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Belly fat increases the risk of dementia

Sagittal abdominal diameter
Sagittal Abdominal Diameter

Here is another reason to get rid of that pot belly. It turns out that belly fat, the "apple" body shape, increases the risk of dementia. Dr. Rachel Whitmer, an epidemiologist working for Kaiser Permanente, has found strong association between obesity in middle age and future risk of Alzheimer disease, dementia, and cognitive impairment. Obese people with a Body Mass Index (BMI) of 30 or higher had a 74% increased risk of dementia.[1]

Although BMI has been used as a measure of corpulence, BMI reflects only the ratio of body weight to the square of the height, so it does not take into consideration the distribution of the weight. It is well known that bodybuilders with massive chest muscles and small waists have BMIs over 30 which is the range for obesity. Similarly, persons with skinny legs and fat abdomens have BMIs in the normal range. Increasingly, BMI is being displaced or supplemented by other measures that more accurately reflect the degree of abdominal adiposity, such as the Waist-to-Height ratio and the Sagittal Abdominal Diameter.

The Sagittal Abdominal Diameter, normally measured with a caliper, is the distance from the back to the upper abdomen midway between the top of the pelvis and the bottom of the ribs. This is basically the distance between the belly button and the back, as illustrated above. The Sagittal Abdominal Diameter closely correlates with the amount of belly fat and has become a good predictor of risk of sudden death from cardiovascular disease[2] and of insulin resistance[3].
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[1] Whitmer RA, et al., Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study, BMJ (British Medical Journal) 2005 Jun 11;330(7504):1360. Epub 2005 Apr 29. PMID: 15863436

[2] J.P. Empana, et al., Sagittal Abdominal Diameter and Risk of Sudden Death in Asymptomatic Middle-Aged Men. The Paris Prospective Study I, Circulation, 2004;110:2781-2785.

[3] Ulf Risérus, et al., Sagittal Abdominal Diameter Is a Strong Anthropometric Marker of Insulin Resistance and Hyperproinsulinemia in Obese Men, Diabetes Care, 27:2041-2046, 2004.

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