Heart disease remains the leading cause of death in the United States, accounting for one in every five fatalities. A recent groundbreaking study suggests that the risk of heart disease may not solely depend on the quantity of body fat but rather where it is stored. Conducted by researchers at Brigham and Women’s Hospital and Harvard Medical School in Boston, this large-scale study highlights the significance of fat distribution, particularly intramuscular fat, in predicting heart disease risk.
The study, led by Dr. Viviany Taqueti, MD, MPH, Director of the Cardiac Stress Laboratory at Brigham and Women’s Hospital, marks a pioneering effort in comparing different types of fat distribution in the body. Researchers recruited 669 participants with an average age of 63 years, who were being evaluated for chest pain and shortness of breath due to cardiac ischemia but showed no evidence of coronary artery disease. This condition, known as INOCA (Ischemia with No Coronary Atherosclerosis), provided a unique cohort for examining the impact of fat distribution on heart health.
Utilizing CT scan measurements at a specific abdominal level, the study quantified the amount of fat relative to muscle. The findings revealed that even individuals of a healthy weight could be at increased risk of heart disease depending on their fat storage patterns. Specifically, a mere 1% increase in the fatty muscle fraction correlated with a 2% rise in coronary microvascular dysfunction (CMD) risk and a 7% increase in the likelihood of future serious heart disease.
"This observational study found an association between specifically the 'intramuscular' fat and increased risk of developing heart disease. This is the first large-scale study to compare different types of fat distribution in the body (intramuscular vs. subcutaneous) and provides insight into how we might better assess someone’s health status by their fat distribution." – Viviany Taqueti, MD, MPH
Dr. Taqueti emphasized the relevance of these findings, noting that identifying individuals at high risk for heart disease extends beyond traditional measures like body mass index (BMI).
"Knowing that intermuscular fat raises the risk of heart disease gives us another way to identify people who are at high risk, regardless of their body mass index." – Viviany Taqueti, MD, MPH
The study's results suggest that intramuscular fat may contribute to increased heart disease risk by potentially elevating inflammation in surrounding tissues, affecting blood vessel function.
"It is not yet clear why intramuscular fat might increase someone’s risk of developing heart disease. It is possible that the intramuscular fat increases inflammation in the surrounding tissues, which then affects the function of the blood vessels in the area. More study is needed to better understand this relationship." – Viviany Taqueti, MD, MPH
To mitigate overall body fat accumulation and its potential risks, Dr. Taqueti advises adopting a lifestyle that includes regular exercise and a balanced diet.
"In order to reduce total body fat, we advise patients to exercise regularly (both cardio and weight training) and eat a healthy diet higher in fiber and protein and lower in saturated fat and carbohydrates." – Viviany Taqueti, MD, MPH
The research team also explored future possibilities for measuring intramuscular fat through alternative techniques beyond CT scans.
"This study used CT scan measurements at a certain level of the abdomen to quantify the amount of fat in relation to the muscle detected. In the future, intramuscular fat might be measured through other techniques." – Viviany Taqueti, MD, MPH
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