Apples and Pears—Does Waist Size Really Matter?

As we get older, we all struggle with extra inches that seem to creep up overnight around our waists.

As we get older, we all struggle with extra inches that seem to creep up overnight around our waists. While we once might have accepted this as an annoying but inevitable part of ageing, medical research is showing that added girth is also a risk to heart health.

An important Swedish study has revealed that even for people of normal weight, a larger waistline brings a significantly higher risk of heart disease. Extra abdominal weight, also called visceral fat, creates an “apple-shaped” body type that places its owner at risk. While this body type is more common in men, women may also be “apples.” Many women, however, tend to carry weight around the hips and thighs, creating what is known as a “pear-shaped” body type.

What makes visceral fat so dangerous to your heart? A Harvard Medical School report says there is increasing evidence that it pumps out immune system chemicals called cytokines. These chemicals promote insulin resistance and low-level chronic inflammation—both of which can increase the risk of cardiovascular disease. 

Insulin is a hormone produced in the pancreas to carry glucose into the body’s cells, and has a major impact on metabolism. Insulin resistance means that your body’s muscle and liver cells don’t respond adequately to normal levels of insulin. This causes glucose levels in the blood to rise and increases the risk for diabetes. Insulin resistance, combined with high blood glucose, excess abdominal fat, unfavorable cholesterol levels and high blood pressure create what is known as the metabolic syndrome, a major risk factor for heart disease and stroke.

Is your waist size increasing your risk for heart disease? There are several ways to calculate your risk by using your waist measurement, the difference between your waist and hip measurements, and your Body Mass Index, or BMI—a number based on your height and weight. A simple guide can be found on the President’s Challenge Web site.

Once you have figured out your risk, what can you do about it? Losing weight, especially abdominal fat, can improve the function of your cardiovascular health, according to a study presented by Johns Hopkins researchers at a March 2012 American Heart Association scientific meeting. The study showed that the more belly fat the participants lost, the better their arteries were able to expand when needed, allowing more blood to flow more freely.

Half of the participants in the Hopkins study were on a low-fat diet and half were on a low-carbohydrate diet. Results demonstrated that the amount of improvement in the blood vessels was directly linked to how much abdominal fat the participants lost, regardless of which diet they were on. This was especially significant because it countered earlier concerns that a low-carb diet, which is higher in fat, would have a harmful effect on cardiovascular health. 

Increasing evidence, including that reported by Harvard Medical School, shows that diet combined with regular exercise is even more effective than dieting alone in reducing abdominal fat. While target exercises such as abdominal crunches may tighten stomach muscles, they will not decrease abdominal fat cells. The best approach has proven to be a combination of nutrition, increased activity and weight training. Interval training, which combines moderate-intensity aerobic activity with quick bursts at a higher intensity, also appears to be effective, as are core-strengthening exercise such as yoga and Pilates. Ask your health care provider or a personal trainer to help you create an exercise program that’s appropriate for you.

Eating one or two servings of fish rich in Omega-3 fatty acids per week, like salmon or tuna, decreases your risk for heart disease and even heart attack.