Where a woman gains weight can increase the risk of heart disease

It's not only how much weight you put on, but where you gain the flab that can affect your risk of heart disease, a new study suggests.

Researchers have found that women who store excess pounds around their midsections are more likely to also accumulate fat around their hearts, a risk factor for heart disease. This was especially true for black women, according the study which was published in Menopause.

"Studies have shown that it's not just being overweight that matters, it's also where you store the fat," said study coauthor Samar R. El Khoudary, Ph.D, associate professor of epidemiology at the University of Pittsburgh. "When the fat is near the heart it can be like a metabolically active organ that can secrete toxic chemicals. And because there is no border between the fat and the heart, it's much easier for those toxic chemicals to pass into the heart."

While the study focused on women who were near, at, or post menopause, the results would most likely pertain to younger women also, El Khoudary said. She and her colleagues chose to focus on women near the menopause because for women, "once you hit your 40syou start to put your fat in the abdominal area."

El Khoudary and her colleagues evaluated 524 women from Pittsburgh and Chicago whose average age was 51, scanning their hearts and other areas of the body to determine whether fat was stored just under the skin or around the organs. The scans of the heart revealed how much fat had accumulated around that organ.

After accounting for the potential health effects of lifestyle and socioeconomic factors, including smoking, alcohol consumption and financial strain, the researchers determined that the more excess weight a woman carried, the more likely she was to develop a fatty heart.

How much fat accumulated around the heart depended on race and on where the fat was stored.

White women with higher BMIs had significantly more heart fat than black women with a similar BMI, no matter where the fat accumulated. But black women with larger waistlines ended up with more fat surrounding their hearts compared to white women with a similar BMI and amount of belly fat. What this may mean, El Khoudary said, is that abdominal fat "may be more metabolically active in black women than in white women."

Not overweight, but overfat?

A separate, recent article found that as many as 80 percent of women in developed countries may be "overfat" — that is, carrying an excess of body weight, especially belly fat. Overfat means someone may not be considered overweight according to a scale or to the body-mass index, but have excess fat around the abdomen. The way to determine whether you're overfat is by taking a measure of the waistline at the level of the belly button, according to the article in the journal Frontiers in Public Health. The waist measure should be less than half your height.

Because it's not possible to see how much fat has accumulated around the heart without a specialized scan, white women who are overweight and black women with excess abdominal fat need to think about lifestyle changes to protect their hearts, said Mercedes Carnethon, an associate professor of preventive medicine Northwestern University's Feinberg School of Medicine.

"The focus needs to be on appropriate weight management strategies," Carnethon said. "I would suggest changing over to a healthy diet and increasing exercise."


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