McClatchy Newspapers

KANSAS CITY, Mo. — That Buddha belly makes your jeans tight.

That paunch gets in the way when you bend over for the change in the candy machine.

The study, begun in the 1960s, concluded that people who were both obese and had a big belly were three times more likely to be diagnosed with dementia in their 70s and 80s than those of normal weight and belly size.

And, because the dementia risk nearly doubled in people who were considered a healthy weight but had large waists, researchers concluded that it matters where you carry your weight.

The research, published recently in Neurology, is said to be the first to link mid life belly bulge with dementia in older age. It didn't look at why belly fat increases the dementia risk or whether losing the belly reduces the risk.

But it squares with other research suggesting that cardiovascular health problems — the same ones that can be created by excessive body fat around your middle — put you at risk for dementia and Alzheimer's disease.

High blood pressure, high cholesterol and diabetes are all known risk factors for the most common form of Alzheimer's that affects 90 percent of patients.

"We cannot prevent the disease, but it is encouraging to know that we can prevent some risk factors," says Michelle Niedens, education director for the Heart of America Alzheimer's Association in Prairie Village. "We might as well control those things that we can."

Bad fat

The relationship between brain health and stomach fat is complicated. The study's researchers can only hypothesize about it, suggesting that the fat might release toxins that have been associated with the buildup of brain plaque found in Alzheimer's patients.

Belly fat has long been known to be a health hazard. The deep fat stored in big bellies — visceral fat — packs itself around internal organs, leading to inflammation and metabolic changes that can unleash a host of health problems.

"I think it should energize us to understand that choices we're making now and priorities we're making now directly relate to the quality of end life," Niedens says. "We may not be able to control whatever faces us in the future, but we can control some pieces."

Taking a cue from this new study — which lends credence to what's good for the heart is good for the brain — is a start, Niedens says.

Her advice: Stay physically active and follow a brain-healthy diet.

Brain food

The good news about the kind of diet that will help you lose that gut? It will also be healthy for your brain.

"A diet like that has a lot of color, vibrant colors, has a lot of whole grains and lean foods, and those will be good in helping your brain stay healthy," says registered dietitianMary Meck Higgins, a certified diabetes educator at Kansas State University.

To banish excessive body fat, load up on the fruits and vegetables, without any added sugar, she says.

"A lot of times people will say, 'It has to be fresh,' " says Higgins. "It can be frozen. Fresh is a good choice, but it could be dried, it could be canned. I would recommend not filling up on 100 percent juices because you can drink a lot of extra calories."

Whole grains "provide satiety," says Higgins. "They make you feel full after you've eaten them. You don't want to walk around saying, 'Oh, I'm not eating much."'

Higgins recalled a nutritional campaign last fall that prompted the public to "just ask for whole grain" when dining out.

"It was the notion that if restaurants didn't have customers asking for them they might not know customers want them," Higgins says.

Lean protein also will help with the bulge battle. In red meats, look for cuts that have less marbling, or fat, in them. A loin cut, for instance, typically translates into "lean," she says.

Eat fish, but keep it lean "by not deep-fat frying it," Higgins says.

And don't forget dairy products. Just make them low-fat or fat-free.

Burning off the belly

Fat stomachs are a common complaint among men and women who come in for workout advice, says personal trainer Brian Haines, division program director for health and fitness for the YMCA of Greater Kansas City.

"Men tend to come in and say, 'I want to lose weight,' and it's very general. But if they do have a specific area, it's usually the mid-section, the belly," Haines says. "When women come in, they say 'I want to lose weight' and then they say particularly from that core area, belly, hips and thighs."

Medical experts say that losing just two inches off your waistline can decrease your chances of getting diseases such as diabetes and high blood pressure by as much as 50 percent.

But fitness experts warn that spot-reducing is a myth, that there are no exercises that will banish fat from just one area of your body, which is why Haines doesn't spend a lot of time trying to figure out what "body type" his clients are.

Instead, "we talk to them about the importance of a balanced workout program," he says.

Balance means combining cardiovascular workouts with strength-training.

"I like to throw in the strength component because when you have healthy muscle mass it raises your metabolism and you burn fat even at rest," says Haines.

Haines recommends that beginners start with strength-training exercises that work large-muscle groups — leg presses that work the quadriceps, hamstrings and glutes, and the seated row and lat pull down for the upper body and chest.

Also for beginners: 30 minutes of moderate-intensity exercise every day.

Moderate intensity means you can converse with someone while exercising, "but you can't do all the talking," says Haines.

It doesn't really matter what type of exercise it is. Walking, jogging, swimming, tennis, hoops in the schoolyard. Make it something you enjoy, says Haines.

"If you don't like it, you're not going to do it," he says. "Anything to get you moving."

How did they

do the study?

More than 6,000 patients at Kaiser Permanente of Northern California had their waists measured between 1964 and 1973, when they were between 40 and 45 years old. Researchers compared medical exam records from that period to those from 1994 to 2006.

Over the course of the study, 1,049 participants were diagnosed with dementia, including Alzheimer's disease. People in the upper 20 percent of the belly sizes had a 2.72 times greater risk of dementia compared to people in the bottom 20 percent.

Since not everyone who is overweight has a big belly, and some normal-weight people carry excess belly fat, researchers looked at the effects of both weight and belly fat. Those who were both obese and had a large belly in their 40s were 3.6 times more likely to be diagnosed later with dementia than those who'd had a healthy weight and belly size. Those who were a healthy weight but had a large belly were 1.9 times more likely to develop dementia.

Source: webmd.com

Can you pinch

an inch?

People who carry most of their excess weight around their waist — "apple" shapes — are at higher risk for many diseases than those who pack most of their extra weight below the waist, "pear" shapes.

How to know if you have too much around the middle? Here are two ways:

Waist circumference: Use a tape measure to measure the circumference of your waist at its smallest point — usually just above your naval. A waist measurement of greater than 40 inches for men or 35 inches for women indicates increased health risks.

Waist-to-hip ratio . Use a tape measure to measure the circumference of your waist at its smallest point. Then measure the circumference of your hips at their widest point. To calculate your waist-to-hip ratio, divide your waist measurement by your hip measurement. A waist-to-hip ratio of greater than 0.9 for men and 0.85 for women indicates increased health risks.

Source: mayoclinic.com

Maintain your brain

You can't prevent Alzheimer's disease, but you can take steps to keep your brain healthy. Here's advice from the Alzheimer's Association:

Keep your brain active every day. Stay curious and involved; commit to lifelong learning. Read, write, work crosswords or other puzzles. Attend lectures and plays. Play games. Garden.

Stay socially engaged in activities that stimulate mind and body. Stay active in the workplace. Volunteer. Travel. Join clubs.

Exercise regularly. Physical exercise maintains good blood flow to the brain and encourages new brain cells. Exercise is most effective when done regularly and in concert with a brain-healthy diet, mental activity and social interaction.

Follow a brain-healthy diet . Reduce your intake of foods high in fat and cholesterol. Increase your intake of "protective" foods that reduce the risk of heart disease and stroke and appear to protect brain cells. Dark-skinned fruits and vegetables have the highest levels of naturally occurring antioxidants. Cold-water fish contain beneficial omega-3 fatty acids. Some nuts, including almonds, pecans and walnuts, can also be a useful addition to your diet.