Over 40, female and getting fatter? Beware risks

TRENTON, N.J. - Getting fatter around the middle? Have a family history of heart disease or diabetes? You could be headed for the same trouble, especially if you’re over 40 and female.

There are no obvious symptoms from high blood sugar or the condition called insulin resistance, so few people realize it is creeping up and putting them on the path to diabetes, heart disease or both.

But insulin resistance, a type of pre-diabetes, is a growing national problem: Some experts believe half of all overweight or obese American adults are insulin-resistant.

Yet, even many women with a family history of heart disease or diabetes don’t know they need to eat a healthier diet and get more exercise to avoid those problems — two of the nation’s top killers.

“We think this is a very important new issue for women,” said Audrey Sheppard, chief executive of the National Women’s Health Resource Center. “There’s very little awareness.”

As women enter the years leading to menopause, the hormonal changes that trigger hot flashes and end menstruation make women more likely to add fat around the waistline than in other places. A key tip off of looming trouble is a waistline over 34 inches, according to one expert. (For men, it’s 40 inches.)

Fat also builds up in the liver and other vital organs, predisposing them to insulin resistance, a condition in which insulin no longer can inject enough glucose into the body’s cells for fuel, said Dr. David Katz, co-founder of the Yale Prevention Research Center and author of several books on weight control.

Cascade of insulin resistance
The body’s compensatory mechanisms eventually fail, blood pressure rises along with levels of blood sugar and blood fat — making cells even more resistant to insulin. Diabetes, heart disease or both often follow.

“That’s the sequence that’s occurring in tens of millions of American adults” and an increasing number of children amid the country’s obesity epidemic, said Katz. “It’s an enormous problem. We’re just starting to get doctors’ attention.”