In Nigeria, it is typical for a slim man or woman to be regarded as a poor person. Having a pot belly is perceived as a status symbol of wealth and success. But having a pot-belly – even if you are not overweight – increases your risk of dying from heart problems than being generally obese.
Potbelly or excess belly fat is extremely unhealthy. Much more, research suggests that individuals with potbelly, despite having a normal body weight stand a higher risk of death over the years from heart problems than overweight or obese people whose fat is more concentrated on the hips and thighs.
Abdominal fat — an apple-shaped figure — has long been considered more worrisome than fat that settles on the hips and below, the so-called pear shape. Fat packed around the organs in the abdomen is more dangerous than fat on the hips because it’s ‘metabolically active’, releasing more of the inflammatory, toxic chemicals that raise heart disease risk.
The US study in 2012 found that those who were not overweight but had a bulging midriff were 2.75 times more at risk of dying from cardiovascular disease than normal weight and a proportionate waistline. They were also at 2.08 times the risk of dying prematurely from all causes. It was presented at the European Cardiology Congress in Munich.
Most strikingly, Dr Suraj Ogunyemi, a consultant cardiologist at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, stated, that an individual with a potbelly, despite having a normal body weight, will be classified as obese.
“When you want to define obesity, it is about the abdominal circumference. Men with an abdominal circumference that is more than 102cm or women with a waistline greater than 88cm are obese,” he said.
Dr Ogunyemi said excess abdominal fat is a dangerous risk factor that predisposes individuals to many diseases, including hypertension, stroke, asthma, type 2 diabetes, heart attack and sleep apnea.
Sleep apnea is a condition in which breathing stops repeatedly during the night due to soft tissue in the throat blocking the airway.
He declared that even when an individual seems to have normal weight, an excess abdominal fat, what many people refer to as potbelly or protruding tummy, irrespective of the gender, only suggests that the individual is already overweight.
Certainly, the relationship between waist circumference and health risk varies by ethnic group. For example, in Asian women, a waist circumference above 31.5 inches is considered a health risk.
Also, according to the World Health Organization, the risk of cardiovascular diseases like heart attacks or strokes is considered to be higher in those with a waist measurement of above 94 cm in men and above 80 cm in women. The risk is thought to be substantially increased in men with a waist wider than 102 cm and 88 cm in women.
Dr Abiodun Adeoye, a consultant cardiologist, University College Hospital (UCH), Ibadan, Oyo State, added: “Once the tummy is getting bigger, one has a multiplied fold increase for cardiovascular diseases, including diabetes and hypertension.
“Once there is uncontrolled hypertension and diabetes, then other diseases such as stroke and heart attack will come. A person with a high-fat deposit in the waist area also stands a higher risk of fat blocking blood vessels. They form plaques, which plaster the blood vessels, harden the blood vessels and clog it.”
Dr Adeoye declared that people should not link affluence with potbelly as the wider a person’s waistline, the shorter the person’s lifespan would be. He stated: “For us, cardiologists and physicians, pot or beer belly is not a good sign. Even as medical doctors, we also work on our bodies so that we do not end up with big tummies.”
Most strikingly, people with a healthy overall weight but too much abdominal fat are even more likely to be heart victims than generally obese people, whose risk is 2.34 times more than those of normal weight with a regular waistline.
The study looked at data on 12,785 people aged 18 and over, who were divided into three categories of BMI – normal, overweight and obese – then divided by whether waistlines were normal or larger. Over 14 years, there were 2,562 deaths, of which 1,138 were cardiovascular-related. The highest risk of death was in people with normal BMI and large waistlines.
In 2018, researchers kept track of heart attacks over a seven-year period in a study that involved about 500,000 people ages 40 to 69, in the United Kingdom. During that period, the women who carried more weight around their waist had a 10per cent to 20per cent greater risk of heart attack than women who were just heavier overall.
The study, published in the Journal of the American Heart Association, said a larger waist-to-hip ratio, in particular, appeared to be a bigger heart attack risk factor for women than for men. The analysis showed that compared with BMI, waist-to-hip ratio was 18 per cent stronger as a heart attack predictor in women — versus 6per cent stronger in men. What’s more, heart attack survivors who carry extra weight around their belly are at greater risk of another heart attack or stroke.
In the latest study, published Monday in the European Journal of Preventative Cardiology, researchers stressed that waist circumference was a more important marker than overall obesity and advised doctors to measure their patient’s waists to identify those at risk.
The study tracked more than 22,000 Swedish patients after their first heart attack and looked at the link between their waist circumference and events caused by clogged arteries like fatal and non-fatal heart attacks and stroke. Patients were followed for nearly four years, with 1,232 men (7.3 per cent) and 469 women (7.9 per cent) experiencing a heart attack or stroke.
It found that belly fat was associated with heart attacks and stroke independent of other risk factors like smoking, diabetes, hypertension, body mass index and prevention treatments.
Why do individuals develop beer or pot belly? Beyond gender (men are more prone to belly fat than women) and genetics, reasons people gain belly fat include a poor diet, lack of exercise, late-night eating, and stress.
A steroid hormone known as cortisol helps the body control and deal with stress. When a person is in a dangerous or high-pressure situation, their body releases cortisol, and this can impact on their metabolism. People often reach for food for comfort when they feel stressed, and cortisol causes the excess calories to remain around the belly and other areas of the body for later use.
Also, alcohol consumption is directly associated with waist circumference and with a higher risk of abdominal obesity in men than in women. Increasing alcohol consumption significantly increased the risk of exceeding the recommended energy intake.
One study found that men who consumed more than three drinks per day were 80 per cent more likely to have excess belly fat than men who consumed less alcohol.
In another study, daily drinkers who consumed less than one drink per day tended to have the least abdominal fat, while those who drank less often but consumed four or more drinks on “drinking days” were most likely to have excess belly fat.
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