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Your waistline matters more than your weight

Why fat around the belly is worse than fat elsewhere

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By EDUARDO GONZALES

Q—Is it true that a pot belly carries a higher risk for a heart attack than excess weight in other parts of the body? Why is this so?—rouina_bebden@gmail.com

A—Yes, it’s true. The circumference of a person’s waist—which indirectly measures the amount of excess fat a person has in and around the belly—is a more sensitive gauge and determinant of the metabolic and cardiovascular complications of obesity than body mass index (BMI), the current yardstick still preferred by most physicians and researchers in determining obesity.
Incidentally, BMI is determined by dividing a person’s weight in kilograms by his/her height in meters squared (BMI=kg/m2). Waist circumference, on the other hand, is measured at the midpoint between the highest point of the hip bones and the lowest abdominal ribs just after breathing out.
It has been established by scientific data that abdominal obesity increases your odds of having a heart attack or stroke regardless of whether you are slim elsewhere, but a recent Swedish study published in the European Journal of Preventative Cardiology has also found a link between belly fat and the risk of a subsequent heart attack or stroke. In other words, abdominal obesity not only increases your risk for a first heart attack or stroke, but also for recurrent events of the same nature. Also, the increase risk for a heart attack and stroke that a beer belly confers is independent of the other risk factors for the conditions like smoking, diabetes, hypertension, and body mass index.
In other words, if you have a pot belly, you have an increased risk for a heart attack or stroke even if you take your maintenance medications religiously and even if your blood tests for sugar and cholesterol and lipids are normal.

What is fat?
Fat consists of fat cells or adipocytes whose main function is to store, in the form of fat, the excess food that you consume. But adipocytes are not simply storage sites for fat. They have another function—they produce a variety of substances called adipocytokines.
There are good and bad adipocytokines. Bad adipocytokines are detrimental to health. They propagate obesity, induce the development of diabetes, and increase the risk for atherosclerosis and coronary heart disease. In contrast, good adipocytokines are beneficial to the body. They help prevent the development of type two diabetes and protect against atherosclerosis and coronary heart disease.
The type of adipocytokines that adipocytes produce depends on their location in the body. The adipocytes that are around the waist are double whammies: they produce a lot of bad adipocytokines and very little good adipocytokines.

How small should you keep your waistline?
According to the World Health Organization Asia-Pacific Guidelines for central obesity, Filipino women should have a waist circumference of no more than 80 cm (31.5 inches) while Filipino men should have no more than 90 cm (35.5 inches).

How to eliminate belly fat
The best way to tackle belly fat is through exercise and diet. For maintenance of good health, you need only 30 minutes of moderate exercise five days a week. Moderate exercise can simply consist of brisk walking. But to burn your belly fat, your workouts may need to be stepped up. You can do this by doubling your brisk walking time to an hour at least five days a week. Strength training with weights may also help.
In so far as diet is concerned, the most practical way to lose weight and reduce your waist line is by simply cutting down on the volume of food that you eat. For example, if you are 150 lbs. now and would like to go down to 120 lbs., you need to lose 30 lbs. or about 15 percent of your body weight. Hence, at every meal time, just set aside for all food items what you think is about 15 percent of what you used to take.
If you are able to religiously do this, you will notice that you will gradually lose weight and that over a period of a several months you will go down to 120 lbs. By the way, whenever you get hungry during the first few days to weeks of your new diet, you can eat as much boiled leafy vegetables as you want. Once you have attained your desirable body weight there is no need to change your diet, because you are already on your maintenance diet in the first place.

(Note: Email inquiries on health matters to: medical_notes2@yahoo.com)

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