March 4th Menopause: Accelerated belly fat associated with a higher risk of heart disease
MedicalResearch.com Interview with:
Samar El Khoudary, PhD, MPH, BPharm, FAHA
Associate Professor of Epidemiology
University of Pittsburgh Graduate School of Public Health
MedicalResearch.com: What is the background for this study?
Answer: Research is increasingly showing that it is not as important how much fat a woman carries, which doctors usually measure by weight and BMI, since that is where that fat is carried. To investigate this, we looked at 25 years of data on 362 women from Pittsburgh and Chicago who participated in the Study on Women’s Health Nationwide (SWAN). The women, with an average age of 51, had visceral adipose tissue – fat that surrounds the abdominal organs – measured at some points during the study using CT and the thickness of the internal carotid artery in their neck was measured using ultrasound. The thickness of the carotid artery is an early indicator of heart disease.
MedicalResearch.com: What are the key results?
Answer: My team found that for every 20% increase in belly fat, the thickness of the carotid artery increased by 2%, regardless of total weight, BMI, and other traditional heart disease risk factors.
We also found that on average, abdominal fat began a steep acceleration within two years prior to the participants’ last period and continued to grow more gradually after the transition into menopause.
MedicalResearch.com: What should readers take away from your report?
Answer: Women who experience accelerated accumulation of belly fat during menopause are at greater risk of heart disease even if their weight remains constant. This suggests that measuring waist circumference during preventive health appointments for middle-aged women could be an early indicator of risk of heart disease beyond the widely used body mass index (BMI) – a calculation of weight and height.
In the past, there was a disproportionate focus on BMI and cardiovascular diseases. Through this long-term study, we found a clear link between belly fat growth and the risk of cardiovascular disease that can be tracked with a tape measure but can be overlooked by calculating BMI. If doctors can identify women at risk, they can help them make lifestyle and diet changes early on, hopefully to reduce that risk.
MedicalResearch.com: What are your recommendations for future research as a result of this work?
Answer: Late last year, I led a team on the release of a new scientific opinion for the American Heart Association, raising awareness of the cardiovascular and metabolic changes in menopausal transition and the importance of advising women on early interventions to reduce risk factors for cardiovascular disease is required.
More research is needed to determine whether certain diet, exercise, or lifestyle interventions are more effective than others, and whether there is a clear limit to when waist size growth affects risk for heart disease.
MedicalResearch.com: Is there anything else you would like to add?
Answer: The lead author of this research was Saad Samargandy, Ph.D., MPH, of the Graduate School of Public Health, University of Pittsburgh. Additional authors include Karen A. Matthews, Maria M. Brooks, Emma Barinas-Mitchell, and Jared W. Magnani, all from Pitt; and Imke Janssen, Ph.D., and Rasa Kazlauskaite, MD, M.Sc., from Rush University.
This research was funded by the National Institutes of Health with grants U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, HL065581, and HL065591.
Saad Samargandy, Karen A. Matthews, Maria M. Brooks, Emma Barinas-Mitchell, Jared W. Magnani, Imke Janssen, Rasa Kazlauskaite, Samar R. El Khoudary. Abdominal visceral adipose tissue over the menopausal transition and carotid atherosclerosis. Menopause 2021; Publish before going to press DOI: 10.1097 / GME.0000000000001755
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