Belly Fat Linked with Repeat Heart Attacks

Sophia Antipolis wrote . . . . . . . . .

Heart attack survivors who carry excess fat around their waist are at increased risk of another heart attack, according to research published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).1

Prior studies have shown that abdominal obesity is an important risk factor for having a first heart attack. But until now, the association between abdominal obesity and the risk of a subsequent heart attack or stroke was unknown.

“Patients are typically put on a stringent medical treatment regimen after their first attack to prevent second events (called secondary prevention),” said study author Dr. Hanieh Mohammadi of the Karolinska Institute, Stockholm, Sweden. “Secondary prevention works through reducing risk factors associated with heart attack and stroke such as high blood sugar, lipids and blood pressure. It

was previously unknown whether abdominal obesity is a risk factor for recurrent events among patients on secondary prevention treatments.”

The study, the largest and most definitive ever conducted on this topic, followed more than 22,000 patients after their first heart attack and investigated the relation between abdominal obesity (measured by waist circumference) and the risk for recurrent cardiovascular disease events. The researchers specifically looked at events caused by clogged arteries, such as fatal and non-fatal heart attack and stroke. Patients were recruited from the nationwide SWEDEHEART registry and followed for a median of 3.8 years.

Most patients – 78% of men and 90% of women – had abdominal obesity (waist circumference 94 cm or above for men and 80 cm or above for women).

Increasing abdominal obesity was independently associated with fatal and non-fatal heart attacks and strokes, regardless of other risk factors (such as smoking, diabetes, hypertension, blood pressure, blood lipids and body mass index [BMI]) and secondary prevention treatments. Waist circumference was a more important marker of recurrent events than overall obesity.

Dr. Mohammadi said: “The reason abdominal obesity is very common in patients with a first heart attack is that it is closely linked with conditions that accelerate the clogging of arteries through atherosclerosis. These conditions include increased blood pressure, high blood sugar and insulin resistance (diabetes) as well as raised blood lipid levels.”

“Our results, however, suggest that there may be other negative mechanisms associated with abdominal obesity that are independent of these risk factors and remain unrecognised,” she added. “In our study, patients with increasing levels of abdominal obesity still had a raised risk for recurrent events despite being on therapies that lower traditional risk factors connected with abdominal obesity – such as anti-hypertensives, diabetes medication and lipid lowering drugs.”

This was the first study of its kind to analyse men and women together and separately. The relationship between waist circumference and recurrent events was stronger and more linear in men. In women the relationship was U-shaped, meaning that the mid-range waist circumference (rather than the lowest) was the least risky. It must be noted that the mid-range waist circumference for women included in the study was above the cut-off traditionally recognised for abdominal obesity (80 cm).

Dr. Mohammadi noted: “There were three times as many men in the study compared to women, contributing to less statistical power in the female group. Therefore, more studies are needed before definite conclusions can be drawn according to gender, but this is a start.”

Regarding possible reasons for the different results between sexes, she said: “Some studies have suggested that abdominal obesity may be more directly associated with the evil visceral fat (fat that sits around your organs) in men compared to women. In women it is thought that a greater portion of the abdominal fat is constituted by subcutaneous fat which is relatively harmless.”

Dr. Mohammadi concluded: “Abdominal obesity not only increases your risk for a first heart attack or stroke, but also the risk for recurrent events after the first misfortune. Maintaining a healthy waist circumference is important for preventing future heart attacks and strokes regardless of how many drugs you may be taking or how healthy your blood tests are. Abdominal obesity can be tackled by eating a healthy and balanced diet and regular physical activity.”

The authors recommend using waist circumference in clinical settings to identify first-time heart attack patients at increased risk of recurrent events.

Source: European Society of Cardiology

Changes in the Immune System Explain Why Belly Fat Is Bad for Thinking

Whitney Baxter wrote . . . . . . . . .

Iowa State researchers have found for the first time that less muscle and more body fat may affect how flexible our thinking gets as we become older, and changes in parts of the immune system could be responsible. These findings could lead to new treatments that help maintain mental flexibility in aging adults with obesity, sedentary lifestyles, or muscle loss that naturally happens with aging.

The study, led by Auriel Willette, assistant professor of food science and human nutrition, and Brandon Klinedinst, a PhD student in neuroscience, looked at data from more than 4,000 middle-aged to older UK Biobank participants, both men and women. The researchers examined direct measurements of lean muscle mass, abdominal fat, and subcutaneous fat, and how they were related to changes in fluid intelligence over six years.

Willette and Klinedinst discovered people mostly in their 40s and 50s who had higher amounts of fat in their mid-section had worse fluid intelligence as they got older. Greater muscle mass, by contrast, appeared to be a protective factor. These relationships stayed the same even after taking into account chronological age, level of education, and socioeconomic status.

“Chronological age doesn’t seem to be a factor in fluid intelligence decreasing over time,” Willette said. “It appears to be biological age, which here is the amount of fat and muscle.”

Generally, people begin to gain fat and lose lean muscle once they hit middle age, a trend that continues as they get older. To overcome this, implementing exercise routines to maintain lean muscle becomes more important. Klinedinst said exercising, especially resistance training, is essential for middle-aged women, who naturally tend to have less muscle mass than men.

The study also looked at whether or not changes in immune system activity could explain links between fat or muscle and fluid intelligence. Previous studies have shown that people with a higher body mass index (BMI) have more immune system activity in their blood, which activates the immune system in the brain and causes problems with cognition. BMI only takes into account total body mass, so it has not been clear whether fat, muscle, or both jump-start the immune system.

In this study, in women, the entire link between more abdominal fat and worse fluid intelligence was explained by changes in two types of white blood cells: lymphocytes and eosinophils. In men, a completely different type of white blood cell, basophils, explained roughly half of the fat and fluid intelligence link. While muscle mass was protective, the immune system did not seem to play a role.

While the study found correlations between body fat and decreased fluid intelligence, it is unknown at this time if it could increase the risk of Alzheimer’s disease.

“Further studies would be needed to see if people with less muscle mass and more fat mass are more likely to develop Alzheimer’s disease, and what the role of the immune system is,” Klinedinst said.

Starting a New Year’s resolution now to work out more and eat healthier may be a good idea, not only for your overall health, but to maintain healthy brain function.

“If you eat alright and do at least brisk walking some of the time, it might help you with mentally staying quick on your feet,” Willette said.

Source: Iowa State University

How Exercise Reduces Belly Fat in Humans

Some of you may have made a New Year’s resolution to hit the gym to tackle that annoying belly fat. But have you ever wondered how physical activity produces this desired effect? A signaling molecule called interleukin-6 plays a critical role in this process, researchers report December 27 in the journal Cell Metabolism.

As expected, a 12-week intervention consisting of bicycle exercise decreased visceral abdominal fat in obese adults. But remarkably, this effect was abolished in participants who were also treated with tocilizumab, a drug that blocks interleukin-6 signaling and is currently approved for the treatment of rheumatoid arthritis. Moreover, tocilizumab treatment increased cholesterol levels regardless of physical activity.

“The take home for the general audience is ‘do exercise,'” says first author Anne-Sophie Wedell-Neergaard of the University of Copenhagen. “We all know that exercise promotes better health, and now we also know that regular exercise training reduces abdominal fat mass and thereby potentially also the risk of developing cardio-metabolic diseases.”

Abdominal fat is associated with an increased risk of not only cardio-metabolic disease, but also cancer, dementia, and all-cause mortality. Physical activity reduces visceral fat tissue, which surrounds internal organs in the abdominal cavity, but the underlying mechanisms have not been clear. Some researchers have proposed that a “fight-or-flight” hormone called epinephrine mediates this effect. But Wedell-Neergaard and co-senior study author Helga Ellingsgaard of the University of Copenhagen suspected that interleukin-6 could also play an important role because it regulates energy metabolism, stimulates the breakdown of fats in healthy people, and is released from skeletal muscle during exercise.

To test this idea, the researchers carried out a 12-week, single-center trial in which they randomly assigned abdominally obese adults to four groups. A total of 53 participants received intravenous infusions of either tocilizumab or saline as a placebo every four weeks, combined with no exercise or a bicycle routine consisting of several 45-minute sessions each week. The researchers used magnetic resonance imaging to assess visceral fat tissue mass at the beginning and end of the study.

In the placebo groups, exercise reduced visceral fat tissue mass by an average of 225 grams, or 8 percent, compared with no exercise. But tocilizumab treatment eliminated this effect. In the exercise groups, tocilizumab also increased visceral fat tissue mass by approximately 278 grams compared with placebo. In addition, tocilizumab increased total cholesterol and “bad” low-density-lipoprotein (LDL) cholesterol compared with placebo, in both the exercise and no-exercise groups. “To our knowledge, this is the first study to show that interleukin-6 has a physiological role in regulating visceral fat mass in humans,” Wedell-Neergaard says.

The authors note that the study was exploratory and not intended to evaluate a given treatment in a clinical setting. To complicate matters, interleukin-6 can have seemingly opposite effects on inflammation, depending on the context. For example, chronic low-grade elevations of interleukin-6 are seen in patients with severe obesity, type 2 diabetes, and cardiovascular disease. “The signaling pathways in immune cells versus muscle cells differ substantially, resulting in pro-inflammatory and anti-inflammatory actions, so interleukin-6 may act differently in healthy and diseased people,” Wedell-Neergaard explains.

In future studies, the researchers will test the possibility that interleukin-6 affects whether fats or carbohydrates are used to generate energy under various conditions. They will also investigate whether more interleukin-6, potentially given as an injection, reduces visceral fat mass on its own. “We need a more in-depth understanding of this role of interleukin-6 in order to discuss its implications,” Wedell-Neergaard says.

In the meantime, the authors have some practical holiday exercise tips. “It is important to stress that when you start exercising, you may increase body weight due to increased muscle mass,” Wedell-Neergaard says. “So, in addition to measuring your overall body weight, it would be useful, and maybe more important, to measure waist circumference to keep track of the loss of visceral fat mass and to stay motivated.”

Source: EurekAlert!


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Nearly Two-thirds of People at High Risk of Heart Disease and Stroke Have Excess Belly Fat

Dubai, United Arab Emirates, 7 December 2018: Nearly two-thirds of people at high risk of heart disease and stroke have excess belly fat, according to results of the European Society of Cardiology (ESC) EUROASPIRE V survey presented today at the World Congress of Cardiology & Cardiovascular Health in Dubai, United Arab Emirates.1

Excess fat around the middle of the body (central obesity) is a marker of abnormal fat distribution. This belly fat is bad for the heart, even in people who are not otherwise overweight or obese.

Cardiovascular diseases are the leading cause of death in Europe. Each year in Europe there are more than 11 million new cases of cardiovascular disease and 3.9 million deaths caused by cardiovascular disease.2 Elimination of risk behaviours would prevent at least 80% of cardiovascular diseases.3

The study also found that less than half (47%) of those on antihypertensive medication reached the blood pressure target of less than 140/90 mmHg (less than 140/85 mmHg in patients with self-reported diabetes). Among those taking lipid-lowering drugs, only 43% attained the LDL cholesterol target of less than 2.5 mmol/L. In addition, many participants not taking any antihypertensive and/or lipid-lowering therapy had elevated blood pressure and elevated LDL cholesterol. Among patients being treated for type 2 diabetes, 65% achieved the blood sugar target of glycated haemoglobin (HbA1c) less than <7.0%.

Professor Kornelia Kotseva, chair of the EUROASPIRE Steering Committee from Imperial College London, UK, said: "The survey shows that large proportions of individuals at high risk of cardiovascular disease have unhealthy lifestyle habits and uncontrolled blood pressure, lipids and diabetes."

EUROASPIRE is a series of cross sectional surveys on the prevention of cardiovascular disease in ESC member countries.4 The results of the primary care arm of EUROASPIRE V are reported today. The study was conducted in 2017 to 2018 in 78 general practices in 16 primarily European countries.5

Each general practice enrolled consecutive individuals under the age of 80 years with no history of coronary artery disease or other atherosclerotic disease, but who were at high risk of developing cardiovascular disease. High risk was defined as having high blood pressure, high cholesterol, and/or diabetes; the study therefore recruited individuals who had been prescribed antihypertensive, lipid-lowering, and/or anti-diabetes treatments (diet and/or oral hypoglycaemics and/or insulin).

Participants were retrospectively identified using medical records and invited to an interview and clinical examination. Questions were asked about smoking, diet, physical activity, blood pressure, lipids and diabetes. Measurements included height, weight, waist circumference, blood pressure, low-density lipoprotein (LDL) cholesterol levels, and blood sugar levels. The primary outcomes were the proportions of participants achieving targets for cardiovascular disease prevention in the 2016 European guidelines.3

A total of 2,759 participants were interviewed and examined using standardised methods and instruments. Nearly two-thirds (64%) were centrally obese (waist circumference 88 cm or greater for women and 102 cm or higher for men). Some 37% were overweight (body mass index [BMI] 25 to 29.9 kg/m2) and 44% were obese (BMI 30kg/m2 or above). Nearly one in five participants (18%) were smokers and just 36% achieved the recommended physical activity level of at least 30 minutes, five times per week.

Professor Kotseva said: "GPs should proactively look for cardiovascular risk factors so that comprehensive treatment and advice can be given. She added: "GPs need to go beyond treating the risk factors they know about, and always investigate smoking, obesity, unhealthy diet, physical inactivity, blood pressure, cholesterol, and diabetes. People are often unaware that they need treatment – for example they visit their GP for their diabetes but do not know they also have high blood pressure. In our study, many participants with high blood pressure and cholesterol were not being treated."

She continued: "These data make it clear that more efforts must be made to improve cardiovascular prevention in people at high risk of cardiovascular disease. Our analysis highlights the need for health care systems to invest in prevention."

"Public health initiatives will also help to prevent heart disease and stroke," Professor Kotseva highlighted. "This includes smoking bans, taxing foods high in sugar and saturated fat, and providing areas for exercise."

Source: EurekAlert!


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Waist-to-chest Ratio Helps You to Calculate How Much Dangerous Belly Fat You Are Carrying

Miranda Larbi wrote . . . . . . . . .

Belly fat is the most dangerous kind because it can smother and put pressure on our vital organs.

But how can you tell if you’re carrying too much of it or not?

Forget your BMI and waist-to-hip measurements, you need to start calculating your abdominal obesity index (ABOI), according to a new study by the Hackensack Meridian School of Medicine at Seton Hall University, New Jersey.

Why isn’t BMI any good?

Weight is a notoriously inaccurate measurement; loads of factors can affect how much we weigh, such as bone density, hormones and muscle mass. It’s just a measurement of your gravitational pull…nothing else.

And that means that even though it’s pretty good for a rough estimate, using the body mass index scale is increasingly being poo-pooed.

BMI has traditionally been used to work out if someone is underweight, normal, overweight or obese.

Unless you do a tonne of exercise or you’re naturally super-slim, the chances are that your BMI calculation will give you a ballpark idea of where you sit in terms of being a healthy weight.

But there are better tools to use if you want to know how much fat you’re packing.

Doesn’t waist-to-hip tell you all you need to know?

What is ABOI and how do you calculate it?

The waist-to-hip (WHR) radio has long been considered an important and easy way of finding out if you’re carrying too much dangerous belly fat, but it doesn’t consider body shape.

The WHR tends to underestimate obesity of pear-shaped people, while overestimating it for those with apple-shapes.

What’s a healthy ratio?

Men ideally want their waist circumferences under 40in and for women, that’s under 35in. Anything above that is associated with things like type 2 diabetes, heart disease and high blood pressure.

And the point is that it’s not concerned with your total body weight, height or body shape – it just focuses on central obesity.

To determine its validity, scientists recruited 282 people aged between 20 and 90 to have their ABOI and BMI calculated.

And they found that there was no strict relationship between someone’s ABOI and BMI scores – particularly when it came to being classed as “obese” with a high BMI.

Scientists now believe it’s most useful when combined with your WHR.

If your waist-to-chest is smaller than your waist-to-hip ratio, you’re carrying too much weight up top.

And if your waist is wider than your chest or hips, that’s an obvious sign that you’ve got a stack of belly fat.

Source: The Sun


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