Posted by: 4pack | June 5, 2008

To Be Fat…or Not To Be Fat…what’s the Question again?


They’re all signs of abdominal or central obesity, too much fat tissue in and around the abdomen.

If you’ve been turning a blind eye to yours — or just hanging a longer shirt over it — it’s time to do something about your puffy paunch, experts say.

“We need to pay more attention to the central fat,” said Dr. Daniel Eitzman, a cardiologist and associate professor at the University of Michigan. “We should be more aggressive about trying to lose that fat.”

For some time, it’s been known that too much heft in the midsection increases the risk of certain health problems, such as cardiovascular disease and diabetes. Earlier this year, dementia was tentatively added to the list.

And researchers from Harvard and the National Institutes of Health reported this spring that white women who carry excess fat around their waists are at greater risk of dying early from cancer or heart disease than women with smaller waistlines.

“We know that obesity is a risk factor for a variety of ailments, including cardiovascular disease, and recent clinical studies have shown that the risk attributed to obesity is primarily due to central obesity,” Eitzman said.

“You could be actually normal weight and have a large waist circumference or an elevated waist-to-hip ratio and still be at risk,” he said. So “you should do your best to try to lose that belly fat.”

Unfortunately, there’s no way to magically target — or spot reduce — belly fat, experts say. It’s not about doing a million crunches or buying the latest ab machine.

“You just have to exercise more and reduce caloric intake,” Eitzman said. “For right now, that’s the best strategy. We know that reducing body weight in general will lead to a reduction in body fat.”

And many people could stand to lose it.

“About 45 percent of people over 50 have big waistlines, and if you see guys that are over 50, very often they’re struggling to keep their belts in what they consider their waist (area),” said Dr. James W. Anderson, an emeritus professor of medicine and clinical nutrition at the University of Kentucky.

Big bellies often go hand-in-hand with other problems, such as elevated blood pressure, inability to properly use insulin or blood sugar, and blood fat disorders, such as high triglycerides. These problems, including the worrisome waistlines, are collectively referred to as metabolic syndrome, according to the American Heart Association.

“If you store a lot of fat in your belly versus storing a lot of fat in your hips and legs, there seems to be this metabolic syndrome (that) occurs, and it’s not clear how or why it happens,” said Bob Topp, a distinguished professor and Shirley B. Powers Endowed Chair at the University of Louisville.

But it’s another reason to keep tabs on your gut.

There are a couple of different ways to gauge abdominal obesity, which also has been associated with plaque buildup in the arteries.

Some experts say you should be concerned if your waist measures more than 40 inches if you’re male or more than 35 inches if you’re female.

Others look to waist-to-hip ratio — waist circumference divided by hip circumference. The danger zone varies, depending on whom you consult, but hovers around 0.95 for men and 0.88 for women.

“Definitely try to stay below those (waist circumference) guidelines, and waist to hip ratios of less than 1 for males and less than 0.8 for females,” Eitzman said.

To find your waist to hip ratio, “measure around your (middle) at the level of your belly button and then the widest point on your hips,” Topp said. (Your physician’s office can help you do a precise measurement and may require you to take your clothes off for the hip measurement, Eitzman said.)

A less formal guide is to ponder your body shape. Are you an apple or a pear?

“If you stand in front of the mirror and you have a shape like an apple, that’s not optimal, but if you’re shaped like a pear — that is carrying a lot more weight down below your waist — then that’s a little more desirable from a health perspective,” Topp said.

Abdominal obesity is associated with deep visceral fat that collects around the internal organs and is thought to be more dangerous than the subcutaneous fat that lies closer to the surface and collects in other places, such as the hip area.


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