Add COVID-19 to the dangers associated with the “beer belly,” an anatomical feature long associated with increased risks for death.
Doctors in the Netherlands have concluded that a waist size over 40 inches for men or 35 inches for women significantly increases the danger that the pandemic disease caused by the SARS-CoV-2 virus will become severe.
Beer-bellied patients, they reported in a peer-reviewed study published in the BMJ Journals, were at greater risk than the obese and people suffering from some other major co-morbidities that have been linked to COVID-19 deaths.
“In contrast to earlier large studies,” they wrote, “hypertension or a history of cardiovascular disease (CVD), which are common comorbidities among COVID-19 and well-known risk factors for clinical deterioration, were not associated with severe respiratory failure in our cohort.”
Beer bellies, on the other hand, were, and the researchers said their findings should help doctors assess the risk COVID-19 patients face “based on a simple measurement as the waist and hip circumference.”
The Dutch findings should not come as a big surprise to those who pay attention to personal health. Doctors at the Mayo Clinic a decade ago recognized the beer belly as a better indicator of health risks than body mass index (BMI), the common standard used to identify obesity in the Western world.
Their study was one of the first to question BMI as a health determinant.
“The findings refute the obesity paradox, a puzzling finding in many studies that shows that patients with a higher BMI and chronic diseases such as coronary artery disease have better survival odds than normal-weight individuals,” a Mayo Clinic media release summarizing the peer-reviewed work published in the Journal of the American College of Cardiology at the time.
“We suspected that the obesity paradox was happening because BMI is not a good measure of body fatness and gives no insight into the distribution of fat,” the clinic quoted Dr. Thais Coutinho, the study’s lead author, saying. “BMI is just a measure of weight in proportion to height. What seems to be more important is how the fat is distributed on the body.”
This is definitely the case with people who contract COVID-19, according to the Dutch, who suggested “several mechanisms may explain the observed relation between abdominal adiposity and respiratory failure.
“First, visceral fat deposits, which are increased in abdominal adiposity, act as a reservoir for viral load promoting an inflammatory response. Augmented visceral fat volume is also associated with an impaired viral shedding. Second, an imbalance in pro-inflammatory and anti-inflammatory adipokines can cause increased respiratory distress.”
Younger at risk
The Dutch, who said their study was the first to look at belly fat dangers, said the increased risks apply across all ages, and to both men and women.
“Similar observations are made in recently published studies analyzing the amount of intra-abdominal fat depositions in patients with COVID-19 (examined with CT imagining),” they added. “However, our results are based on measurement of the waist–hip circumference, which is…a clinically more feasible and non-invasive method to assess abdominal adiposity.
“Overweight ( greater than 50 percent) and obesity (15.9 percent) are highly prevalent in the general Dutch population. Patients presenting with respiratory symptoms at our centre who tested positive for COVID-19 had a higher BMI compared with those without COVID-19. Given that (abdominal) adiposity is a treatable risk factor, in contrast to other risk factors such as age and gender, our results underline the relevance of this topic in COVID-19 research.”
The results also underline the importance of weight control and, coupled with another new study, physical fitness in these pandemic times.
The other new study – a peer-reviewed meta-analysis published in the latest issue of the BMJ Journal found that “though young patients had lower prevalence rates of cardiovascular comorbidities than elderly patients, the relative risk of fatal outcome in young patients with hypertension, diabetes and cardiovascular disease was higher than in elderly patients.”
The study noted the high death rates among those of all ages already suffering from other diseases.
“…The case fatality rates (CFR) of patients with CVD, diabetes, hypertension and cancer were 10.5 percent, 7.3 percent, 6 percent and 5.6 percent, respectively, while that of patients without any comorbid condition was only 0.9 percent,” the study reported.
“Our review of the literature indicates that the CFR of this infection is less than 1 percent among patients younger than 50 years of age, while the rates are 1.3 percent, 3.6 percent, 8 percent and up to 14.8 percent among patients in their 50s, 60s, 70s and 80s, respectively.”
Those higher rates of death by age have generally been attributed to the greater likelihood older people will be found suffering from diabetes, hypertension, cardiovascular diseases and obesity, but those diseases have been steadily growing among those under 50.
“Diabetes was the seventh leading cause of death in the United States in 2017 based on the 83,564 death certificates in which diabetes was listed as the underlying cause of death,” the association says. “In 2017, (however), diabetes was mentioned as a cause of death in a total of 270,702 (death) certificates.”
And the organization believes that even those more than 270,000 deaths linked to diabetes are underreported, noting that “studies have found that only about 35 percent to 40 percent of people with diabetes who died had diabetes listed anywhere on the death certificate.”
The BMJ study – “Impact of cardiovascular disease and risk factors on fatal outcomes in patients with COVID-19 according to age: a systematic review and meta-analysis” – pointed out that the rise in some of the comorbidities driving up deaths from COVID-19 in people under the age of 50 is not an accident.
“…The prevalence of hypertension and diabetes in young people continues to increase due to obesity caused by a sedentary lifestyle and a processed food diet, which in turn increases the risk of developing CVD,” the study said. “In summary, age itself or age-related diseases act as risk factors in elderly patients, while CVD and its risk factors are associated with a higher mortality rate in younger patients.”
The sorry physical condition of many in the West has gone little discussed during the pandemic though generally poor fitness is known to reduce immunity to many diseases.
Belly fat was a particular redflag in this area long before COVID-19.
“Beer doesn’t necessarily lead to belly fat,” Lizette Borreli wrote at The Medical Daily in 2015. “The consumption of too many calories – a single beer contains about 150 calories – is what turns your trim waistline into a belly that hangs over your pants. However, alcohol does have an association with midsection fat. The liver prioritizes burning alcohol before metabolizing fat….
“It’s time to stop being Beercules (and) learn the dangers of a beer belly….”
Her story was headlined “The Naked Truth: 6 Dangers Of Having A Beer Belly.”
COVID-19 can now be added as number seven. Medical Daily listed the other six as increased risks of:
- Metabolic syndrome
- Cardiovascular disease
- Dementia and Alzheimer’s disease
- Erectile dysfunction (a problem unique to males)
- Breast cancer in both men and women
- And a variety of obesity-related diseases, including diabetes.
Diet and exercise are the recommended treatments to avoid the beer belly and the risks of associated health problems, but they are not as easy as a vaccine.
On the other hand, the effectiveness of the vaccine for the beer-bellied has not yet been studied, and none of the COVID-19 vaccines are said to 100 percent effective.
And even if they were, those beer bellies are linked to lots of other diseases that can kill.