Abdominal fat linked to poor brain health, cognition


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A new study suggests abdominal fat could impact brain health and cognition among people with a high risk for Alzheimer’s. Shana Novak/Getty Images
  • Researchers from Rutgers University say abdominal fat could impact brain health and cognition among people at risk for Alzheimer’s disease.
  • Researchers found that middle-aged males with a high Alzheimer’s risk who had higher amounts of pancreatic fat had lower cognition and brain volumes.
  • Abdominal fat also affected Alzheimer’s risk among female participants, but less so compared to males.

There are about 47 million people around the world living with Alzheimer’s disease (AD), with that number expected to jump to 76 million by 2030.

Alzheimer’s disease is the most common type of dementia.

There is currently no cure for Alzheimer’s disease. While anyone can develop Alzheimer’s, several factors may influence a person’s risk of developing the condition. These include:

Now, researchers from Rutgers University present evidence suggesting the amount and location of abdominal fat a person has can impact their brain health and cognition if they are at a high risk of developing Alzheimer’s disease.

The study was published February 27 in the journal Obesity.

Abdominal fat comprises subcutaneous or visceral fat located deep within the body’s abdominal cavity and surrounds organs such as the pancreas and liver.

A person’s visceral fat can be determined using a tape measure to measure their waistline.

While a healthy level of visceral fat is used to protect these organs, too much has been linked to health issues such as:

Previous studies have also looked at a link between unhealthy body weight levels and dementia risk.

A study presented at the annual meeting of the Radiological Society of North America in November 2023 reported visceral fat could trigger brain changes related to Alzheimer’s up to 15 years before diagnosis.

Research published in August 2018 found that higher levels of abdominal fat in older adults are associated with cognitive decline.

Dr. Michal Schnaider Beeri, director of the Herbert and Jacqueline Krieger Klein Alzheimer’s Research Center at Rutgers Brain Health Institute and senior author of this study, explained to Medical News Today why they decided to study the impact of abdominal fat on brain health and cognition in people with a high risk of developing Alzheimer’s disease.

“The pathology that develops in the brain of Alzheimer’s patients begins in middle age,” Dr. Schnaider Beeri detailed. “Also, the associations of risk factors — such as obesity — with Alzheimer’s (are) strongest when the risk factors evolve in midlife. So we have a great interest in focusing (on) midlife as a critical epoch for potential prevention of Alzheimer’s disease.”

“We focus on (the) offspring of Alzheimer’s patients because they are at higher risk for developing the disease — a group of people for whom discoveries for prevention would be of the highest clinical value,” she continued. “(And) in general, the focus of research on the relationships of obesity with Alzheimer’s has been on body mass index (BMI) which does not represent (fat well), especially in older adults.”

— Dr. Michal Schnaider Beeri, senior study author

For this study, Dr. Schnaider Beeri and her team recruited 204 healthy middle-aged adults with a history of Alzheimer’s disease in their families. Study participants had a mean age of about 60, and 60% of the group was female.

Participants underwent abdominal magnetic resonance imaging (MRI) to measure their visceral and subcutaneous fat and measurements of their cognition and brain volumes.

Upon analysis, researchers found a higher amount of abdominal fat in their participant pool was associated with lower total gray matter volume in the brain and cognition.

They also discovered that middle-aged men at high risk for Alzheimer’s disease with higher amounts of pancreatic fat were correlated with lower cognition and brain volumes, compared to female participants.

“The finding regarding pancreatic fat cannot be named a surprise since this is likely the only study that investigated the potential role of pancreatic fat in brain and cognition,” Dr. Schnaider Beeri said.

“Diabetes and pre-diabetes — which occur because of impaired pancreatic function — are consistently associated with a higher risk of dementia, and our study suggests the involvement of pancreatic fat in this association.”

“Regarding the stronger findings in women, this was a surprise to us and we are investigating the causes for such differences,” she added. “Yet, our findings strongly suggest that research on the role of fat on brain aging must be done in the context of sex differences.”

After reviewing this study, Dr. Verna R. Porter, a board certified neurologist and director of the Dementia, Alzheimer’s Disease, and Neurocognitive Disorders at Pacific Neuroscience Institute in Santa Monica, CA, told MNT that this study underscores the importance of comprehensive risk assessment and management strategies for patients.

“Focusing not only on traditional risk factors like genetics and lifestyle but also on metabolic factors such as abdominal fat distribution,” Dr. Porter added.

For the next steps in this research, Dr. Porter said she would like to see further exploration into the mechanisms underlying the relationship between abdominal fat and brain health, particularly in different population groups and across various stages of Alzheimer’s disease progression.

“Longitudinal studies could provide valuable insights into the long-term impact of interventions targeting abdominal fat reduction on cognitive function and Alzheimer’s risk. Moreover, investigating the efficacy of targeted interventions, such as dietary modifications or exercise programs specifically aimed at reducing abdominal fat, would be beneficial in developing personalized approaches for Alzheimer’s risk management.”

— Dr. Verna R. Porter, neurologist

Dr. Mir Ali, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, said the main causes of abdominal obesity are poor diet — primarily too much sugar, alcohol, trans-fat, and not enough protein. Dr. Ali was not involved in the study.

“Unfortunately, you cannot target weight loss to certain areas like your abdomen,” Dr. Ali told MNT. “However, losing weight overall will lead to a reduction in truncal obesity. A diet high in fiber and protein as well as low in sugar is a great place to start.”

In addition to a healthy diet, Dr. Porter said regular physical activity, getting enough sleep, and limiting alcohol consumption can help lower visceral fat.

“Chronic stress can contribute to abdominal fat accumulation,” she explained, noting the following stress-reduction techniques:

“Drinking plenty of water throughout the day can help support metabolism and promote feelings of fullness, potentially reducing overeating and abdominal fat accumulation,” Dr. Porter said.



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