Fran Yeoman
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For many people, middle-aged spread is as much a part of getting older as laughter lines, receding hairlines and worsening hangovers. But research suggests that even the smallest of pot bellies may be a serious health risk.
After examining more than 2,700 men and women with an average age of 45, scientists at the University of Texas Southwestern Medical Centre in Dallas found that those with even a little fat around their waists were significantly more vulnerable to heart disease, even if their overall weight was normal.
Their findings, published in the Journal of the American College of Cardiology (JACC), may come as a shock to many who would not consider themselves fat. But they reinforce a growing belief among medical experts that waist-to-hip ratio (WHR) is a more accurate measure of healthy shape than the widely used body mass index (BMI).
BMI, which is calculated by dividing weight in kilograms by height in metres squared, gives an overall indication of heaviness compared with height. But according to BMI measurements, well-toned specimens from Brad Pitt to the rugby star Jonah Lomu would be classed as overweight, and increasing numbers of experts are now questioning BMI’s usefulness.
The new study by James de Lemos and his team adds credibility to the theory that WHR is a more accurate means of measuring heart-disease risk because it identifies potentially dangerous “central obesity” even in those who are not overweight.
The researchers conducted a series of examinations on their participants, ranging from blood sampling to MRI scans. All underwent imaging tests to look for early signs of calcium build-up in the arteries of the heart, which is linked to an increased risk of developing cardiovascular disease later in life.
These deposits are a reflection of atherosclerosis – commonly referred to as “hardening” of the arteries – and can be detected years before a patient suffers chest pain or has a heart attack.
Researchers examined the relationship between body shape and early signs of disease in the arteries. They found that the likelihood of there being calcium deposits in the arteries grew in direct proportion to the increase in waist-to-hip ratio.
A breakdown of the participants into five groups showed that those with the highest WHR were almost twice as likely to have calcium deposits in their coronary arteries as those with the smallest WHR. Even when factors such as blood pressure, diabetes, age, high cholesterol levels and smoking were taken into account, the link remained strong.
Dr de Lemos said: “In our thirties and forties, we often gain three to four inches in the midsection. It’s a day-to-day, meal-to-meal battle, but it’s worth fighting. We don’t have to clean our plates. It’s better to throw food out than add it to our waists. Even a small pot belly puts us at higher risk when compared to a flat tummy.”
June Davison, cardiac nurse at the British Heart Foundation, said: “People who are overweight or obese have an increased risk of developing heart disease. The risks are even higher when fat is mainly concentrated around the abdomen.
“What’s important is that people consider their body shape as well as their weight.”
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90% of the time:
Moderate your carb intake which should be taken only at meal times, with gap of 5 hours between, eat high protein breakfast & don't skip breakfast, exercise(some sweat needed) daily, eliminate transfats esp. & avoid fatty & sugary food & drinks.
This all helps control your insulin sensitivity which will help loose weight.
10% of the time: Treats, special occasions, celebrations.
Use Body Fat Percentage as the main indicator then Hip to Waist and finally BMI. Fat releases hormones the execess of which causes modern age illnesses. Fat around the belly is associated with increased risks but overall fat is more important.
Genetically you may have thrifty genes & be efficient at exercising, you will need take a more focused approach than someone who has inefficient muscles, genes, absorption etc. You would have survived in a calorie scarce past but are burdened in a calorie dense present.
Think for the long term, not quick fix!
Kiran, London, UK
I think some people who have posted that they are at a healthy weight yet seem to have an at risk WHR (eg Alex, London) are measuring the waist at the wrong place. In order for the ratio to work your waist is the narrowest part, so above your belly button. So, Alex, at 5'8 and 9.5 stone I very much doubt that this measurement is 31inches.
Kathryn, london,
Best thing to do, is exercise every day, be it walking, running, sports, when drinking in pubs, try to drink water or a little red wine, eat fresh veg, steam it if you can, cut down on fizzy drinks altogether, eat only enough to stop hunger, there will be no pressure on the heart then, enjoy a smoothie a day, do something that scares you once a day or excites you, get lots of sleep, and generally moderate everything that is bad for you!! Just take care of yourself as best you can but if you want to let go a bit then at least you are making an effort to cut down the damage your doing!!
Adam Webb, MK, UK
It's about waist to hip ratio, maybe starvation is clouding your brain. If you decide to starve yourself, take responsibility for that, don't hate others that don't stoop to your level.
B Adu, London, UK
Duuuuh...
Having a body shape that is very likely to be as a result of being inactive and over-eating/drinking is likely to increase you chances of having heart disease.
These people get paid for this kind of research do they?
eckythump, Salisbury, UK
The main thing I find confusing about this idea is what the difference is between FLAB and FAT. Your picture shows a gentleman with a stomach that relaxes to tip over his belt. Mine does the same, and if I relax my stomach muscles, then I am over the top on the ratio. But if I tighten my stomach muscles, I am well within the suggested healthy ratio. How does one tell the difference between poorly conditioned stomach muscles and fat?
Michael, London, UK
im a 16 year old female and rate way over the danger zone for waists and hips - 86cm and 91cm, my hip waist ratio is also over. this concerns me greatly- i am a size 12 in most clothes however this is mainly to do with my body shape - something the article doesnt take into account. I have slim arms and legs however my stomach has always been my problem area. My sister on the other hand, who has an identical diet and proportion of exercize as myself, has larger arms and legs yet a flatter stomach, so thus rules healther following the limits set in the article. My diet isnt appalling; i have a low salt consumption although a sweet tooth - but nothing i previously considered overly excessive. perhaps this is the reason behind my apparant strong risk of heart disease?
kate, london,
Mia-Of course it's quite clearly wrong to eat dairy, animal products and bread..It's not as if it hasn't served our ancestors well since the dawn of time. I think people should be more distrustful of quacks coming out with dieting theories every five minutes than tried and tested food stuffs. I'm off for a burger..I'm 6ft and weigh 12 stone. Toodle pip.
Jon, London, UK
Bmi is much more important then WHR. Consider 100 individuals, 10 with high BMI and 90 with high WHR, one wud give more importance to those 10 individuals because they are at high risk of developing any sort of illness.
david thomson, karachi, pakistan
I'm 5ft 8in, weigh 9 and a half stone. My hips are 34 in and my waist is 31 in. I have no discernible 'pot belly', and when I pinch the fattest part of my abdomen, the pinch is less than 1 inch, yet this latest research, as reported, suggests that I need to reduce my waist measurement by 2 inches to achieve the optimum WHR of .85 for a woman. This would, I assume, entail a weight reduction of at least half a stone, meaning that, at 5ft 8 in I would weigh less than 9 stone,which I would consider to be on the underweight side for my height. What is the risk issue here? I would assume that it is the existence of a pad of fat in the belly region. Those of us who simply have a tubular body shape with no indentation at the waist will have a larger waist measurement than overall weight and height would predict, but is this a danger signal ? - I doubt it. Perhaps, just like BMI, this is not a 'one size fits all' system.
Alex , London,
I am amazed that anyone could say that it is near impossible to keep a flat stomach after forty.A man should be in his prime then.Perhaps after sixty it becomes more difficult but even then it can be controlled with a bit of self discipline.Too many people,especially men,use their age as an excuse for their shape"Too much food and too little exercise makes Jack a fat boy".People should stop kidding themselves.
robin hart, sutton coldfeld,
I am exactly the same weight (10st/ 5'10"), and have the same WTH ratio (0.8) that I had as a young man, now 55, I think that I have an extremely high risk of heart disease!!!
Roger, Manchester, UK
What is the point of an article suggesting that WHR is a more meaningfull index,if it doesn't contain any indication of what is a good WHR and what is bad?
Dr Seoul, Seoul, South Korea
Years ago the Institute for Aerobic Research (Dr. Ken Cooper) established that the fit, fat guy had a similar mortality rate of an unfit skinny guy. The "fitness factor" is not addressed here. I had an EBT (electron beam tomography) to spot calcium build-up in my arteries and it was non-existent at age 50. I am overfat by 25 lbs (have been for years) and a crappy HDL/total ratio of 6.8. But I exercise most days per week and have since age 38.
George
Mount Vernon WA USA
George, Mount Vernon WA, USA WA
Peopele should eat 6 small meals per day, but only natural foods (not processed) and this will keep insulin levels even which will help prevent fat storage and Type II diabetes. The WHR is still viable, but it should be a tool in a tool box, not the only tool ever used. I don't understand why governments are always looking for 1 easy number to classify people with. Like cholesterol for example. thats a big ass scam too.
Eddie, Colorado Springs, USA
"For me, James de Lemos and his team can take a walk."
They probably already are Bob, if not a run or bike ride
Francis, Colchester, UK
I agree about the fast food comment...looking at the people on line will easily send you to the salad bar. But as to skipping a day...without going into gory details, I remember being so sick for several days and unable to eat, consoling myself with the thought that I'd lose weight, and unfortunately, gained two pounds! However, there is a biological link to obesity. Some people have a brain chemistry that does not signal the appestat to register fullness. I've dieted down to 800 or less calories a day and not lost weight, and also followed advice and eaten 1800 calories a day and not lost and sometimes gained. All on healthy food... and always feeling like I hadn't eaten in weeks. The only true remedy for me, I"ve found, is a hypoglycemic diet, such as the Zone or 40-30-30 plan and EXERCISE! It's the key. I dropped 40 pounds and kept it off for six years until an injured knee sidelined me for over a year. Now it's back to my meal plan and exercise to lose the weight I gained.
Gillian Romain, El Mirage, Arizona, USA
I am 5 feet six and a half - just 10 stone- my BMI is fine. But yes, I have a tummy (baby at 40) I've struggled to keep my tummy at bay, even when I was half a stone lighter.
Any ideas how I can flatten it? (without time in the gym which I can't do either time or money wise) I don't feel I overeat, and I'm not overweight. Tummies run in our familily among the women.
Fiona, London,
I think the hip to center ratio is nigh on unachievable for most normal people as it means your hips have to be bigger than your mid or exactly the same. I feel it's yet another impossible challengethat could spark anorexia in people. The best measure of how your weight is, is your body fat percentage.
Peter Nicholls, Stoke on Trent, UK
If you are anxious about being overweight don't blame the medical team. Knowing how to guage how overweight we are helps us to control our risk to heart disease. This provides me with comfort not anxiety, ignorance Bob may well be bliss but its also the quick route to death.
David, london,
If you go to the BMI website you will see that there are exceptions, body builders, elderly and children. I think the BMI offers these guidelines so one can maintain a healthy evaluation and direction in your life.
I have several friends, myself included, that are mid 50s, flat tommies and are the same weight that we were when we were in school. I don't know if I'll live any longer, but this type of information helps us all against the odds.
Long life to all!!
Gregory, Pasadena , California
What was the sample size? What is the correlation between artery calcification and heart attacks? What was the range of WHRs between the smallest and largest groups? What are the figures for likely risk of heart attack for the lowest and highest WHR groups?
I think we need some facts in this article, not just conclusions. Then we can decide whether we need to do something or not. Vague exhortations coupled with dire warnings are how the government gets its propaganda across, and not the way that real science is performed and communicated.
Peter, Warwick, UK
Rubbish Bob - My Dad and Uncle are both still very trim well into their 60's - mainly by watching what they eat and still exercising. If what you say is true then it's because 'most' men are lazy and short of will-power.
Having said that - BMI has always been complete rubbish. Any male with any kind of developed muscle is immediately thrown by this ridiculous method developed in the 50's, which incidentally and ridiculously, the army still use.
By the way - My BMI is 26.9 (overweight) but my body fat measurement is around 9% (average 12-18%) and my resting heart rate is around the 40bpm mark.(55-60bpm - 'fit') Clearly a fine indicator of health and fitness then.
matt, london,
Most men are too lazy to keep a flat tommy (sic)after 40. Anxieties that are caused by these kind of researches will boost many more hart and other problems.
For me, James de Lemos and his team can take a walk, I'm going to drive to the pub and eat some more pies.
Andy, Lardston,
Untrue - get a decent exercise regime and watch what you eat and drink - that is the killer. The stomach puts on what goes in. There were no fat people in Belsen, as a GP once said to me.....
Steely Dan, Gloucester,
Strange isn't it, but the average age of death just keeps on going up.. With all these scare stories I'm just amazed that happens. Anyone else notice how the present generation seem to be bigger than the last one (especially young females)? Seems to me that generally we are fitter, stronger, healthier and live longer than people did say 40 or 50 years ago. Don't recall their WTH ratio being in the wrong direction.
Ian Burgess, Bristol,
Science has proved irrefutably that if you drink a pint of milk every day for 5,200 weeks, you'll live to be a hundred, irrespective of BMI, WHR or BFG.
Clive Russell, Coleraine,
I agree with Paolo. I am 5'11", 14 stone with a chest of 43" and a waist at 35". I am, by standard definition "overweight".
I have a friend who is my height and weighs only a touch above 12 stone but is all blubber. he is "ideal weight". Its a joke.
Nathan, Surrey,
It would have been much more useful for the article to have mentioned some idea of what these ratios are, as they must be different for men and women, surely? A man with a woman's normal WHR would be a very odd shape, while a woman with a normal man's WHR would be at risk.
alexandria, Sheffield, UK
A shame the article doesn't actually give a numeric indication of what represents a healthy or unhealthy WHR.
Julian Burn-Callander, London,
BMI is rubbish. I'm 27.5 (overweight), 6'3" and 15 stone 10, a 45" chest and a 36" waist with body fat at 18%.
BMI takes so little account of build and musculature as to be next to useless. I wouldn't be at all surprised if Redgrave and Pinsent were close to being "obese" the day they won their last gold medal in Sydney.
All this would be a bit of a chuckle were it not for the fact that insurance companies in rely in large part on BMI to calculate their premiums so that male sporty-types who do resistance training and eat plenty of protein (and put on muscle) end up paying much the same as slobs, and "fat-thin people" (lots of body fat and no muscle) are classified as "normal" and pay the smallest premiums.
Anything that leasts to a more scientific assessment of obesity and risk is to be welcomed but I suspect it is going to be a long time before insurance companies give up the blunt tool of BMI which allows them to classify so many fit and muscular people as "overweight".
Paolo Bagarino, Roma, Italy
On average I walk 10 miles a week, eat healthily taking on about 1,800kcal a day and have a waist to hip ration 10% above the recommended limit.
They can get lost as far as I'm concerned.
John, London, UK
As long as you eat 3 meals a day, consume dairy, animal products, alcohol, bread, margarine, desserts, and other unwholesome foods, you will be overweight and unhealthy. We should probably eat every other day then everyone will be fed not fat and there wont be anyone starving !! Have you seen people who are so overweight that they can hardly walk and they are still queing for the fast food to consume more garbage!!
mia, Brisbane, Australia
For most men it is near impossible to keep a flat tommy after 40. Anxieties that are caused by these kind of researches will boost many more hart and other problems.
For me, James de Lemos and his team can take a walk.
bob, steveston,