A Big Belly Increases Risk for a Heart Attack

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Having excess fat in your liver is associated with increased risk for a heart attack (The Lancet: Gastroenterology & Hepatology, Sept 20, 2021). A review of 36 studies on 5,802,226 middle-aged individuals with 99,668 cases of heart attacks, in a median follow-up period of 6.5 years, found that those with fatty liver disease had 1.5 times the incidence of heart attacks as the general population. The more fat in the liver, the greater the chances of a person suffering and dying from a heart attack.

How Can You Tell If You Have a Fatty Liver?

You can often tell if people have a fatty liver just by looking at them. A person with a big belly and small buttocks is at very high risk because those who store fat primarily in the belly are most likely to also store a large amount of fat in their liver. Many studies show that having excess fat in your liver markedly increases risk for Type II diabetes and heart attacks (JAMA, 2017;317(6):626-634), and also increases all markers of inflammation that are associated with increased risk for heart attacks (Clinical Gastroenterology and Hepatology, February 28, 2019).

At your routine physical exam, your doctor should order the usual liver function blood tests. If you have abnormal liver tests or a big belly and small buttocks, your doctor can order a simple sound-wave sonogram of your liver that does not expose you to radiation. The sonogram will show excess fat buildup as white spots in the liver (Nutrition, Metabolism & Cardiovascular Diseases, Dec 30, 2015).

How a Fatty Liver Increases Heart Attack Risk

A high rise in blood sugar after meals causes plaques to form and can also cause plaques to break off to cause a heart attack. Everyone’s blood sugar rises after they eat. To prevent blood sugar from rising too high, your pancreas releases insulin which is supposed to lower high blood sugar levels by driving sugar from the bloodstream into the liver. However, if your liver is full of fat, the excess fat prevents the liver from accepting the sugar and blood sugar levels can rise even higher (Eur J Gastroenterol Hepatol, Dec 2016;28(12):1443-1449). A high rise in blood sugar causes high blood insulin levels that convert blood sugar to a type of fat called triglycerides. Then insulin drives triglycerides into your liver. Having high triglycerides and a fat belly are signs of high blood insulin levels, and high blood levels of insulin constrict arteries to increase the chances of a plaque breaking off.

What Causes a Fatty Liver?

A liver full of fat can be caused by anything that damages the liver. Doctors may separate liver damage into that caused by alcohol and that not caused by alcohol (non-alcoholic fatty liver disease or NAFLD). However, a liver damaged by excess alcohol has the same harmful consequences as a liver damaged by anything else, such as obesity or excess sugar intake (Gastroenterology, May 31, 2019).