Waist Size Determines Cardio-Metabolic Risk in Diabetes

Researchers are uncovering more links between abdominal fat and the chronic inflammation that leads to heart disease, diabetes and a host of other ailments.

In a special report at the International Congress on Abdominal Obesity, scientists are gaining a better understanding of how inflammation, which normally protects the body against injury, can spiral out of control and increase the risk for disease. They also are learning more about the role that fat cells in belly fat play in promoting inflammation.

Last week, the International Chair on Cardiometabolic Risk, based at Université Laval in Quebec City, held its third International Congress on Abdominal Obesity which gathered a wide range of medical specialists to present new research on topics relating to visceral, or intra-abdominal, belly fat.

A group including Peter Libby, chief of the cardiovascular medicine division at Brigham and Women's hospital in Boston and a professor at Harvard Medical School, presented a summary of results of an international study showing links between intra-abdominal fat and liver fat and higher disease risk. Asians were found to be more prone to intra-abdominal fat and liver-fat accumulation than other ethnic groups with similar body mass indexes.

Libby, a founding member of ICCR, stated that the group's aim is to fight the rising tide of abdominal obesity, diabetes and cardiovascular disease sweeping the world and warn of the "impending catastrophe of bulging bellies." As many areas in the developing world adopt a Western diet high in sugar and fat, "we are sitting on a powder keg and incubating an epidemic of cardiovascular risk to come," Libby says.

Researchers presenting the study data said it is critical to measure waist circumference in patients with type 2 diabetes because the greater the waistline, the higher the risk will be of developing cardio-metabolic complications.

Studies show that moderate weight loss -- as little as 5 to 10% of initial body weight -- can reduce intra-abdominal fat or visceral fat by 10% to 30%. For a given amount of weight loss, according to ICCR, exercise burns more intra-abdominal fat than cutting calories, while preserving lean body mass. This makes it possible to reduce intra-abdominal fat without necessarily losing weight.

Libby blames food and beverage producers for marketing unhealthy foods and sugary beverages, and physicians for not doing enough to goad their patients onto diets and exercise. But he also says consumers have to take responsibility and not rely on weight loss remedies or supplements to knock off pounds and get the right nutrients.

Presented at the International Congress on Abdominal Obesity, July 2012