Menopause: Accelerated Belly Fat Linked to Greater Risk of Heart Disease

MedicalResearch.com Interview with:

Samar El Khoudary, PhD, MPH, BPharm, FAHA Associate Professor of Epidemiology University of Pittsburgh Graduate School of Public Health

Dr. El Khoudary

Samar El Khoudary, PhD, MPH, BPharm, FAHA
Associate Professor of Epidemiology
University of Pittsburgh Graduate School of Public Health

MedicalResearch.com: What is the background for this study?

Response: Research increasingly shows that it isn’t so important how much fat a woman is carrying, which doctors typically measure using weight and BMI, as it is where she is carrying that fat. To investigate this, we looked at 25 years of data on 362 women from Pittsburgh and Chicago who participated in the Study of Women’s Health Across the Nation (SWAN) Heart study. The women, who were an average age of 51, had their visceral adipose tissue—fat surrounding the abdominal organs—measured by CT scan and the thickness of the internal carotid artery lining in their neck measured by ultrasound, at a few points during the study. Carotid artery thickness is an early indicator of heart disease.

 MedicalResearch.com: What are the main findings?

Response: My team found that for every 20% increase in abdominal fat, the thickness of the carotid artery lining grew by 2% independent of overall weight, BMI and other traditional risk factors for heart disease.

We also found that abdominal fat started a steep acceleration, on average, within two years before the participants’ last period and continued a more gradual growth after the menopausal transition. 

MedicalResearch.com: What should readers take away from your report?

tape-measure-abdomen-adipose-fat.jpgResponse: Women who experience an accelerated accumulation of abdominal fat during menopause are at greater risk of heart disease, even if their weight stays steady. This suggests that measuring waist circumference during preventive health care appointments for midlife women could be an early indicator of heart disease risk beyond the widely used body mass index (BMI)—which is a calculation of weight vs. height.

Historically, there’s been a disproportionate emphasis on BMI and cardiovascular disease. Through this long-running study, we’ve found a clear link between growth in abdominal fat and risk of cardiovascular disease that can be tracked with a measuring tape but could be missed by calculating BMI. If doctors can identify women at risk, they can help them modify their lifestyle and diet early to hopefully lower that risk.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Late last year, I led a team in publishing a new scientific statement for the American Heart Association that calls for increased awareness of the cardiovascular and metabolic changes unique to the menopausal transition and the importance of counseling women on early interventions to reduce cardiovascular disease risk factors.

More research is needed to determine if certain diet, exercise or lifestyle interventions are more effective than others, as well as whether there is a clear cut-off point for when growth in waist circumference becomes concerning for heart disease risk.

MedicalResearch.com: Is there anything else you would like to add? 

Response: The lead author on this research was Saad Samargandy, Ph.D., M.P.H., of the University of Pittsburgh Graduate School of Public Health.  Additional authors include Karen A. Matthews, Ph.D., Maria M. Brooks, Ph.D., Emma Barinas-Mitchell, Ph.D., and Jared W. Magnani, M.D., M.Sc., all of Pitt; and Imke Janssen, Ph.D., and Rasa Kazlauskaite, M.D., M.Sc., of Rush University.

This research was funded by National Institutes of Health grants U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, HL065581 and HL065591.  


Saad Samargandy, Karen A. Matthews, Maria M. Brooks, Emma Barinas-Mitchell, Jared W. Magnani, Imke Janssen, Rasa Kazlauskaite, Samar R. El Khoudary. Abdominal visceral adipose tissue over the menopause transition and carotid atherosclerosis. Menopause, 2021; Publish Ahead of Print DOI: 10.1097/GME.0000000000001755



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Last Updated on March 4, 2021 by Marie Benz MD FAAD