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protein (CRP). This protein particle, which can easily be measured in clinical practice with a blood test known as the high-sensitivity CRP (hs-CRP) test, is appropriately elevated when there is infection in the body, but it has also been found in dangerously high levels in people with belly fat, prediabetes, and diabetes. Overall, studies show that we Americans have 20 percent higher levels of CRP than our British cousins. And it is this and other research that indicates that we are indeed a hyperinflamed society.
Paul Ridker, MD, and his colleagues at the Center for Cardiovascular Disease Prevention at Harvard, who did the initial research on CRP, have taught us that elevated levels of CRP are a risk factor for heart disease and that chronic inflammation is intimately involved with atherosclerosis, the buildup of fatty plaque in our arteries that leads to the blockages that cause heart attack and stroke. But we are only now realizing that the scourge of inflammation goes well beyond affecting the heart and blood vessels. In recent years, we have learned that inflammation appears to be a common denominator behind numerous other diseases, including diabetes, Alzheimer’s, macular degeneration, asthma, arthritis, and many forms of cancer. Belly fat and inflammation also appear to play a role in such common conditions as acne and psoriasis.
Belly Fat = Inflammation
Why should inflammatory substances be associated with belly fat? It turns out that an inflammatory response requires energy. If early man was starving, he could not afford the energy expenditure needed for an inflammatory response. All his energy was required just to bring blood and nourishment to his organs. This trade-off meant he was vulnerable to death from injury or infection, and it is probably why our inflammatory response became associated with belly fat. The presence of belly fat in our forebears ensured the fuel reserve that was required for the protective inflammatory response. The fact is, humans were never intended to be carrying around the excess fat so many of us are lugging around today.
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WHY YOUR BMI CAN BE MISLEADING
B ody mass index (BMI) is a formula for measuring optimal weight. It uses your height to adjust for your weight as it compares you to other individuals and populations. For instance, two men may weigh 200 pounds, but if one is 5-foot-5 and the other is 6-foot-2, then weight alone is obviously a very poor predictor of which one is in fact overweight. BMI is the most common method of classifying normal versus overweight versus obese individuals. If your BMI is between 18.5 and 24.9, you’re considered to be in a healthy weight range for your height. If your BMI is between 25 and 29.9, you’re considered overweight. And, if the figure is 30 or greater, you’re considered obese. To determine your BMI, just use one of the quick BMI calculators available on the Web.
While BMI has been a more helpful measure of obesity than weight alone, when it comes to comparing obesity rates in two different cities or states, it can be a misleading indicator of health in individuals. That’s because BMI does not take into account the distribution of body fat. Remember, fat concentrated in the belly is much more dangerous than fat concentrated directly under the skin. For instance, you might have a professional athlete with a great deal of muscle mass who has an elevated BMI but little belly fat, or a severely overweight person with a high BMI who has fat predominantly concentrated under the skin. Both of these people may well be at low risk for prediabetes, diabetes, and heart disease. Conversely, you can have someone with a normal BMI who carries a dangerous amount of visceral fat in a potbelly. That person’s BMI might be normal because of thin arms and legs and little weighty muscle—but that person is nevertheless at increased risk for heart disease and many other diseases as well.
So if BMI can’t accurately predict if your fat is
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