Belly fat is the shape of cardiovascular risk

Extra fat that accumulates around the abdomen goes by many names: beer belly, spare tire, love handles, apple shape, middle-age spread, and the more technical “abdominal obesity.” No matter what the name, it is the shape of risk.

Abdominal obesity increases the risk of heart attack, stroke, diabetes, erectile dysfunction, and other woes. The danger zone is a waist size above 40 inches for men and 35 inches for women.

As I describe in the April 2011 issue of the Harvard Men’s Health Watch, beer is not specifically responsible for a beer belly. What, then, is to blame? Calories. Take in more calories with food and drink than you burn up with exercise, and you’ll store the excess energy in fat cells.

Many studies indicate that people who store their extra fat around the midsection (apple shape) are at greater risk for heart and other problems than people who carry it around their thighs (pear shape). An analysis of 58 earlier studies covering over 220,000 men and women suggests that excess fat is harmful no matter where it ends up. This work was published in The Lancet.

Back to beer for a moment. Although it is not a special problem, its extra calories can add to abdominal obesity. A standard 12-ounce beer contains about 150 calories. In comparison, a 5½-ounce glass of wine or a 1½-ounce shot of hard liquor provides about 100 calories.

Many people who drink alcohol, like many who drink sugar-sweetened soda, tend to forget that these beverages contain calories. And they often don’t cut back on calories elsewhere to make up for them. So if you want to prevent a beer belly, wine belly, or soda belly, drink caloric beverages in moderation, if at all, and work them off with exercise.