Belly Fat Predicts Dementia in Women

July 05, 2020

"My tummy keeps getting fatter, and I'm not even gaining weight!" she said.  This is such a common complaint in my practice, I could recite it for you.  You are age 57, postmenopausal, and you feel like your tummy won't get smaller, no matter what you do.  And it gets worse!  Here comes data that predicts that tummy fat is going to result in your developing dementia.

This week's study is from England where Alzheimer's is now the number one cause of death.  The Brits live some 3 years longer than Americans, which accounts for some of the difference, but Americans are on track to have dementia be our number one cause in a couple more years. So, just what is this study showing us?

The British ELSA (English Longitudinal Study of Ageing) study looked at 6582 adults over age 50who were dementia-free at the beginning of the study. Everything got measured and then followed for 11 years.  Women's waists over 88 cm (34.7 inches) and men's over 102 cm (40 inches) were considered too big.  The correlated pretty well with a BMI of greater than 24.9. When controlling for all the usual variables that make risk for dementia, including APOE-4, women with larger waist sizes had a 39% increased risk of developing dementia.  Now, that was just in 11 years.  Those who developed dementia were, on average, 71 years of age when they entered the study.  Those who didn't were, on average 10 years older.  This supports the notion, well documented elsewhere, that the longer you live, the higher your risk.   Now you have to add the "bigger your waist".

What could be going on with bigger bellies?   Well, belly fat isn't just idle calorie storage.  It is actually quite inflammatory stuff.  When you measure blood coming out of the portal vein of folks with high "visceral fat", their IL-6 is much higher than folks with normal-sized tummies and lower visceral fat.  (VIsceral fat is the stuff around your intestines and organs, not the stuff the plastic surgeon sucks out.  Sorry.  That's right, a tummy tuck won't help reduce your risk.). High IL-6 results in high CRP, which you can easily measure.  

Is it high insulin?  It's clear that the larger your fat mass, the higher your insulin level.  As you get bigger, your fat cells go rogue and start being less insulin-responsive.  You need a higher insulin level to control your blood sugar.  High sustained insulin is hard on your brain.  Curiously, you act as though you can only make so much insulin in a lifetime.  If you are forcing your body to make a lot to control high blood sugar by being overweight, you then eventually run out of insulin and deplete your ability to resist high sugar.  And that's what you see in humans.  Low grade elevated blood glucose, associated with a big belly in the 40s turns into higher sugar and a blood glucose controlling medication in the 50s turns into full-blown, insulin-dependent diabetes in the 60s. 

We can fix this.  The fast mimicking diet taught by Longo does it.  You will lose weight when you eat only 800 calories for 5 days.  Better yet, you will rebound with a burst of stem cells and repopulate your pancreas gland with more insulin-producing stem cells.  (At least in mice you will.  It's really hard to find humans willing to let themselves be sacrificed and their pancreas glands examined for the sake of science.  The informed consent for mice is shorter.). And Belly Fat appears to go first, along with waist size and CRP.   Nice combo.

References:  Int Jr EpidemiologyDiabetes,  Curr Opin End Diabetes, CellValterLongo

www.What will work for me.  Hmm.  I have a mother who developed dementia.  I'm concerned for myself.  My waist size hovers around 38.  I have work to do.  Join me.  Every month I spend 5 days eating 800 calories for the last 5 weekdays of the month.  It was hard the first time I did it but after 4-5 months it got to be easy and routine.  On day 3 my brain turns into a laser and I correlate that with my ketones rising above 2 on my Keto Mojo beta-hydroxybutyrate meter.  

Pop Quiz

1.  You are a 61 year old woman with a waist size of 35 inches, or even 36.  Should you be worried about dementia".             Answer:   YES!

2.   Ok, how worried?    Answer:  39% worried, in just 11 years.

3.    Whew.  You are a man so you don't have to worry as much with a big waist size.  T or F.   Answer: Curiously, true.  At least in this study.  There has to be more to this but for now, being a slightly pudgy man, at least an Englishman, is ok. Fee, Fi, Fo, Fum.....

4.   So you just saw a belly fat sculptor who was going to freeze off your belly fat.  That will reduce your risk of dementia.  T or F.    Answer:   Sorry. False.  You may feel better about yourself but all you did was take off the superficial stuff.  It does look ugly but the harm appears to come from the fat around your intestines and organs and that isn't sculpted off.  

5.   Belly fat looks awful but it's not really dangerous.  T or F.      Answer:  This study says it's not so bad for men, but for women, it carries a 39% increased risk of dementia.  It's got to be addressed if we are to reduce risk of dementia.