Waist Size Predicts Heart Failure

The main reason people over 65 wind up in the hospital is heart failure, also known as "congestive heart failure". And the very best predictor of whether or not you're likely to get heart failure might surprise you.

It's waist size.

A new study published in the journal Circulation tracked data from two Swedish population based studies that together included 80,000 men and women aged 45-83. All participants filled in questionnaires about their height, weight, waist circumference and other vital statistics. They were then followed for seven years.

The researchers found- not surprisingly- that weight was linked to risk for heart failure. But they also found that even within the normal weight range (BMI 25 or less), those who had an extra 10cm (about 4 inches) on their waist had about 15% higher risk of heart failure. This went up to 18% for those who were heavier (BMI of 30 or more).

The researchers measured waist size, waist-to-hip ratio, waist-to-height ration and BMI (body mass index). All four measures were associated with heart disease, but waist circumference alone predicted heart disease risk regardless of other measures.

I've written before about the importance of waist size and of the waist-to-hip ratio. Nutritionists and smart doctors have long known that 35" for women and 40" for men represent a danger point for insulin resistance (which is the cornerstone of Metabolic Syndrome, also known as pre-diabetes). Metabolic Syndrome significantly increases the risk for heart disease.

If your waist is over 35" (women) or 40" (men) it's time to start doing something. I've found that a low-carb diet is one of the most effective ways to combat belly fat and reduce the size of your waist.

Blueberries May Help Banish Belly Fat

You've probably heard me rant and rave about blueberries. I eat them about six out of seven days a week, I gave them a "star" in my book "The 150 Healthiest Foods on Earth", and I've spoken at length about their high antioxidant content, their low sugar content, and their ability to boost memory.

Well, get ready for some hot news: Blueberries may also help banish belly fat.

A new study by researcher E. Mitchell Seymour, MS, of the University of Michigan shows that rats that ate a diet high in blueberries lost abdominal fat- the kind linked to increased waist size and increased risk for diabetes and heart disease. This happened even when the rats ate a high-fat diet. As an extra added bonus, the blueberry eating rats also had improved glucose control (meaning their blood sugar was more stable).

The researchers suggest that blueberries- with their high antioxidant content- may somehow alter the way the body stores and processes sugar, great news for those at risk for both heart disease and diabetes. "Our findings in regard to blueberries show the naturally occurring chemicals they contain, such as anthocyanins, show promise in mitigating these health conditions," said researcher Steven Bolling, MD, of the University of Michigan,

In the current study- presented at Experimental Biology 2009- rats were bred to become obese were fed either a low-fat diet or a high-carb diet, both of which were enriched with whole blueberry powder (about 2% of their total caloric intake).

After three months the rats fed the blueberries had improved glucose control and improved insulin sensitivity. Better glucose control and improved insulin sensitivity are both strongly related to lowering the risk for diabetes.

I find blueberries one of the easiest foods to incorporate into your diet. In season or not, you can always get them frozen, and I like to eat them right out of the freezer (mixed with frozen cherries). I put some FACE 2% yogurt on them, sprinkle with some slivered almonds, flaked unsweetened coconut and some probiotic powder and have them as a nightly "dessert". It's the ultimate "anti-aging" treat!

Belly Fat Doubles Death Risk

Belly fat is in the news again, big time.

First some background: A ton of stuff has been written about the difference between "apples" and "pears", apples being folks who store their fat around the middle and "pears" being those who store it on the hips butt and thighs. Fact is, all fat is not created equal. The fat stored around the butt hips and thighs- also known as subcutaneous fat since it's right below the skin- might drive you crazy and make it hard to put on your jeans, but it's not nearly as dangerous as the other kind. The fat stored around the middle- also called VAT or visceral abdominal fat- is a metabolic nightmare. Stored deep inside the abdominal walls, it is metabolically active fat that directly increases the risk for all sorts of health problems from metabolic syndrome to diabetes.

OK, now on to the study.

Researchers looked at data from almost 360,000 Europeans who had been enrolled in a larger study called the European Prospective Investigation into Cancer and Nutrition. They followed these folks for ten years, during which 14,723 of the participants died. What they found was that men and women with the largest waists had virtually twice the risk for premature death as those with the smallest ones.

According to Tobias Pischon, MD, MPH, the lead author of the study, the single most important finding in their study was that it the distribution of body fat affected the risk of premature death. Where you store your fat is even more important than what you weigh. And this was true even when weight is normal. "There aren't many simple individual characteristics that can increase a person's risk of premature death to this extent, independent of smoking and drinking" said Pischon.

For years we nutritionists have been using a "low-tech" shorthand for insulin resistance: a 40 inch (or greater) waist for men, a 35 inch (or greater) waist for women. Interestingly, that was exactly the number that correlated with a doubled risk for death when compared with smaller waists (less than 34 inches for men, less than 28 inches for women). Each 2 inch increase in waist circumference added about 17% increased risk for mortality in men and about 13% increased mortality in women.

Earlier this year I reported research showing that these numbers (40 inch waist for men, 35 for women) also indicated an increased risk for stroke.

Bottom line: reduce your belly fat. If you're an apple, chances are you're also insulin resistant, and would benefit from a diet low in carbohydrates. In my opinion, that's the absolute best "nutritional intervention" to reduce the most dangerous kind of fat on the body (as well as the plain old garden variety "unsightly" kind).

Just remember that low-carb doesn't mean unlimited calories. The absolute best way to go is lower calorie combined with controlled carb eating. For a good calorie goal take your target weight and multiply by 10. That's a great starting point.

And remember also that you'll not only be reducing your belly fat- you'll also be reducing the risk of stroke, heart disease, diabetes, dementia, some cancers and... oh yes, just plain dying.

Seems to me those are pretty good reasons to start eating differently!