Cardiovascular risk linked not to weight, but to body fat storage – especially in women over 50.
A recent study published in the European Heart Journal looked at data from 161,808 women aged 50–79 to find out whether BMI or fat distribution was associated with cardiovascular risk
This research, from the Albert Einstein College of Medicine, in New York, NY, and other institutions, points to another potential factor, namely, where fat is stored in the body, particularly for women over the age of 50,
Menopause and heart risk
We know there is an increase in heart disease risk at menopause, and that it can be a greater cause of death than breast cancer.
Coronary heart disease kills more than twice as many women as breast cancer. 28,000 women die from heart attacks each year in the UK and unfortunately women are much less aware of this risk than of cancer.
This new study suggests that in women over 50, body shape is associated with cardiovascular risk.
Existing studies have suggested that it is your body mass index (BMI), calculated in reference to total weight and height, that is associated with the risk of experiencing cardiovascular events.
Thus, the higher a person’s BMI, the greater their risk of experiencing stroke, heart disease, and similar events and conditions.
However, these new findings have added another element to calculating risk.
All of the participants in the study had enrolled in the Women’s Health Initiative between 1993 and 1998.
None of these women had cardiovascular disease at baseline but throughout the study period, however, the researchers recorded 291 new cases of cardiovascular disease during it.
Body shape matters
In the study, the investigators measured body fat mass through dual-energy X-ray absorptiometry, a type of scan that assesses a person’s fat, muscle, and bone density.
The team found a pattern. Women with the highest percentage of fat stored around their middles and trunks and the lowest percentage of fat around their legs, giving them an “apple” body shape, also had the highest risk of cardiovascular disease.
These women had more than three times the risk of cardiovascular disease than their peers with a low percentage of fat around their middles and a higher percentage of fat around the legs: the “pear” shape.
Moreover, women in the top 25th percentile with the most body fat around their middles had almost double the risk of experiencing heart problems or a stroke, compared with the top 25% of women with the least body fat around their middles.
At the same time, women with the most fat around their legs had a lower risk of cardiovascular disease. That was 40% lower than those who had the least amount of fat around their legs.
“Our findings suggest that postmenopausal women, despite having normal weight, could have varying risk of cardiovascular disease because of different fat distributions around either their middle or their legs. In addition to overall body weight control, people may also need to pay attention to their regional body fat, even those who have a healthy body weight and normal BMI,” says lead author Qibin Qi, Ph.D.
Furthermore, the investigators argue that reducing the amount of midriff body fat alone could help reduce the risk of cardiovascular disease.
The researchers calculated that, among 1,000 participants, around six cases of cardiovascular disease per year could be prevented.
They estimated a similar outcome for women who do not lose any midriff fat but who increase the proportion of leg fat: Among 1,000 women who increase leg fat from under 42% to over 49%, around three cases of cardiovascular disease per year could be prevented, the researchers found.
A need for better assessments?
At the same time, the researchers believe that their current findings make a good case for using measurements other than just BMI when considering the risk of cardiovascular disease.
Some people who are categorised as having a normal weight may not be recognised as being at increased risk of cardiovascular disease due to the distribution of their body fat, and so may not have preventive measures recommended for them.”
Menopausal women are particularly vulnerable and much of can be down to hormone imbalance.
Putting weight on around the middle is very common at menopause and due to the changing balance of hormones. As the ovaries cease production of oestrogen it is then being made in the fat cells and usually this is distributed around the problem areas: stomach, hips and thighs.
If a woman is oestrogen dominant – whether from the natural shift in the hormones at menopause or additional oestrogen load from HRT – the result will be the same and the risk increased for heart disease and other health concerns.
Rebalancing with bioidentical progesterone which opposes excess oestrogen is a simple, safe way to ensure your hormones in balance.
Losing weight is the first step and ensuring you have both a healthy diet and exercise is the best way to future proof your heart.
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