Fat can show up in all sorts of places. It can strain the seat of a pair of jeans, hang over a belt, or make a wedding ring nearly impossible to remove. In these thin-conscious times, many people worry about every extra ripple and bulge, no matter where it shows up. Doctors, however, see things differently. When it comes to your health, there’s one place where fat is especially dangerous.
Fat around the midsection is a strong risk factor for heart disease, type 2 diabetes, and even some types of cancers, says Samuel Klein, MD, the director of the Center for Human Nutrition at Washington University School of Medicine in St. Louis, Missouri.
Despite many years of studies — and an overabundance of potential study volunteers — experts aren’t exactly sure why people with large midsections are such frequent targets for disease. They do know that fat cells actually regulate metabolic functions, and many experts believe fat cells in the belly release especially large amounts of fatty acids, which can wreak havoc on a person’s blood sugar and insulin metabolism.
One thing’s certain: people with large bellies and deep (visceral) fat tend to lose sensitivity to insulin, a crucial hormone that helps the body burn energy. When insulin loses its power, the body responds by pumping out more of the hormone, which only throws the system further off balance.
As a result, people with extra belly fat are vulnerable to a whole cascade of problems known as insulin resistance syndrome or metabolic syndrome. The syndrome — which is estimated to affect over 50 million Americans — comes with a frightening array of potential complications. For one thing, people with insulin resistance often develop type 2 diabetes. They also tend to have high blood pressure and too much bad cholesterol, a recipe for heart disease, according to numerous studies.
Don’t start worrying, though, if you only have “love handles” — those are composed of fat near the surface of the skin. It’s the visceral fat that wraps around organs deeper in the abdomen that appears to be metabolically active.
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The tale of the tape
It’s not hard to find out if you have a potentially unhealthy amount of belly fat. All you need is a tape measure. Exhale, relax, and wrap the measure around your stomach. The bottom of the tape should be exactly even with the top of your hip bone. Keep the tape straight and snug, but don’t let it dig into your skin. If you’re a man, a waist circumference of more than 40 inches means you are at a higher risk for heart and other diseases. Women with a waist circumference of over 35 inches are at increased risk.
According to a report in the British Medical Journal, the size of your waist may say more about your health than other common measures of obesity, including body mass index (BMI) or waist-to-hip ratio. For most people, however, the scale really does tell the story. “Almost everyone with a BMI over 30 [the standard definition of obesity] also has a large waist circumference,” Klein says. The small number of people with healthy BMIs and large waists still seem to be targets for health problems, he says, a testament to the dangers of belly fat.
Apples and pears
In general, your body shape is a reflection of both your genes and your lifestyle. Different people put on fat in