Why Waist Size Matters

A slimmer waistline isn’t always about looking or feeling good – it can actually help reduce the risk of developing many chronic diseases such as cardiovascular disease, type 2 diabetes and even certain cancers. Learn more about how your body stores fat and how excess abdominal weight can negatively impact your health.

What is visceral fat?

To understand waist size, you must first know the difference between visceral fat and subcutaneous fat. Visceral fat has the most impact on your health.

Visceral fat vs. subcutaneous fat

Your overall body fat contains about 90 percent subcutaneous fat, a type of fat that sits between the skin and outer abdominal wall. Think of this type of fat that you can pinch, poke or grab.

The remaining 10 percent is made up of visceral fat, a type of fat that surrounds internal organs. This fat is deep inside your body and can’t be felt. For example, visceral fat surrounds the liver, intestines and stomach. It is also located in tissue called omentum, which connects the stomach to other internal organs.

Visceral fat, unlike subcutaneous fat, is metabolically active, meaning it releases small proteins called cytokines that produce inflammation. This inflammation can damage nearby organs, leading to an increased risk in heart disease, cancer and diabetes.

Waist size and your health

Many people associate obesity with health problems, but the reality is you don’t need to be clinically overweight to be at risk. Simply carrying around excess weight in your midsection can lead to many complications.

Not many people know this, though, especially with an emphasis on body mass index (BMI). While BMI can provide a glimpse of your health (anything over a 25 is considered overweight), the American Heart Association found that waist size was a more accurate risk factor than BMI to predict heart attacks in women.

Why? BMI isn’t always the best measure of the weight you carry and doesn’t account for the distribution of fat. For example, it can overestimate body fat for people with more muscle mass. Athletes are a perfect example. An in-shape, muscular football player who is 6-foot-2 and 200 pounds would have a BMI of 25.7, which is clinically overweight. The classification of being overweight would be misleading due to the increased muscle mass.

Plus, BMI can be misleading for adults who aren’t in an at-risk category. By definition, a 6-foot man who weighs 170 pounds would fall under the “normal weight” category. However, if that man has more visceral fat in his waist, he could still be at-risk for developing health problems despite a healthy BMI.

The larger your waist, the higher the risk you have at developing the following conditions:

• Type 2 diabetes
• Heart disease
• High blood pressure
• Insulin resistance
• Glucose intolerance
• High cholesterol
• Metabolic syndrome
• Death
• Colorectal cancer
• Breast cancer
• Asthma
• Dementia
• Gallbladder disease
• Sleep apnea
• Stroke

Fat cells are more than just for energy storage. Adipose tissue secretes hormones that fight infection and inflammation, but they also produce hormones that can have a negative impact on your health. 

Here are some examples of these hormones and their role on your health:

Leptin: Leptin is a hormone secreted by fat cells that regulates your appetite by telling you when you’re full. When you have too much leptin in the bloodstream, your body can become resistant to it and won’t be able to regulate the food you eat.

Adiponectin: Adiponectin helps insulin work efficiently and also reduces inflammation. But as fat storage increases, adiponectin levels decrease.

Angiotensin: Angiotensin plays a role in regulating blood pressure by narrowing blood vessels. When these levels become too high, they can contribute to hypertension.

Resistin: Resistin received its name in part because high levels induce insulin resistance, which can lead to type 2 diabetes and other cardiovascular problems.

Chemerin: Chemerin plays a role in inflammation. Too much chemerin creates excess inflammation in people who carry excess weight.

Lipocalin-2: Lipocalin-2 increases insulin resistance and inflammation. Studies show people who are obese have higher levels of this hormone.

More recently, researchers found a link between visceral fat and insulin resistance and inflammation. Visceral fat cells contain a regulatory molecule called TRIP-Br2, which alters lipolysis (the breakdown of fat in fat cells), according to a study at the University of Illinois at Chicago.

What is a healthy waist size?

Several organizations, such as the Centers for Disease Control and Prevention, American Heart Association and the National Heart, Lung and Blood Institute, define abdominal obesity as anything above the following waist circumference measurements:

Men: Greater than 102 cm (40 inches)

Women: Greater than 88 cm (35 inches)

There isn’t a defined “healthy” waist size, per se. Instead, the focus is on keeping it less than 40 inches for men and 35 inches for women.

For context, a BMI between 25 and 30, combined with less than a 40-inch waist for men or less than a 35-inch waist for women, puts you at an increased risk of developing type 2 diabetes, high blood pressure and cardiovascular disease. But when your waist size is above 40 (for men) or 35 (for women), this risk becomes even higher, according to the National Heart, Lung and Blood Institute. 

To get an accurate waist size, place a tape measure around your waist above your hip bones. Don’t suck your stomach in, either. Be sure to breathe out to get an accurate number.

But because height plays a role, too, some medical experts use waist-to-height ratio as a better gauge of abdominal fat. In general, keep waist circumference to less than half your height.

For example, for a 6-foot man (72 inches), a healthy waist size would be anything less than 36 inches. For a 5-foot-2 woman (62 inches), a healthy waist size would be anything less than 31 inches.

You can also measure your waist-to-hip ratio, which can be more accurate since it includes fat near your hips and buttocks. To measure this figure, take the tape measure and place it around the widest part of your hips. Divide your waist measurement by your hip measurement. Anything below 0.8 for women and 0.9 for men is healthy.

How to reduce waist size

Lowering the amount of visceral fat in your body takes a combination of various changes. It’s more than just doing a bunch of crunches or situps.

Exercise: Exercise is the key to burning fat. Any activity that increases your heart rate can help accomplish this, whether it’s aerobic activity or strength training. Use a mix of both to maximize your efforts.

Diet: Swap whole foods for processed foods, packaged goods and sweets. Foods and drinks high in fructose (mainly from processed high fructose corn syrup) are especially dangerous. Fructose can cause significant weight gain, according to several studies. Fruit, vegetables, lean proteins, nuts, seeds and legumes are all good choices to add to your plate. Many of these foods are full of fiber, which will keep you full longer.

Sleep: A lack of sleep has been attributed to an increase in abdominal fat. Try to get seven to nine hours of sleep each night.

Relieve stress: Stress is a normal part of everybody’s day. But when stress happens often and becomes chronic, the hormones released during this process (cortisol) can actually stimulate visceral fat to form.

As you age and your metabolism slows down, it’s important to be aware of how much visceral fat you have in your abdominal area. Eliminating or reducing this fat can help reduce your risk of developing many chronic diseases. Contact an INTEGRIS Health physician today to assess your health needs and to come up with a plan to reduce your waist size.