Target Belly Fat to Reduce the Risk of Heart Disease

By Michael A. Smith, MD

Did you know that belly fat is a strong predictor of heart disease? It is, and it’s hardly breaking news. As a matter of fact, this finding was first reported by the British Medical Journal back in 1984.

In the study, researchers measured a surrogate marker for belly fat known as the waist-hip-ratio or WHR, and this is what they concluded: “results indicate that in middle aged men the distribution of fat deposits may be a better predictor of cardiovascular disease and death than the degree of adiposity [fat].”1

In short, it’s not about the amount of fat, but where it’s found that leads to trouble.

Several studies since then have confirmed and supported the same conclusion. One particular study in 1999 also measured the waist-hip-ratio and its effects on heart disease in women. They concluded, “These results emphasize the importance of WHR (waist-hip-ratio) as a coronary risk indicator in younger women.”2

So what’s being done to target belly fat, improve the waist-hip-ratio, and reduce heart disease risk as a result of these findings? Not nearly enough.

Balancing Hormones for a Healthy Heart

The advice that doctors typically offer when walking patients out of the examination room today is to “diet and exercise.” Unfortunately, little (or nothing) is done to help and inform patients about losing belly fat to reduce the risk of heart disease.

What doctors should be offering is help in correcting the three common hormonal imbalances that are typically to blame: Excess cortisol, estrogen dominance, and excess insulin leading to reduced insulin sensitivity.

As it turns out, these hormonal imbalances are at the center of the belly fat epidemic, and resolving them can reduce your waist size, improve your heart health, and ultimately help you avoid a potentially lethal trip to the hospital.

Chronic Stress and Cortisol

Rush-hour traffic, screaming kids, relentless workloads — many of us are under lots of pressure and trying our best to keep it together. But chronic stress can affect more than just our sanity — it’s also a direct path to excess fat in our midsections.

Stress releases cortisol into the bloodstream, and cortisol helps to fight back against the stress by mobilizing sugar energy. This flood of cortisol spikes your blood sugar, giving you immediate energy to burn.

However, if this cortisol-driven sugar isn’t burned for energy, it gets stored as belly fat. As such, the long-term effects of stress can be devastating to your waistline.

And from here, you know how the rest plays out. As belly fat increases, so does the risk for heart disease. So, managing cortisol is definitely in you and your heart’s best interest.

Estrogen and Our Midsections

A study published just last year followed blood levels of estrogen in three groups: men suffering from acute heart attacks, men who have suffered from a heart attack in the past, and men who had no history of heart disease at all.

The results showed significantly higher levels of estrogen and lower levels of testosterone in both groups of heart attack patients compared to those without a history of heart disease.3

Why does the rise in estrogen increase the risk for heart disease? One reason may just be the increase in belly fat. Excess estrogen in both men and women has shown to be a major cause of fat accumulation in our midsections.

Excess Insulin Leads to Belly Fat

Refined sugar, the American diet’s all-around nemesis, promotes an overproduction of insulin, the hormone responsible for transporting sugar into our cells. Simply put, when there’s too much sugar, there’s too much insulin.

The real problem, however, lies within our insulin receptors. When they’re overworked, they can become damaged and “desensitized” to insulin. The result is a steady rise in blood sugar over time. Once again, if this excess sugar is not burned for energy, it’s stored in your waistline as fat. See a trend here?

Correcting Hormonal Imbalances

So aside from eating well and getting plenty of exercise, how else can we combat and correct these common hormonal imbalances? Here are some tips for doing exactly that:

  1. Adaptogenic herbs, such as Ashwagandha and American ginseng, enhance mood and help us deal with stress. In one large study, Ashwagandha reduced cortisol levels by 26%.4 These potent herbs may help to minimize belly fat and reduce the negative impact of stress on heart health.
  2. Cruciferous vegetables, like broccoli, cauliflower, and cabbage are concentrated with compounds like DIM and I3C which help promote healthy estrogen metabolism. This is good for your waist size and your heart.
  3. Lipoic acid is a powerful antioxidant that helps restore youthful insulin sensitivity.5 We suggest supplementing with the bioactive form known as R-lipoic acid.

How are you keeping your midsection in check? Have you ever considered the role that hormones play in belly fat and heart health? Please share your thoughts in the comments.


  1. Br Med J (Clin Res Ed). 1984 May 12;288(6428):1401-4.
  2. Arterioscler Thromb Vasc Biol. 1999 Mar;19(3):695-9.
  3. Neuro Endocrinol Lett. 2007 Apr;28(2):182-6.
  4. Unpublished study, 2005. Nutrigenesis, LLC.
  5. Expert Opin Investig Drugs. 2007 Mar;16(3):291-302.


tom said...

nice post but i would like to ask if BMI is a better tool to analyze obesity or Waist hip ratio?

Life Extension said...

Tom, BMI is what doctors use to measure obesity...if you have a BMI greater than 30 you're considered obese. However, it's not a great measurement of overall health. The waist-to-hip ratio can be used to predict risk for cardiovascular disease. You can have a normal BMI but a high waist-to-hip ratio which would put you at risk for heart disease.

Waist to Hip Ratio said...

Is there any similarity with men? Do older overweight men also suffer of a loss of memory?

Life Extension said...

Waist to Hip Ratio, the hormonal imbalances describe in the post affect men and women. Also, both genders suffer from memory loss with age and this may not correlate to excessive weight. However, a few population studies have shown a possible link between weight and memory.

Waist to Hip Ratio said...

I don’t usually comment on posts like this one (though I read them), but I just have to add:

WHR can be very misleading if you want to use it to judge someone’s appearance (or attractiveness). But I can see the point; in general, women do have lower WHR than men. Historically, women with lower WHR (if we interpret “low WHR as “hourglass higure”) were considered more attractive, in most parts of the world. Today the image (at least media image) is a bit different.

I am around 0.61 and it’s considered unattractive.

health500 said...

recently heard the news that a lack of sleep can be bad for one's heart. What does it have to do with that? And how does it lead to gaining weight?

greatnnatural said...

Great blog man.
Keep up the good work you have some good articles here.


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