A groundbreaking study by researchers from Brigham and Women's Hospital and Harvard Medical School has shed new light on the relationship between fat distribution and heart disease risk. This is the first large-scale study comparing different types of fat distribution in the body, specifically intramuscular versus subcutaneous fat. Led by Dr. Viviany Taqueti, the research unveils a crucial insight: not just the presence of excess body fat, but its location, significantly impacts heart disease risk.
The study utilized CT scan measurements at a specific level of the abdomen to assess fat distribution in 669 participants with an average age of 63 years, all of whom were being evaluated for chest pain and/or shortness of breath due to cardiac ischemia but showed no signs of coronary artery disease—a condition known as INOCA (Ischemia with No Coronary Atherosclerosis). The findings indicate that only a small increase in fatty muscle fraction can substantially heighten heart disease risk. A 1% increase in fatty muscle fraction correlates with a 2% increased risk of coronary microvascular dysfunction (CMD) and a 7% increased risk 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
Heart disease remains the leading cause of death in the United States, responsible for one in five fatalities. The study's findings suggest that evaluating fat distribution could become vital in assessing cardiovascular risk, independent of overall body mass index. Dr. Taqueti emphasized the importance of this new understanding, highlighting how intramuscular fat presence serves as an indicator for identifying individuals at high risk.
“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
Despite this significant correlation, the underlying mechanisms remain uncertain. Dr. Taqueti speculates that intramuscular fat may elevate inflammation in surrounding tissues, subsequently affecting blood vessel functionality. However, further research is necessary to unravel this complex relationship.
“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 and its associated risks, Dr. Taqueti advises patients to engage in regular exercise—both cardio and weight training—and adhere to a diet high in fiber and protein while reducing saturated fats and carbohydrates.
“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 study introduces a new approach for quantifying fat in relation to muscle mass using CT scan measurements but suggests alternative methods might emerge in the future.
“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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