What matters more is body fat and where it’s carried, Titano said.
Research has found that fat concentrated around the mid-section is particularly problematic. A larger waist size can signal more visceral fat — deep fat that wraps around the internal organs. And that type of fat is far from “inert,” Titano said.
Visceral fat, she explained, appears to be more “metabolically active” than fat that accumulates under the skin of the hips and thighs. It releases cytokines and other substances that promote inflammation and can inflict damage on the blood vessels and organs.
Visceral fat is also associated with insulin resistance, Titano said. That’s a loss of sensitivity to the blood-sugar-regulating hormone insulin, which can lead to type 2 diabetes, a major risk factor for heart disease and stroke.
Wrapping a tape measure around the waist does not precisely gauge visceral fat. But there is a good correlation between waist size and that deeper fat, Titano said.
When does heart risk rise?
According to the U.S. National Heart, Lung, and Blood Institute, the risk of heart disease rises when waist size expands beyond 35 inches for women and 40 inches for men.
Dr. Tiffany Powell-Wiley, an investigator with the NHLBI, led the writing committee on the AHA statement.
When it comes to managing extra belly fat, there are no magic diets, she said.
Instead, it comes down to the familiar mantra of portion control, and opting for “whole” foods — fruits, vegetables, fiber-rich whole grains, beans, fish and lean meat — over processed and sugar-laden foods, Powell-Wiley said.
As for exercise, the good news is that grueling workouts are not necessary.
