Abdominal Girth More Significant than BMI
A report this year in the New England Journal of Medicine confirmed earlier findings that a higher body mass index (BMI) is significantly associated with mortaility. More importantly, a large European study found that the risk of premature death increased as waist circumference increased, even among individuals with identical BMI.
The risk of premature death for those with a larger waist (at least 40.4 inches for men, and 35 inches for women) was double that for those with a smaller waist (less than 34 inches for men and 28 inches for women). For each 2 inch increase in waist circumference, mortality increased 17% for men, and 13% for women.
Lurking behind that expanding waistline is the real danger. Intra-abdominal adiposity, or visceral fat, is a highly metabolically active generator of silent inflammation. These fat cells produce and release inflammatory cytokines that cause a cascade of inflammatory responses throughout the body, that can lead to high blood pressure, blood sugar imbalances, insulin resistance, excess lipid levels, cardiovascular disease, type 2 diabetes and premature death.
Compounding this issue is the interaction of viceral fat with the cannabinoid hormone system (named after the marijuana or cannabis, plant). These hormones are made from omega-6-fatty acids. In the brain they cause overeating (munchies), particularly fatty foods and sugars, resulting in abdominal obesity, which leads to insulin resistance and glucose intolerance. Stimulation of intra-abdominal receptors causes the liver to produce more fat, causing elevated triglyceride and LDL (bad) cholesterol levels.