Tag Archives: fitness column

The truth about holiday weight gain…and how to prevent it!

The holiday season has arrived. It is a time for shopping, spending time with family and friends, and eating, often too much. The bad news is that weight gain between Thanksgiving and the New Year is a very real possibility. The good news is that the typical holiday weight gain is less than you might think. The even better news is that this weight gain can be prevented, as I explain in my Health & Fitness column in the Aiken Standard this week

First, the bad news. Research shows that, on average, people gain about one pound during the holidays. Even subjects who said they were trying to lose weight over the holidays ended up gaining about 0.5 pounds on average. The problem is that this extra weight is not lost during the spring or summer, meaning that holiday weight gain is a major contributor to the gradual increase in weight (about one pound per year) most people experience over time.

Now for the good news: The weight gain that typically occurs during the holidays can be prevented. Since people tend to gain less than one pound, even small modifications to activity or diet can make a difference. Here are some strategies:

  1. Stay active. The average holiday weight gain could be prevented by walking about one mile, or about 20 minutes, per day. Since time may be a factor, you can turn a shopping trip into a chance to be active by taking an extra lap around the mall or parking farther away in the parking lot. Go for a walk before or after a family meal or party—take your family and friends with you.
  1. Don’t hang around the food. Most holiday parties include lots of food, and usually not the healthiest choices. You can reduce the amount you eat by limiting your time near the food—literally, fill your plate and move away from the food. Using a smaller plate will reduce the amount of food you take, too. Getting rid of the candy dish on your desk at work or the plate of treats on the countertop at home are also smart ideas.
  1. Don’t drink your calories. Alcoholic beverages, soda, and juice all contain calories and can add up to a big part of your total calorie intake. For example, egg nog can contain over 300 calories per glass. This doesn’t mean you can’t enjoy your favorite drinks, but enjoy them in moderation.
  1. Plan ahead. If you are trying to watch what you eat, have a healthy snack before you go to the party. You will feel less hungry so you will probably be less inclined to eat as much. If you are bringing a dish to the party make it something healthy that you like.
  1. Focus on family and friends, not food. The holidays are a time to enjoy meals and events with family and friends, and that should be your focus. You should enjoy your favorite foods and drinks, just do it in moderation.

You can prevent holiday weight gain by watching what you eat and staying active. It is easier to keep the weight off than it is to lose it later, so a little extra effort now is worth it in the long run. Considering that many people plan to exercise and lose weight after the holidays, you could get a head start on your New Year’s resolutions along with making this a happy and healthy holiday season.

Advice for staying healthy for the holidays

Now that Thanksgiving is behind us, the holiday season is in full swing. At the same time, though, we are in the midst of cold and flu season. In addition to the natural spread of cold and flu viruses at this time of year, the holiday season itself, with hectic schedules, stress, and lack of sleep, can weaken your immune system making you more susceptible to getting sick.

The good news is that there is much you can do to keep yourself healthy for the holidays. This is the topic of my Health & Fitness column in the Aiken Standard this week.

For starters, getting a flu vaccine is the most sensible thing you can do to prevent seasonal influenza (flu). If you haven’t gotten your flu shot yet, it’s not too late. I have written about flu previously, including the fact that exercise may make your flu vaccine even more effective!

Another basic step in preventing sickness is to wash your hands regularly. Soap and water is best, and there is no additional benefit in using an antibacterial soap. If you can’t wash your hands, an alcohol-based hand sanitizer is an acceptable alternative. Keep in mind that hand sanitizers don’t actually clean your hands and aren’t as effective if your hands are dirty.

Cold and flu viruses are spread through the air when an infected person coughs or sneezes, so avoiding close contact with people who are sick is important. If you are sick, you should stay away from others as much as you can. Cover your mouth and nose with a tissue or cough or sneeze onto your sleeve to help keep the germs from spreading through the air or on your hands.

You can also be exposed to cold and flu viruses by touching something with virus on it (a doorknob, for example) and then touching your nose, mouth, or eyes. You can protect yourself by not touching your face and by washing your hands frequently.

People who participate in moderate exercise on a daily basis have fewer and less severe colds than people who aren’t regularly active. This is because exercise has the effect of stimulating the immune system, making it better able to respond when you are exposed to cold or flu viruses.

More exercise isn’t always better, though. Research shows that immune function is depressed in the weeks after running a marathon, leading to an increased risk of becoming sick. Athletes who engage in vigorous and prolonged training also tend to be more susceptible to upper respiratory infections. The bottom line is that regular exercise improves your immune system, but very vigorous exercise may not.

Good nutrition is also essential for optimal immune system function. Deficiencies of certain nutrients can have a negative effect on immune function, so eating a balanced diet is essential. That said, there is no support for “boosting” the immune system by taking high doses of vitamins, minerals, or other supplements, despite the claims made by supplement companies.

You can get benefits from two more common-sense recommendations: getting adequate sleep and reducing stress. Poor sleep habits are associated with suppressed immunity and more frequent illness. High levels of stress increase susceptibility to colds and flu and can lead to more sick days from work or school. Stress and poor sleep habits tend to occur together, creating a double negative effect on the immune system.

By taking these steps, you can improve your chances of celebrating the holidays in good health. As a bonus, eating a healthy diet, exercising every day, managing your stress, and getting enough sleep will give you a head start on what are likely to be New Year’s resolutions.

 

 

Take a lesson in healthy eating from your turkey this Thanksgiving.

My Health & Fitness column in the Aiken Standard this week is about Thanksgiving dinner. With all the talk about how to make it a “healthier” meal by replacing traditional dishes and modifying recipes, I think we may be missing an important lesson in healthy eating.


This is Thanksgiving week, and people throughout the country are planning a feast including traditional dishes and family favorites. Even though many of these are not the healthiest choices, they make an appearance on the dinner table each year. Combined with the common occurrence of over-indulging, Thanksgiving dinner can represent a day of poor nutrition choices.

In an effort to make Thanksgiving dinner healthier, recommendations for modifying or replacing traditional dishes are a common theme in magazines, on the morning TV shows, and on the web. While these suggestions are meant to be helpful, I’m not sure they actually serve to make a significant impact on health.

After all, Thanksgiving is one day, and if there was ever a day to give yourself license to indulge, this is it! Of course, trying new foods and cooking techniques is always good, but the impact of replacing the butter in your mashed potatoes with fat-free sour cream or taking the marshmallow topping off Granny’s famous sweet potato dish isn’t realistically going to make you any healthier in the long run.

The truth is that if you eat a healthy diet every day, or even most days, and you have an active lifestyle you can get away with a day—or weekend—of overeating. (Obviously, you should always follow dietary restrictions for any medical conditions you have.) The problem comes when Thanksgiving dinner is yet another unhealthy meal in addition to the others that week or month.

Some of these recommendations are worth trying, for sure. Making an alternative to a traditional dish can get your family to try new foods they might not otherwise consider. And cooking using different ingredients or techniques on Thanksgiving can give you ideas for other meals, too.

However, focusing on modifying your Thanksgiving dinner may distract you from appreciating the greatest potential health benefit of this meal. Given the current confusion about how much and what type of carbohydrates and fats we should eat, there is an increased push to get us to eat less processed food and more real food.

For many of us, Thanksgiving dinner is one of the only times we cook and eat real food. A real turkey, vegetables, and home-made dessert are a huge improvement over the processed foods most of us eat on a daily basis. While we eat turkey at other times, it is almost always in a processed form such as ground turkey or deli meat, which frequently includes other additives. Cooking and eating a whole turkey is, for most families, relatively rare. So is eating a meal that doesn’t come from a restaurant or is heated in a microwave.

Additionally, Thanksgiving dinner is shared simultaneously around a common table (and maybe a kids’ table, too). All too often, meals are consumed away from the family table, frequently at different times. The benefits of eating together as a family are well-known, and can impact nutrition, psychological well-being, and health in general. Maybe Thanksgiving dinner isn’t about the food as much as it is the company. Why not make this a habit at other meals?

This week, let’s all give thanks for family, friends, and a shared meal. Let’s also take a lesson from the day and try to prepare and eat more real food as a family. This may be the biggest benefit of Thanksgiving. That, and a second serving of pumpkin pie!

Funny calorie math.

Have you ever heard that a few extra calories each day—an extra soda, for example—can add up to significant weight gain over time? Or that making small changes in what you eat, such as skipping dessert, can promote weight loss? If so, you are familiar with the concept of energy balance. And if you were ever surprised by those claims, you are familiar with what I call funny calorie math.

This is the topic of my Health & Fitness column in the Aiken Standard this week.

Your body weight at any time is determined by the balance between the energy you take in and the energy you expend. The “energy in” part is simple, it’s the calories in the food you eat.

Your energy expenditure is determined by your basal metabolic rate (BMR), the calories burned keeping you warm and alive, as well as the energy you expend in activity. Of these, the BMR accounts for the majority of your energy expenditure, but you have the most control over your level of activity.

According to this energy balance model, eating or drinking an additional 250 calories per day would add up to about one pound of weight gain every two weeks and 26 pounds after one year (using the rough estimate that to gain a pound requires 3500 extra calories.

+250 calories/day  x  7 days/week  =  1750 calories/week  =  3500 calories/2 weeks

3500 calories/2 weeks  x  1 lb. weight gain/3500 calories  =  1 lb. weight gain every two weeks  =  26 lbs. weight gain per year!

Calculations like this are common, typically used to point out how fattening a particular food or beverage can be. But the same principle can be applied in reverse to determine weight loss.

Example: Eat (or drink) and extra 250 calories per day

250 calories/day  x  7 days/week  =  1750 calories/week  =  3500 calories/2 weeks

3500 calories/2 weeks  x  1 lb. weight loss/3500 calories  =  1 lb. weight loss every two weeks  =  26 lbs. weight loss per year!

The same formula predicts that cutting back by 250 calories per day should lead to losing 26 pounds in one year. This idea is the basis for suggesting that making small changes to your diet can lead to significant weight loss over time.

You can do the same thing with physical activity, too. Adding a 45-minute walk, which burns approximately 250 calories, each day should lead to the same 26 pounds of weight loss in a year.

Example: walk 2.5 miles in 45 minutes each day, using the rough estimate that you will burn 100 calories per mile.

2.5 miles/day  x  100 calories/mile  =  250 calories/day

250 calories/day  x  7 days/week  =  1750 calories/week  =  3500 calories/2 weeks

3500 calories/2 weeks  x  1 lb. weight loss/3500 calories  =  1 lb. weight loss every two weeks  =  26 lbs. weight loss per year!

The assumption, of course, is that you aren’t changing anything else as you eat 250 fewer calories or burn an additional 250 calories per day through exercise. It would be relatively easy to offset the energy expended though a walk by even a small change in what you eat. This is the biggest weakness of this energy balance model—in order for it to accurately predict weight loss or gain, nothing else can change.

Unfortunately, this isn’t the way it really works. Changes in body weight through eating or exercise also lead to changes in total energy expenditure. As you lose weight, the total calories you burn in a day drops, mostly due to a decrease in BMR, since it is based on your body weight. The result is that over time you don’t lose weight as quickly. The exact opposite occurs with weight gain, which causes BMR to go up, limiting weight gain.

This leads to a different outcome: the extra 250 calories per day is likely to lead to a weight gain of closer to 10 pounds (maybe less) due to your BMR increasing as you gain weight over the year. And the estimation of weight loss will be different, too, given that BMR will drop slightly over time.

This is one of many reasons why exercise is important for weight loss. You can offset the lower BMR that occurs as you lose weight by increasing energy expenditure through activity. Additionally, regular exercise can add to the weight you lose through a diet and help keep the weight off later.

Why turning off your phone is so hard, and what it means for losing weight

I had an interesting conversation with one of my students recently about making a behavior change. It brought up a good point. So good, I wrote about it in my Health & Fitness column in the Aiken Standard this week.


One of the courses I am teaching right now is Health & Behavior Change. In it we identify the major factors that contribute to chronic disease and discuss how to modify them to improve health. Throughout the course, the emphasis is on health behaviors and how to change them for the better.

For example, smoking is among the most difficult health-related behaviors to change. Obviously, there is the addictive nature of nicotine that makes smoking cessation challenging. Beyond the drug effect, smoking also has a behavioral component. This includes what a smoker does first thing in the morning, after a meal, or on a work break as well as the act of holding a cigarette in his or her hand. Add to that the social aspects of smoking, including the influence of friends and family members, and it is easy to understand why it is a difficult habit to break.

This same principle applies to other health behaviors, including eating and activity. Like smoking, what we eat and our activity level are complex behaviors that are difficult to change. Because of this, losing weight can be as difficult as quitting smoking for similar biological and behavioral reasons. We think of weight loss as being about a diet or exercise program, but it’s really about changing behaviors and habits.

his is a difficult concept to teach, so I have my students learn through experience. Since almost all of my students are non-smokers and most are active and at a healthy body weight, I have them complete a project in which they change some other behavior. They are responsible for identifying a behavior that has a negative effect on their life, coming up with a plan to change it, and embarking on a four-week behavior change experience.

One student wanted to change her social media habits. As a compulsive social media user, she spent more hours than she realized checking, posting, and commenting on Facebook, Twitter, and other sites. Her goal was to limit her social media time so that it didn’t interfere with classes or studying. One of the steps she took was to turn off the notifications that alerted her to new activity. This was helpful, but she still found the habit of checking her phone hard to break.

In a conversation, she noted that the one thing that would help more than anything else would be to switch her phone off during the day. This way she would have her phone if she needed it, but it wouldn’t be so easy, or tempting, to use it. Despite knowing the most effective strategy—the one thing—that would help her, she never did it.

I thought this was an excellent example of something that is common in making health behavior changes. In many cases, people probably know the one thing they need to do to be successful but for a host of reasons, they don’t do it. This may lead people to make other changes that aren’t nearly as helpful. While even the smallest behavior modifications can help, successfully losing weight or quitting smoking really does require making big changes.

This goes a long way in explaining why quitting smoking, losing weight, and changing eating and activity behaviors can be so difficult, even when people know what they need to do. There is no easy solution for this problem, but finding someone to hold you accountable for making the necessary changes and sticking to them is a good start.

Chill out! Why less stress is essential for good health.

Chronic stress can have serious emotional, psychological, and physiological effects that lead to or exacerbate many health problems. While it is impossible to avoid all stress in life, minimizing stressors and managing the way you respond to stress can have important benefits. Regular exercise, including yoga, managing time better, and getting enough sleep, can help with minimizing your feelings of stress as well as the effects it has on your body.

The importance of stress management and getting enough sleep is the topic of my Health & Fitness column in the Aiken Standard this week.


Chronic stress can have serious emotional, psychological, and physiological effects that lead to or exacerbate many health problems. In fact, the negative health effects of chronic stress are similar to those of eating a poor diet or not getting enough physical activity. That said, managing stress, including getting enough sleep, is often overlooked as a key component of good health.

The word “stress” is typically used to indicate both the feeling of being “under a lot of stress” as well as the things that cause that feeling. The events and situations that cause stress are properly called stressors, which lead to a stress response that includes consequences we feel as well as physiological changes we may not notice.

The immediate effect of a stressor is called the “fight or flight” response since it prepares the body to deal with a dangerous situation. A classic example of this is a caveman who encounters a saber-tooth tiger, clearly a stress-inducing event.

The sympathetic nervous system is immediately activated, which raises heart rate and blood pressure to pump more blood to the muscles. Additionally, stored fat and carbohydrate fuels are broken down as fuel for the muscles. The adrenal glands release catecholamines (adrenaline) and cortisol (the stress hormone) to prolong and enhance this effect. This coordinated response makes sure the caveman’s body is ready for action. After the danger passes, everything returns to normal.

This physiological response is appropriate for major events like saber-tooth tiger encounters, but not for less perilous stressors like being stuck in traffic, pressure at work and home, or other personal and family issues. But the body responds with the same increase blood pressure and hormones to them all. Unlike a rare saber-tooth encounter, these stressors tend to occur on a daily basis, leading to continuous stress response.

The increase in hormones can lead to high blood pressure, obesity, type 2 diabetes, and other chronic diseases. This is partly due to elevated levels of cortisol, a hormone that plays a role in storing fat and increasing appetite. While elevated cortisol during exercise (including running away from a saber-tooth tiger) is normal, chronic overproduction can have negative effects.

While it is impossible to avoid all stress in life, minimizing stressors and managing the way you respond to stress can have important benefits. To the extent that it is possible, avoiding stressful situations through better time management, setting realistic expectations for ourselves and with others, and learning to say “no” are common recommendations.

Learning how to deal with stressors to avoid the negative effects of stress is also important. Techniques that can be implemented in the heat of a stressful moment include taking a break from the situation, listening to calming music, and progressive relaxation. Even taking a deep breath can help.

Exercise has long been recognized as beneficial for reducing stress and the long-term effects of stress on your health. This includes doing something active during a stressful situation and exercising regularly to improve the way your body responds to stress. While all forms of exercise seem to work, much research and practice has focused on specific types of exercise including yoga and Tai Chi.

Other effective strategies traditionally include meditation and relaxation exercises. More and more research shows that getting enough sleep is also critical for reducing stress and the impact it has on your health. Eating a healthy diet can reduce the effects of stress as well.

The bottom line is that a healthy lifestyle includes stress management as well as a good diet and regular activity. Since all three are essential for good health, it would be wise to eat smart, move more, and chill out!

Celebrate Food Day every day by eating real food

This Friday is Food Day, an annual event that aims to raise awareness about the food we eat and the impact it has on our health, environment, and quality of life. It turns out that many of us don’t know much about our food including where it came from, the method of preparation, and the quality and nutritional value.

As I describe in my Health & Fitness column in the Aiken Standard this week, we are increasingly disconnected from our food, a fact that has implications for our health and the health of the environment.

Our lack of knowledge about the food we eat has been replaced by a heightened awareness about nutrients. In fact, many people follow diets that either emphasize or restrict certain nutrients in order to obtain health benefits. But the research to support the importance of these individual nutrients is often mixed or lacking altogether. Still, as we seek out sources of these nutrients we are led to supplements, such as fish oil, or processed foods with added nutrients, like fiber.

To be sure, fish oil and fiber are good for us. But does that mean that taking a fish oil supplement will have the same health benefits as actually eating fish instead of, say, fried chicken? Or is adding fiber to a chocolate breakfast bar equivalent to getting more fiber from fruits and vegetables? Both research and common sense suggest that the answer is no.

Beyond the individual nutrients, the food we eat has changed. Even the way food gets to our table has changed. Since nearly half of our meals are eaten outside the home, it’s not even “our” table anymore. And when we do eat at home, take-out and prepackaged heat-and-eat meals have become the norm. In fact, the idea of cooking meals from ingredients is so foreign that we have to be reminded about how and why we should do it.

Events like Food Day are an attempt to get us back to the basics of cooking and eating real food. This, of course, is how people ate for years before the obesity and diabetes epidemics we are dealing with now, so eating real food again is a step toward reducing these, and other, health problems.

In addition to the potential health benefits of focusing on food over nutrients, this approach is also good for the environment and the economy. It turns out that eating healthier food promotes sustainable agriculture and can support local farmers. Locally grown produce, which is picked at the peak of freshness, can be more nutritious and have a lower environmental impact than food from factory farms which is often shipped great distances. And most important, food from local farms usually tastes better!

This is the point of Food Day. We should make ourselves aware of where our food comes from and do our best to eat “real food” as opposed to processed and pre-packaged foods that tend to be high in calories, added sugar, salt, and unhealthy fats. When possible, we should buy foods that are grown locally to minimize the environmental impact and support local farmers who live, work, and pay taxes in our area.

It turns out that focusing on food, not nutrients, will have a positive impact on your health, the environment, and quality of life for you and others. And that is why it is called Food Day, not nutrient day. You can learn more about how you can celebrate Food Day every day at www.foodday.org.

When it comes to your health, don’t take the high road.

When faced with challenging moral or ethical situations we are advised to do what is right, even if it is more difficult. “Taking the high road” is often synonymous with living a better life. When it comes to your health, though, taking the high road may lead you on a path to chronic disease, disability, and early death.

The high road I am referring to in this case has nothing to do with ethical decisions. It has to do with test results, specifically measurements your doctor makes of your weight and blood pressure as well as blood tests of cholesterol and glucose. This is the topic of my Health & Fitness column in the Aiken Standard this week.

These tests are indicators of your current health as well as risks to your health in the future. The results of these measures are used to classify you as having “normal” or “high” blood pressure, blood glucose, and blood cholesterol. For example, a fasting blood glucose between 70–100 mg/dl is normal but you are considered to have diabetes if your result is 126 mg/dl or higher.

Even if your blood glucose is above normal (100–125 mg/dl) but isn’t high enough for you to be classified as diabetic, it may still be too high. This condition is called prediabetes because without intervention most people in this category will eventually develop diabetes.

Considering that diabetes is a leading cause of heart attacks, blindness, and amputations, preventing your blood glucose from increasing should be a high priority.

The same is true for other measurements including blood pressure and body mass index (BMI), the most common assessment of obesity. Even if you aren’t considered obese or don’t have hypertension, the higher your BMI or blood pressure becomes puts you at increased risk of the condition getting worse over time or leading to other more serious health problems.

In fact, even within the normal range, a higher value is associated with increased health risks. Take blood cholesterol for example, where the risk of heart disease increases at total cholesterol levels above 150 mg/dl, well within the “normal” range of less than 200 mg/dl. At even higher levels, total cholesterol is associated with a much greater risk.

Clearly, having a high BMI, blood pressure, blood glucose, or cholesterol is concerning. But it is important not to be fooled into thinking that a value that is technically below the diagnostic criteria for “abnormal” is necessarily “normal.” For many, even slightly elevated levels of these variables now are likely to get worse over time.

The good news is that modest lifestyle changes including weight loss, regular moderate physical activity, and changes to what you eat can prevent conditions like prediabetes and prehypertension from getting worse. This can be achieved through losing as little as 10 pounds, walking or doing other activity for 30 minutes per day, and adding more fruits and vegetables to your diet.

To be sure, taking the “high road” with BMI, blood pressure, cholesterol, and glucose, even if your test results are within the normal range, can put you at increased health risk. For these conditions, you are far better off taking the low road and making the necessary lifestyle changes to stay there.

“Heart” your heart.

Today is World Heart Day, with a focus on encouraging all of us to make heart-healthy choices to reduce cardiovascular disease risk. I thought that sharing some information about the heart, how it works, and how to keep it healthy would be an appropriate way to celebrate. This is also the topic of my Health & Fitness column in the Aiken Standard this week.

Your heart started beating months before you were born and will continue to beat every second or so…until it stops, signaling the end of your life. During your lifetime, your heart will probably beat more than two billion times, or about 100,000 times per day. (more interesting heart facts here)

The major function of the heart is to pump blood to all of your tissues through the arteries and back again through the veins. The heart has four chambers: the left and right atria that receive blood from the veins and the left and right ventricles that pump blood into the arteries. The right ventricle pumps blood to the lungs to pick up oxygen and the left ventricle pumps oxygenated blood out to the rest of the body.

The activity of your heart will vary throughout the day. At rest your heart rate is low, typically around 70 beats per minute. Some athletes have resting heart rates that are much lower, owing to their bigger, stronger hearts.

But when you are active your heart beats faster and more forcefully to eject more blood to the working muscles. During intense exercise, a young person’s heart rate can go above 200 beats per minute and the amount of blood pumped can be five times higher than at rest!

The heart is made up mostly of muscle that functions similarly to the skeletal muscles you use to move your body. But cardiac muscle is different in that it can spontaneously contract when stimulated by a specialized area of the heart called the SA node or pacemaker. And unlike skeletal muscle, the heart is remarkably fatigue-resistant, meaning that it can contract repeatedly without needing a break.

In order to beat continuously, the heart needs a steady supply of oxygen which is delivered through coronary arteries, not from the blood inside the chambers of the heart. Normally, plenty of oxygenated blood gets through. But if the coronary arteries become narrowed through atherosclerosis, the accumulation of plaque in the vessels, blood supply can be limited.

This can lead to reversible symptoms like angina pectoris (chest pain), especially during exertion. If a clot forms in the narrowed vessel, blood flow can be blocked completely causing a myocardial infarction (heart attack). Heart disease can be managed using medications, angioplasty, or bypass surgery, but the best approach is to prevent the problem from occurring in the first place.

Taking care of your heart is one of the most important things you can do for your health. Like other muscles, regular exercise can make your heart larger and stronger to pump blood more effectively. Exercise also lowers your blood pressure and can help reduce your blood cholesterol, further reducing the risk of heart disease.

A diet that is low in salt and unhealthy fats, like trans fats, can help lower blood pressure and cholesterol, slowing the process of atherosclerosis and preventing heart failure, a condition in which the heart muscle becomes weak. Maintaining a healthy body weight and controlling blood glucose are also keys to a healthy heart.

More than anything, though, your heart likes to be active. So celebrate World Heart Day by taking your heart for a walk!

 

Loosening our belts. Expanding waistlines means expanding health problems.

In a report published this week, researchers showed that the waistlines of Americans are still expanding. This is bad news, since excess fat, especially around the waist, has serious implications for our health. Fortunately, there is much we can do to lose weight and improve our health.

This is the topic of my Health & Fitness column in the Aiken Standard this week.

The study, published in the Journal of the American Medical Association, looked at the percentage of adults who had a high waist circumference (over 35 inches for women and over 40 inches for men). Overall, the average American added over one inch to their waist circumference over the past decade. As of 2012, over half of U.S. adults (51%) meet the criteria for abdominal obesity, compared to 46% in 2000.

Since excess muscle tends to compress the abdomen, this really does reflect an increase in fat around the waist, not the benefits of a national sit-up campaign. And it is the location of the fat that makes this worrisome. Excess fat around the waist includes both subcutaneous fat beneath the skin (what you can pinch) as well as visceral fat stored deep in the abdomen.

Excess visceral fat is associated with an increased risk of high blood pressure, type 2 diabetes, and heart disease, among other chronic conditions. The only way to determine how much visceral fat a person has is through an imaging test like a CT scan. (In my lab we can estimate visceral fat by making a few abdominal measurements.) The important point is that the bigger your waist circumference, the more visceral fat you likely have.

You may have heard of people’s body shapes described as “apple” or “pear.” Upper body obesity (apple), sometimes called android obesity because it is more common among men, is associated with a high waist circumference and visceral fat. Lower body, or gynoid, obesity (pear shape) tends to involve a narrower waist but more fat storage in the hips, thighs, and buttocks.

These body shapes become apparent when you measure both waist and hip circumferences. A high ratio between waist and hip measurements indicates more upper body fat; a low waist-to-hip ratio suggests lower body fat. That said, just measuring your waist circumference can give you the same information. A waist measurement greater than 40 inches for men and 35 inches for women indicates excess upper body—and visceral—fat.

There is no single explanation for why waist circumference has increased so much in the population. But it almost certainly has to do with a combination of individual factors including what foods we eat, how much we eat, and how active we are. The average American with an expanding waistline likely eats too much poor quality food and doesn’t get enough exercise.

These are exactly the same factors that, when reversed, can lead to fat loss. Indeed, research shows that even modest weight loss from a low-calorie diet and exercise can result in reduced body fat, including visceral fat. This is one reason why weight loss is effective for reducing high blood pressure and controlling blood glucose.

Even if you don’t lose weight, increasing your level of physical activity, particularly regular exercise, can offset some of the negative health effects of excess visceral fat. In addition to helping you lose weight, exercise can also help you maintain your waistline and prevent abdominal obesity.

The bottom line is that when your pants start to feel tight, they are trying to tell you something. Listen to them!