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Wellness Wise

Are You an Apple or a Pear?

If you are overweight, do you carry most of your extra pounds around your waist or your hips? Of course, being significantly overweight is unhealthy, but it’s important where the fat is stored. In recent years research has shown that having an “apple-shaped” body (a lot of abdominal fat) increases the risk of heart disease, stroke, Type 2 diabetes, hypertension, several types of cancer, and possibly other disorders. A “pear-shaped” body (fattest in the hips, buttocks, and thighs) is less risky and may be protective in some ways, especially in women.

Why it ends up there

Several factors, notably gender, influence fat distribution. Men store most excess fat in the midsection, while women tend to accumulate it lower on the body. Still, women can be apple-shaped, too, particularly after menopause. Heredity and activity level also affect body shape.

Abdominal obesity increases the risk of developing high LDL (“bad”) cholesterol, triglycerides (fats in the blood), blood pressure, and blood sugar, as well as insulin resistance and low HDL (“good”) cholesterol. This cluster of problems is known as the metabolic syndrome, which in turn increases the risk of many chronic diseases.

While most of the fat in the hips and thighs is stored just under the skin (subcutaneous fat), more fat in the midsection is stored in and around the liver and other organs (visceral fat). These fat cells deep in the abdominal area are more “metabolically active” than subcutaneous fat; they release different substances— more of certain fatty acids, hormones, and inflammatory compounds—which are believed to account for some of the adverse health effects. Visceral fat increases estrogen production, for instance, which may partly explain the increase in breast cancer in some postmenopausal women. By inducing chronic inflammation in the body, excess visceral fat may further boost cardiovascular risk.

Apple-shaped adversities

Here are some recent findings about abdominal fat:

Shrinking the big apple

There is no way to lose fat just around your waist, except by losing weight, period. You can not spot reduce. You have to exercise your whole body—walk briskly, ride a bike, lift weights—and thus burn more calories. You also should reduce your calorie intake, or at least not increase it, and do not smoke: smoking is associated with abdominal fat accumulation.

One piece of good news—While abdominal fat tends to accumulate faster than other fat, it also tends to come off faster. Another—Losing just 2 inches from the waist reduces coronary risk by 11% in men and 15% in women, according to one recent study.

Measuring up

To determine your waist-to-hip ratio, measure your waist at the navel, and your hips at the greatest circumference around the buttocks. Then divide the waist measurement by the hip size. For example, a woman with a 30-inch waist and 40-inch hips would have a waist-to-hip ratio of 0.75. A result greater than 0.9 for men and 0.8 for women indicates above-average risk; above 1.0 for men and 0.9 for women, high risk. In simplest terms, your waist measurement should be less than that of your hips. Ideally a woman’s waist should be at least 20% smaller than her hips, a man’s, at least 10% smaller.

A simpler gauge is to measure just your waist: More than 40 inches for men and 35 inches for women indicates high risk; however, these are not magical numbers; risk starts to rise before those cutoff points.

Where’s that waist? It may not be where your belt is. Measure at the narrowest point between the lower rib and the top of the hip bone, or at the midpoint in between. Do not suck in your belly. If you can’t find the narrowest point, measure just above your belly button. Measure your hips at the widest part of your buttocks, as viewed from the side.

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