“How much do you think this weighs?” I occasionally ask patients after I’ve handed them a large yellow glob of fake fatty tissue similar to human tissue.
They are surprised that it feels quite heavy yet only weighs 1 pound. Suddenly they realize the significance of the 20 pounds they’ve gained since their last checkup. But can they be overweight and fit at the same time?
Dr. Jean-Pierre Després of Laval Research Center in Quebec City reports in the Archives of Internal Medicine what is good news for some men, and what should be a wake-up call for others.
Using computerized tomography (CT) scanning, Després and his colleagues studied 169 healthy men by comparing their cardiovascular fitness to the amount of belly fat they carry.
This study showed that you can be overweight and still have a decreased risk of heart disease and diabetes. But there’s one vital proviso. You must be trim around the waist. On the other hand, if you’re thin, but your belly looks like you’re seven-months pregnant, you can be sitting on a time bomb for heart disease. So being thin is not always healthy.
This relationship also holds true regardless of the body mass index (BMI), the ratio of a person’s weight to height, recognized as the gold standard in gauging obesity.
But now the simple tape measure has taken the place of the BMI.
Després has reassuring news for those who are frustrated that exercise shows little improvement in the BMI. This is not a problem if the waist measurement is getting smaller.
That means that not all fat is equal and that fat has one thing in common with real estate. It’s all about “location, location, location.” If you’ve developed belly fat, it’s the wrong location for good health. Being apple-shaped is more dangerous than being pear-shaped.
If you’re having trouble seeing your feet, there’s some good news. It’s easier to lose weight from this hazardous location, as fat cells are metabolically more active in the midsection. On the other hand, losing pounds from hips is more difficult because fat cells are more sluggish in this location.
Simple Health Tools
Over the years, I’ve told patients and readers that the most important medical instrument that saves lives is the bathroom scale. But you have to step on it every day. This puts an end to being surprised when you’ve gained 20 pounds.
It’s equally important to attach a measuring tape to the scale to monitor waist circumference. It’s so logical and practical that it boggles the imagination as to why so many fail to get this message, doctors included.
For instance, a study conducted by the World Heart Federation revealed that only 14 percent of doctors measured their patient’s waists. And 54 percent of physicians never discussed the link between abdominal fat and heart disease.
According to the World Heart Federation, patients were almost as smart as doctors. The poll showed that 30 percent of patients realized a big belly was a risk factor for heart disease, compared to 42 percent of doctors!
So do you know your own waist measurement? The poll showed that 9 percent of men and 54 percent of women had no idea of their waist size.
Keeping it simple with a scale and tape would save millions of people from cardiovascular disease and diabetes. And there’s no need for fancy gadgets, blood samples, or radiation exposure, which more and more tests require.
We have an ironic situation: Millions of North Americans who never step on a scale or measure their waist can tell you the results of their latest cholesterol and other blood tests.
My advice is to use some old-fashioned horse sense and take the size of your belly seriously. So pick up the tape and calculate your level of fitness. A waistline of more than 40 inches for men and 35 inches for women is considered a risk factor for diseases of the heart, gallbladder, and liver.
Now, “How much do you think this weighs?”
Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com. He may be contacted at [email protected].
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