Risks of an Expanding Waistline – Tufts

Family history, ethnicity, and age play a role in risk for developing metabolic syndrome, but diet is key. High sodium intake raises blood pressure, for example, but foods rich in refined grains, starches and sugars are perhaps the top concern, according to Dariush Mozaffarian, MD, DrPH, dean of the Friedman School and editor-in-chief of Tufts Health & Nutrition Letter. “When we overload on rapidly digested refined starches and sugars, blood sugar (glucose) spikes, leading to an array of counter-regulatory hormones that predispose to metabolic syndrome,” says Mozaffarian.

Buildup of fat around the organs in the abdomen—which shows up as a widening waistline—is harmful to metabolic health, and fat in the liver is of particular concern. “The liver is in charge of transforming excess starch and sugar into fat,” says Mozaffarian. “This newly synthesized fat is supposed to be burned as energy or go to fat cells under the skin for storage. But, when these pathways are overwhelmed by modern processed foods like soda, candy, white bread, and white rice, some of the newly made fat remains in the liver.” Fatty liver is one of the earliest underlying signs of metabolic disorder. “Fatty liver is one of the foundational causes of insulin resistance (which can lead to high blood sugar), high triglycerides, and low HDL-cholesterol levels,” Mozaffarian explains. “Blood pressure also rises with fatty liver, along with systemic inflammation, although the mechanisms behind this are not yet entirely clear.”


The five conditions described below are metabolic risk factors. You can have any one of these risk factors by itself, but they tend to occur together. If you have 3 or more of these conditions, you have metabolic syndrome:

  • Waist larger than 40” for men, and 35” for women, which is also called abdominal obesity or “having an apple shape.” A large waistline means you’re at increased risk for heart disease and other health problems.
  • Fasting Triglycerides over 150 (or you’re on medicine to treat high triglycerides). Triglycerides are a type of fat found in the blood.
  • HDL less than 40 for men, and less than 50 for women.HDL is sometimes called “good” cholesterol because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk for
    heart disease.
  • Blood pressure greater than 130 systolic and/or 85 diastolic (or you’re on medicine to treat high blood pressure). Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup in the arteries.
  • Fasting blood sugar (glucose) greater than 100 (or you’re on medicine to treat high blood sugar/type 2 diabetes). Mildly high blood sugar may be an early sign of diabetes (often referred to as pre-diabetes).

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