Association between expanding waistline in the 40s and 50s and early stages of Alzheimer's disease
New study reveals a concerning link between excess belly fat in middle age and early signs of Alzheimer's disease and dementia Deep abdominal fat contributes to brain inflammation, increasing the risk However, there is hope as this type of fat is easier to lose
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According to Dr. Richard Isaacson, a preventive neurologist at the Institute for Neurodegenerative Diseases of Florida, research suggests that there is a correlation between belly size and the shrinkage of memory centers in the brain, contributing to the development of Alzheimer's disease.
Isaacson, who was not involved in the study, stated that this study presents a new brain imaging marker of neuroinflammation. The brain imaging findings establish a connection between visceral fat, or belly fat, and brain dysfunction through an inflammatory cascade.
According to the study's senior author, Dr. Cyrus Raji, individuals in their 40s and 50s with higher levels of hidden belly fat were found to have increased levels of an abnormal protein called amyloid in a specific area of the brain, known to be one of the earliest locations for Alzheimer's disease.
Beta amyloid plaques and tau protein tangles are two prominent indicators of Alzheimer's disease in the brain. Initially, amyloid plaques are observed, followed by the development of tau tangles as the disease advances.
Regarding the influence of gender, Raji mentioned a notable disparity. Men demonstrate a stronger correlation between their abdominal fat and amyloid levels compared to women. This finding is significant due to the fact that men exhibit higher amounts of visceral fat in comparison to women.
The study also found a relationship between deep belly fat and brain atrophy, or a wasting away of gray matter, in a part of the brains memory center called the hippocampus.
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"Thats important because brain atrophy is another biomarker of Alzheimers disease," Raji said.
The majority of brain cells responsible for directing body functions are located in the gray matter. White matter, on the other hand, consists of fibers that form connections between brain cells and the rest of the nervous system, often organized into bundles known as tracts. According to Dr. Mahsa Dolatshahi, the lead author of the study and a postdoctoral research fellow at Washington University School of Medicine, they discovered that individuals with higher amounts of visceral fat tend to have more inflammation in various white matter tracks in the brain.
Without a functional white matter highway, the brain cannot adequately communicate with different parts of the brain and the body.
Pushing the envelope
The results of a pilot study, initially published in the journal of Aging and Disease in August, investigated the brains and abdominal regions of 32 adults aged 40 to 60. Since then, the research team has expanded the study to include an additional 20 participants, bringing the total to 52. These new findings will be presented at the 2023 conference of the Radiology Society of North America on Monday.
As the study group grew, the team gained valuable insights into the impact of inflammation caused by abdominal fat on the brain regions associated with the onset of Alzheimer's disease. Although the observed brain changes were relatively small, they held significant importance, according to Raji.
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"The subtle effects we have observed can be attributed to the fact that we focused on individuals in their 40s and 50s, unlike previous studies that examined those in their 60s and 70s," he explained. "These individuals are unlikely to develop Alzheimer's disease for another 20 or 25 years, if at all.
"Our aim is to push the boundaries of early detection by identifying the most subtle signs of abnormalities associated with Alzheimer's pathology," Raji elaborated. "By establishing a pathological connection to visceral fat, we may have the opportunity to intervene in this particular population."
Visceral fat and inflammation are closely linked. Subcutaneous fat, commonly associated with being pinchable or found along the waistline, is what most people think of when they hear the word "fat." However, the Cleveland Clinic reports that subcutaneous fat only makes up about 90% of the body.
Visceral fat cannot be physically examined or measured. Instead, it resides within the abdominal muscles, nestled deeply in the belly, enveloping vital organs. Both types of fat release hormones and other substances, but specialists assert that visceral fat is more metabolically active, emitting signals which may lead to insulin resistance and other health complications.
Studying the effects of specific artificial sweeteners is a challenge in today's world due to the prevalence of mixed sweetener combinations used by soda and food manufacturers. This makes it difficult to determine which sweetener may be problematic. However, ongoing studies continue to reveal concerning findings. In 2008, a study linked consuming more than two servings of diet soda per day to a doubled risk of kidney decline in women. Another study in 2012 suggested a potential connection between diet sodas and an increased risk of vascular events. Furthermore, multiple studies have found a correlation between metabolic syndrome and Type 2 diabetes, potentially attributed to alterations in gut bacteria.
"The association between prediabetes and the risk of dementia increases with age," stated Isaacson. "While subcutaneous fat usually does not contribute to insulin resistance, higher levels of visceral fat can lead to inflammation in the body and the brain, resulting in insulin resistance."
Insulin resistance is the result of cells in the body not effectively responding to insulin, a hormone crucial for controlling blood sugar levels. This condition often leads to the development of diabetes and various other chronic diseases.
According to Isaacson, we propose that inflammation in the fat cells is responsible for insulin resistance, a process accelerated by visceral fat. Insulin resistance subsequently triggers inflammation, which accelerates the deposition of amyloid, a major indicator of Alzheimer's disease. This is why individuals with diabetes are twice as likely to develop Alzheimer's disease.
To accurately measure visceral fat, expensive full-body MRIs and body scans are considered the most precise methods. However, many people rely on estimates that are based on waist circumference or waist-to-height ratio. According to the Cleveland Clinic, to measure your waist accurately, you should wrap a flexible tape measure around your waist just above your hips.
The clinic's website specifies that women with a waist measurement of 35 inches (89 centimeters) or more are at risk for health problems associated with visceral fat. For men, the threshold is a waist measurement of 40 inches (102 centimeters) or more.
"People of all weights should be aware of the presence of hidden visceral fat," advised Raji. "This type of fat can go unnoticed when relying solely on body mass index (BMI) or weight measurements."
This is due to the fact that even individuals who appear thin can carry excessive amounts of visceral fat. Referred to as "skinny fat" or "TOFI" (thin outside, fat inside), it is commonly observed among those who exercise but follow an unhealthy diet, as well as within certain ethnic populations. As an example, Asians tend to have higher levels of visceral fat compared to individuals of Black, White, or Hispanic descent.
Great news! According to Raji, visceral fat is more responsive to diet and exercise. Losing visceral fat is easier compared to losing subcutaneous fat since it is metabolized and burned more efficiently.
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From the standpoint of exercise and nutrition, there are various approaches to reduce body fat, according to Isaacson.
Isaacson recommends following a nutritious diet and engaging in regular physical activity. This routine should include strength training sessions a few times each week, along with lower-intensity cardio exercises aimed at burning fat for 45 to 60 minutes, several times per week.
Additional tips for improving your health include: reducing or eliminating ultraprocessed foods, controlling portion sizes, swapping sugary beverages for water, limiting consumption of processed meats, and reducing intake of meat and high-fat dairy products, such as cheese and butter, which are high in saturated fats, as advised by other experts.
It's also important to be mindful of your alcohol consumption. According to the Mayo Clinic, it's not just beer that can contribute to a "beer belly." Consuming any type of alcohol can lead to an increase in waist size.
Watch your sleep as well. Millions of Americans are sleep-deprived on a daily basis, yet studies have found people who sleep less than six hours a day have greater levels of amyloid in their brains.
