From the Wall Street Journal

Original Article here

* NOVEMBER 13, 2008

Bulging Waist Carries Risk
By ROBERT TOMSHO

A bulging waistline may be a stronger predictor of premature death than a person’s overall weight, according to a large-scale European study that bolsters the findings of earlier research.

For the study, published in this week’s New England Journal of Medicine, researchers tracked nearly 360,000 men and women in nine European countries for about a decade. Study participants ranged in age from 25 to 70.

At the outset, researchers calculated participants’ so-called body-mass index. The BMI has been the standard formula for assessing weight. It uses a person’s height and weight to come up with a score. A person with a BMI of between 25 and 29.9 points is considered overweight; those with higher scores are deemed obese.

The researchers also measured the circumference of participants’ waists as well as the ratio of their waist and hip measurements. In recent years, various studies have shown that the location of body fat — particularly if it is in the waist area — can be an important factor in assessing the risk of various diseases and death. Men with waists measuring over 40 inches are considered at a higher-risk; for women, the figure is 35 inches.

Current treatment guidelines call for physicians to measure patients’ waists but usually only when their BMI indicates they are overweight, said Tobias Pischon, the study’s lead author and a researcher at the German Institute of Human Nutrition, in Potsdam-Rehbruecke, Germany.

For the study, patients were divided into groups according to their BMI, waist circumference and waist-to-hips ratio. During the course of the research, more than 14,723 of them died from various causes.

Researchers found that even patients who would be considered at normal weight, according to their BMI, faced increased risk of death if they had a large waist.

Normal-weight male participants with waists measuring 102.7 centimeters (about 40 inches) or more were twice as likely to die as those with waists measuring 86 centimeters (34 inches) or less. Women who weighed in the normal BMI range but had waists that were 89 centimeters (35 inches) or more were 79% more likely to die than those with waists measuring 70.1 centimeters (28 inches) or less.

The researchers also calculated that, for a five-centimeter, or about two-inch, increase in waist size for patients with any given BMI score, the risk of death increased by 17% for men and by 13% for women. The researchers found similar trends when they compared waist-to-hips ratios.

Rob M. van Dam, a Harvard Medical School professor not involved with the research, said that while the European study doesn’t break new ground, its size and breadth make it a “very important” contribution to the field. “They really put it on the table in a very convincing way,” said Mr. van Dam, who has been involved in similar research.

Dr. Pischon, the study’s lead author, said in an email that the research didn’t focus on why larger waists mean a higher death rate, but added that the fat in the abdomen tends to be so-called visceral fat, which builds up around the organs and secretes certain hormones that contribute to the onset of various diseases.

He said future research should focus on whether treatment for weight problems should focus on preventing increases in waist size rather than holding down weight overall.

We need to move folks. Move and relearn to eat properly.

Obesity genes? Fighting a battle with the bulge you cannot win?

Original Article Here: Click Here

Exercise Can Overcome Obesity Gene
Study Shows Physical Activity Can Offset Genetic Predisposition for Obesity
By Caroline Wilbert
WebMD Health News
Reviewed by Louise Chang, MD

Sept. 8, 2008 — Though genetics do play a role in obesity, a new study shows regular physical activity can blunt the impact of a genetic predisposition to being overweight.

Variations of a particular gene, known as the fat mass and obesity associated (FTO) gene, are widely acknowledged to be linked with a high body mass index, according to background material in the study, which is published in the Archives of Internal Medicine.

Evadnie Rampersaud, MSPH, PhD, then of the University of Maryland School of Medicine and now of the University of Miami, and colleagues examined how lifestyle affected the weight of people with a genetic predisposition to being overweight.

Researchers studied DNA samples of 704 healthy Amish adults, collected between 2003 and 2007. Participants also underwent physiological tests, including a seven-day measurement of physical activity using an accelerometer, which participants wore on their body. The instrument measured activity level at 15-second intervals.

The participants had an average age of 44 years; 53% were men. Fifty-four percent of the men were overweight and 10% were obese. About 64% of the women were overweight and 31% were obese.

The group was divided into people with high activity levels and low activity levels. The highly active group burned about 900 more calories per day than the lower activity group. That equals about three to four hours of moderately intensive physical activity, such as brisk walking, house cleaning, or gardening, according to the researchers.

The study showed, as past research has, that people with certain variations of the FTO gene were more likely to be overweight. However, the researchers found that being genetically predisposed to obesity “had no effect on those with above average physical activity scores.”

As obesity increasingly becomes a global health concern, understanding all aspects of the FTO gene is important, the researchers say. Variants of the FTO gene are prevalent — about 30% of European populations have such variants, according to the study. The gene variants are associated with a greater than 20% risk for obesity, write the researchers.

Study authors conclude, “These findings emphasize the important role of physical activity in public health efforts to combat obesity, particularly in genetically susceptible individuals.”

Get up and move folks.

Lifestyle, fitness, diet – what is the key to all this?

Uh oh, another rant.

Sorry, I can’t stop.

But this is different. (Honest). This isn’t a ‘be like me’ rant or anything. This is, IMHO, how to live a better lifestyle for everyone. A universal truth. (If that doesn’t make you afraid or laugh, well, here we go…)

What’s the key to all this diet, exercise, lifestyle? Right here: Common sense, moderation in all things and planning what you do instead of just acting on impulse are the keys.

That’s pretty simple, probably too simple, but it’s all there. I recognize most folks won’t work out as hard or frequently as I do. I recognize that there are VERY many factors that relate to one’s weight and diet lifestyle, many beyond their control.

But all the things I passionately push as keys – being active, eating right, etc – are in that one bold sentence.

Common sense is a bit scary because it assumes a certain knowledge. If you grew up not knowing how to eat or why, or have emotional issues that have manifested themselves in eating wrong, not exercising, or living healthy… that’s an issue. The goal of going to school isn’t to learn things taught to you. The goal is to learn to teach yourself. To me, that’s the mark of someone that’s matured into an adult; they don’t leave their knowledge and life to other’s choices and instead take charge of their life (and by extension ‘lifestyle’) through researching and learning on their own. With the Internet, this is easier than ever. You need a good BS filter with the Internet, but again, with maturity comes wisdom.

Moderation in all things. Portion control falls in here. Exercise falls in here. Most anything you do, anything, needs to be in balance with everything else you do. This goes far beyond just exercise and diet into your life, but I’ll stop there.

The last part is what trips up most folks. You need to plan what you do instead of just operating your life from impulse. For instance, if you have children and ask them what they want to do and eat everyday, they cannot and will not make good choices most of the time. They need guidance and direction to do so. As an adult, young or old, you don’t have that sort of guidance or direction coming at you from anyone… it’s up to you. The entire fast food, comfort food, ‘quickie’ food and everyone’s consistent ‘lack of time’ for anything (meal planning, exercise, quality time with others) is what happens. Like ships without rudders, we instead get so busy with daily life and ‘putting out fires’ that we lose sight of the important things in life. Like making time to plan meals, eat right, exercise, spend time with folks that matter, etc.. We pull up to the drive-thru at McDonalds, order a super size meal and eat it on the way to wherever we are late getting to. It’s just easier to do; we tell ourselves it’s okay and we are just being efficient with our time (“Just this once, it won’t kill me….”).

Not so.

I’ve found as I reinvented my life and ‘grew up’ in my late 30′s and got serious about how: I live my life, I allocate my time and efforts in all things, and I approached living… that some forethought and planning. That is how I ‘found the time’ and started living within my means, got my diet straight and ‘made’ that time for exercise. I also applied this to my work life and personal life beyond diet and exercise; but that’s not the aim of this rant.

What I’d say to those that have looked for ways to combat things that suck their life and energy away without giving you anything back is to step back, reassess and pre-plan some essential things so your entire life can much more positive on all levels.

Too many folks talk the talk, but cannot put good intentions to action. In the hyper world we all live in, it’s just so easy to get caught up and spun so many ways we can’t seemingly control it. You cannot plan for everything; and you have to allow for things to go wrong, days to be lost to emergencies and things beyond our control. But those are bumps in the road if we have an overall plan, goals we can achieve and use moderation, common sense and pre-planning in regards to our lifestyle and how we want to live our lives.

I am not better than anyone else. I am not some shining example of anything. I don’t know more than anyone else. I am not holding myself up as any sort of role model. I am sharing my experience, my thoughts as they relate to my life and hoping that it helps someone else out there to ‘turn on the light’ and take charge of their lifestyle and live a more healthy way. For your sake, for your loved one’s sake, for your children’s sake. Your children need an example and model of how to live life, not just exist and ‘get by’.

/rant

My Obesity Rant

I posted this on The Gear Page (aka ‘TGP’)and it sparked a pretty interesting conversation. I present it here to again, spark conversation.

Disclaimer: this is not a hater post. I am not out to shame fat people or belittle them or make fun of them. I am an Administrator here and can and will shut down any nonsense on this discussion. That’s not my intent, not the direction of what I am trying to say.

My point, right up front was that I read an article today that strikes me personally. Here’s the article: Click Here

I got fat in the early 2000′s. I was in my mid to late 30′s and stopped working out, was eating fast food a lot and drinking Mt. Dew like it was from the fountain of youth (I discovered that it… was not.) I was 205 lbs. at 5’10″. I felt sluggish, got out of breath easily, had a bad back and hurt a lot from just daily living. I never went outside if I could help it. I felt terrible.

I’ve gotten my diet and my fitness in MUCH better control since age 37 and documented it well here on TGP. (I am 41 now). I have been back to 160lbs (where I was in college and my 20′s when I was a gym rat) since then and am in better all-around shape now than I’ve ever been. (I currently do the P90X program you’ve might have seen on infomercials and I’ve done threads along the way as I’ve done it and play competitive indoor soccer).

I live in Michigan, mid-west America. I see and know a lot of people, and have lived in this area my entire life. To paraphrase the kid from “The Sixth Sense”, “I see fat people.” Everywhere. Not just overweight, but dangerously and uncomfortably fat. At the beach, at the store, in restaurants, at my kid’s school, at church, everywhere.

According to that article, if current trends keep up, well, read the first few paragraphs yourself:

By Amy Norton

NEW YORK (Reuters Health) – If the trends of the past three decades continue, it’s possible that every American adult could be overweight 40 years from now, a government-funded study projects.

The figure might sound alarming, or impossible, but researchers say that even if the actual rate never reaches the 100-percent mark, any upward movement is worrying; two-thirds of the population is already overweight.

“Genetically and physiologically, it should be impossible” for all U.S. adults to become overweight, said Dr. Lan Liang of the federal government’s Agency for Healthcare Research and Quality, one of the researchers on the study.

However, she told Reuters Health, the data suggest that if the trends of the past 30 years persist, “that is the direction we’re going.”

Now that’s alarmist and the article is created to generate a buzz with hyperbole… sure.

But look around. I personally know three people that have had gastric bypass surgery. Two of them ended up 300+ lbs again after 3 years because they simply would not learn how to eat right or eat sensibly.

I have a theory about this. I am aware of the high fructose corn syrup theories and all the fast food insanity (“Fastfood Nation”); I think we have forgotten how to eat. At least properly. We’ve gotten so accustomed and used to and entrenched in ‘more, better, faster’ food that we’ve forgotten how to eat correctly. There is no such thing as portion control. Calorie intake? My 11 year old skinny as a rail son will go to Wendy’s and order a Baconator (and it’s disgusting, IMHO). Or a 10 piece McNuggets from McDonalds. When I was a kid and McDonald’s had McNuggests, you got six in an order. Now they have 10 as a ‘standard’ order. Even past the evils of fast food, that’s a massive serving of fried whatever it is. (**Note, we allow the kids fast food every now and then, it is NOT a staple of what we allow our kids in my house to eat.) I grew up with the ‘finish your plate, there are starving children in….’ line. I never finished my plate anyway, I wasn’t hungry anymore. Sometime in my thirties, I started finishing my plate…. and eating more and more. ‘Comfort food’ became my norm and I forgot how to eat.

I don’t want laws to tell us how to eat. Don’t drop politics into this, please. As a species, the parents need to slow down for a few minutes of their work-a-day lives and actually learn about what to eat, when to eat, how to (cook) and eat, why you eat and how MUCH you eat at a time. It’s gotten insane. Figure out what you are doing to yourself and then what it’s doing to your kids. Help your kids to learn, so they can teach themselves.

A special pet peeve of mine is sit-down restaurants “Kid’s Menus”. Always the same things. Always some sort of chicken nuggets, cheeseburgers, mac-and-cheese, etc.. At ALL of them. Why not smaller portions of real food? My oldest (skinny as a rail) 11 year old son loves Salmon. But ordering that costs me $18.99 at a lot of restaurants and it’s such a waste of food and money. Why not a smaller portion for kids? Why? Ahahghghag!!

And my other very personal ‘beef’ with this issue is exercise. As a species, we’ve forgotten how to move. You see athletes who retire in fantastic shape turn up as big as houses just a few years later (Charles Barkley or Brett Hull anyone?) It’s like they have no control. They ‘let go’ because they feel they’ve ‘earned’ the right to indulge a little with their diet (and it ends up spiraling like mad) and stop training at any level. Now that’s just a microcasm of what happens to adults when they marry and get careers going… they just stop anything related to exercise and sensable diet and…. get overweight. Fast.

Now, some folks are big folks no matter what they eat, exercise or anything else. This is not some treatise on hating on fat people. It’s simply an opinion about the practice of using food as a means and not as an end. Food is fuel. If you over fuel your car or mower, it won’t run. You need to turn on the ‘choke’ to ‘lean’ it out. It’s my opinion that we need to turn on the choke and lean out society. If you don’t run the motor hard on a frequent basis, it stops working. Your body is a machine, the same principles apply.

My challenge is for you to focus, for one week, on what you actually are eating and how much. Keep a food diary. I dare you. Go to www.myplate.com or www.fitday.com (both are free) and figure out a) how much are eating and b) the balance of carbs/protein/fats. You’ll be stunned if you have never paid attention. What I’ve come to learn as a ‘serving’ or ‘portion’ of a given dish would (and does) make a lot of folks chuckle and a LOT of folks peer pressure me that I’m not eating enough. I counter, politely, that I know exactly how much I am eating and that’s enough, thank you.

My other challenge is to go outside today and run a 100 yard dash. Full tilt. If it feels good, wonderful. If you feel like hell within 20 yards, look at the machine you call your body and think about what you’ve let it become. We’ve got to move people, we owe it to those that want to use their machines but can’t. My uncle (RIP) lost his legs in the Korean War. I owe it to him to get up and work out everyday; he’d have given anything to just walk on his own legs again. He spent the final 40+ years of his life in a wheelchair. My excuse for not exercising is pretty lame compared to that IMHO.

Failing that, try pull-ups. Many folks, even he-man bad-assed dudes, can hardly do one. Or two. It’s sad and it’s wrong.

That’s my tirade and rant of the day.

Discuss. (And I am serious about my challenges; it’d be fascinating for folks to chime in that tried them. I’d bet there would be a heck of a lot of surprised and alarmed folks).