Don’t Go Belly Up – Control That Waistline

by Paul Rogers on September 7, 2009

A big belly is potentially a health warning — for men and women. True, there may be metabolic types that defy the general health implications of a substantial girth. Some men and women might actually be metabolically normal with a large waistline — especially if they are physically active — but I wouldn’t count on it.

What is Metabolic Normality and Metabolic Syndrome?

When the physicians talk about metabolic syndrome, an unhealthy condition, they usually judge it on these criteria:

  1. High blood pressure
  2. High blood glucose readings
  3. High cholesterol readings (low-density cholesterol)
  4. High triglycerides
  5. Insulin resistance, glucose intolerance
  6. Low high-density cholesterol (HDL)
  7. Overweight or obesity

Three of these may be enough to signal warnings of metabolic syndrome, although it is more a cluster of poor health indicators rather than a discrete health condition. If you have a large waist and you still have the first 6 of these measures under control, then you are probably one of the lucky ones who carry weight and yet stay metabolically normal. The current thinking is that people with large waists who stay healthy for these measures probably carry most of the fat just under the skin. This is called subcutaneous fat. The more dangerous fat deposits appear to be wrapped around the internal organs like the liver, kidneys and intestines. This type of fat is called visceral fat, and it is this fat that is related to the metabolic abnormalities in the list above.

How Big is Too Big for Waist Size?

Different countries have different standards. The US National Institutes of Health say 40 inches (102 centimetres) for men, and 35 inches (88 centimetres) for women is the risk threshold. The Australian guidelines are 94 centimetres for men (37 inches) and 80 centimetres for women (32 inches). I favour the lower number — and it has some scientific backing. Perhaps the lower numbers seem too big  target for some, yet I certainly don’t recommend anyone stop their weight loss efforts at the higher, US waist standard.

Lately we’ve seen some analysis of mortality in various body mass index (BMI) ranges. In some studies, individuals in the overweight range — 25 to 29.9 kg/sq.m — did better than those in the normal BMI range of 18.5 to 24.9. But because many highly-muscled athletes and other physically active people occur in the 25+ range, these results could be very misleading unless waist size is used as a controlling factor. Further, unless the ill and sick, the smokers and alcoholics etc are controlled in the lower BMI category, this will also distort the validity of the results. Claims that being ‘fit and fat’ can be healthy is just a little premature in my view — until we get some better designed studies.

How Best to Reduce Your Waistline

It’s still eat less and move more, but some recent work suggests that high-intensity training might be more more efficient at removing that dangerous visceral fat — even at comparable energy expenditures. This sort of exercise could include aerobic running at around 85% of maximum heart rate, or doing interval sprint running at up to 95% of heart rate max. This, however, is not for the faint-hearted — and I mean that in a technicals sense as well as a trivial sense. The way to go is certainly to get a doctor’s clearance to exercise first, then build up cardiorespiratory fitness gradually — with walking if necessary.

Various trials and case studies have shown that serious lifestyle change at the metabolic syndrome stage can prevent progression to type 2 diabetes, cardiovascular disease, and probably some cancers. It’s well worth the effort.

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