutes a day, five days a week. Both aerobic exercise and strength training are important, and both will raise your metabolic rate. Exercise is also a good way to relieve stress that promotes the production of the hormone cortisol and leads to increases in belly fat.”
Trying to avoid distressing situations and finding healthy ways to alleviate stress—such as yoga, meditation, and other relaxation techniques—are other useful strategies for combating belly fat. For high-tech help, see What You Can Do for a list of Websites where you can track your calorie intake and physical activity.
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