Cut your risk of dementia by losing your belly fat

Not to mention heart disease, diabetes, fatty liver.....

Putting on a few pounds is all too easy, and easy to ignore, but pay attention to where that extra weight is going. If those pounds head straight for your gut area, you risk more than the cost of going up a size or two.

Men are more likely than women to develop a big belly, but once women arrive at the other end of the menopause they join their menfolk in wondering where their waistlines have gone.

That’s because their oestrogen levels have plummeted. In pre-menopausal women, this hormone stimulates fat accumulation around the hips, a distribution that favours childbearing. After the menopause, oestrogen takes its leave, and fat storage is rerouted towards the abdomen.

Know your belly fats

The layer of fat just below the skin is called subcutaneous. Subcutaneous fat protects your organs and forms an insulating layer that helps regulate body temperature.

Visceral fat is much deeper and can begin to accumulate around the internal organs, including the heart, liver and pancreas. This is something to be concerned about, and not just because your muffin top is not the look you were aiming for.

These organs are usually lean. But when they become fatty you increase your risk of certain chronic diseases: heart disease, stroke, some cancers, metabolic syndrome, diabetes and non-alcoholic fatty liver disease (NAFLD).

The brain connection

Visceral fat is also very much associated with dementia.

In 2018 the British Journal of Nutrition published the results of a large observational study that showed how central adiposity – aka a fat belly - was associated with poorer cognitive function in older people. General obesity was not found to have the same association.

‘In conclusion, this is one of the largest studies of older adults to demonstrate that central adiposity is associated with subtle cognitive impairment in community-dwelling older adults.’

Loss of brain volume is one sign of deteriorating cognitive function, and so is loss of cortical thickness, the cortex being the outer layer of the brain. MRI scans reveal that both these signs are frequently seen where there is a high level of visceral fat. Indeed, this fat is considered a predictor of brain shrinkage in multiple regions, including the hippocampus. This is the region that is especially important for memory.

‘These results suggest that already in midlife, abdominal fat accumulation may have deleterious effects on brain health’

How do you know if you have lots of visceral fat?

The body mass index score – BMI – is an international measure of overweight and obesity in general. But BMI, apart from being a crude and not always helpful tool, tells you nothing about body fat distribution.

A waist measurement above 35 inches (89 cm) in women and 40 inches (101.5 cm) in men is considered unhealthy and a risk factor. Another useful measure is waist-to-hip ratio. To calculate this, take your hip measurement around the widest part of your hips, and divide waist by hip. A ratio higher than 0.85 in women and 0.9 in men suggests abdominal obesity.

But even a tape measure can mask what lies beneath. Some people are ‘thin on the outside, fat on the inside’. It is estimated that 14% of men and 12% of women fit this description. The fat is not visible, because it is deeply embedded around organs. This body type is also described as ‘metabolically-obese but normal-weight’.

By understanding how that fat got there, and how to make it go away, you can lower your risk of developing not only dementia but all the other health conditions that come as part of the package.

Here’s how.