Good news: midlife health is about more than a waist measurement. Here’s why
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
You’re not in your 20s or 30s anymore and you know regular health checks are important. So you go to your GP. During the appointment they measure your waist. They might also check your weight. Looking concerned, they recommend some lifestyle changes.
GPs and health professionals commonly measure waist circumference as a vital sign for health. This is a better indicator than body mass index (BMI) of the amount of intra-abdominal fat. This is the really risky fat around and within the organs that can drive heart disease and metabolic disorders such as type 2 diabetes.
Men are at greatly increased risk of health issues if their waist circumference is greater than 102 centimetres. Women are considered to be at greater risk with a waist circumference of 88 centimetres or more. More than two-thirds of Australian adults have waist measurements that put them at an increased risk of disease. An even better indicator is waist circumference divided by height or waist-to-height ratio.
But we know people (especially women) have a propensity to gain weight around their middle during midlife, which can be very hard to control. Are they doomed to ill health? It turns out that, although such measurements are important, they are not the whole story when it comes to your risk of disease and death.
How much is too much?
Having a waist circumference to height ratio larger than 0.5 is associated with greater risk of chronic disease as well as premature death and this applies in adults of any age. A healthy waist-to-height ratio is between 0.4 to 0.49. A ratio of 0.6 or more places a person at the highest risk of disease.
Some experts recommend waist circumference be routinely measured in patients during health appointments. This can kick off a discussion about their risk of chronic diseases and how they might address this.
Excessive body fat and the associated health problems manifest more strongly during midlife. A range of social, personal and physiological factors come together to make it more difficult to control waist circumference as we age. Metabolism tends to slow down mainly due to decreasing muscle mass because people do less vigorous physical activity, in particular resistance exercise.
For women, hormone levels begin changing in mid-life and this also stimulates increased fat levels particularly around the abdomen. At the same time, this life phase (often involving job responsibilities, parenting and caring for ageing parents) is when elevated stress can lead to increased cortisol which causes fat gain in the abdominal region.
Midlife can also bring poorer sleep patterns. These contribute to fat gain with disruption to the hormones that control appetite.
Finally, your family history and genetics can make you predisposed to gaining more abdominal fat.
Why the waist?
This intra-abdominal or visceral fat is much more metabolically active (it has a greater impact on body organs and systems) than the fat under the skin (subcutaneous fat).
Visceral fat surrounds and infiltrates major organs such as the liver, pancreas and intestines, releasing a variety of chemicals (hormones, inflammatory signals, and fatty acids). These affect inflammation, lipid metabolism, cholesterol levels and insulin resistance, contributing to the development of chronic illnesses.
The issue is particularly evident during menopause. In addition to the direct effects of hormone changes, declining levels of oestrogen change brain function, mood and motivation. These psychological alterations can result in reduced physical activity and increased eating – often of comfort foods high in sugar and fat.
But these outcomes are not inevitable. Diet, exercise and managing mental health can limit visceral fat gains in mid-life. And importantly, the waist circumference (and ratio to height) is just one measure of human health. There are so many other aspects of body composition, exercise and diet. These can have much larger influence on a person’s health.
Muscle matters
The quantity and quality of skeletal muscle (attached to bones to produce movement) a person has makes a big difference to their heart, lung, metabolic, immune, neurological and mental health as well as their physical function.
On current evidence, it is equally or more important for health and longevity to have higher muscle mass and better cardiorespiratory (aerobic) fitness than waist circumference within the healthy range.
So, if a person does have an excessive waist circumference, but they are also sedentary and have less muscle mass and aerobic fitness, then the recommendation would be to focus on an appropriate exercise program. The fitness deficits should be addressed as priority rather than worry about fat loss.
Conversely, a person with low visceral fat levels is not necessarily fit and healthy and may have quite poor aerobic fitness, muscle mass, and strength. The research evidence is that these vital signs of health – how strong a person is, the quality of their diet and how well their heart, circulation and lungs are working – are more predictive of risk of disease and death than how thin or fat a person is.
For example, a 2017 Dutch study followed overweight and obese people for 15 years and found people who were very physically active had no increased heart disease risk than “normal weight” participants.
Getting moving is important advice
Physical activity has many benefits. Exercise can counter a lot of the negative behavioural and physiological changes that are occurring during midlife including for people going through menopause.
And regular exercise reduces the tendency to use food and drink to help manage what can be a quite difficult time in life.
Measuring your waist circumference and monitoring your weight remains important. If the measures exceed the values listed above, then it is certainly a good idea to make some changes. Exercise is effective for fat loss and in particular decreasing visceral fat with greater effectiveness when combined with dietary restriction of energy intake. Importantly, any fat loss program – whether through drugs, diet or surgery – is also a muscle loss program unless resistance exercise is part of the program. Talking about your overall health with a doctor is a great place to start.
Accredited exercise physiologists and accredited practising dietitians are the most appropriate allied health professionals to assess your physical structure, fitness and diet and work with you to get a plan in place to improve your health, fitness and reduce your current and future health risks.
Rob Newton, Professor of Exercise Medicine, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
Savor: Mindful Eating, Mindful Life – by Thich Nhat Hanh and Dr. Lilian Cheung
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
We’ve talked about mindful eating before at 10almonds, so here’s a book about it. You may wonder how much there is to say!
As it happens, there’s quite a bit. The authors, a Buddhist monk (Hanh) and a Harvard nutritionist (Dr. Cheung) explore the role of mindful eating in our life.
There is an expectation that we the reader want to lose weight. If we don’t, those parts of the book will be a “miss” for us, but still contain plenty of other value.
Most of the same advices can be applied equally to other aspects of health, in any case. A lot of that comes from the book’s Buddhist principles, including the notion that:
- We are experiencing suffering
- Suffering has a cause
- What has a cause can have an end
- The way to this end is mindfulness
As such, the process itself is also mindfulness all the way through:
- To be mindful of our suffering (and not let it become background noise to be ignored)
- To be mindful of the cause of our suffering (rather than dismissing it as just how things are)
- To be mindful of how to address that, and thus end the suffering (rather than despairing in inaction)
- To engage mindfully in the process of doing so (and thus not fall into the trap of thinking “job done”)
And, as for Dr. Cheung? She also has input throughout, with practical advice about the more scientific side of rethinking one’s diet.
Bottom line: this is an atypical book, and/but perhaps an important one. Certainly, at the very least it may be one to try if more conventional approaches have failed!
Click here to check out “Savor” on Amazon today, and get mindful!
Share This Post
Fast Exercise – by Dr. Michael Mosley & Peta Bee
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
We’ve written before about the benefits of High-Intensity Interval Training (HIIT), but there’s more to say than we can fit in a short article!
Dr. Michael Mosley, who hates exercise but knows his stuff when it comes to the benefits, teamed up with Peta Bee, who loves exercise and is a science journalist with degrees in sports science and nutrition, to bring us this book.
In it, we learn a lot about:
- the science of HIIT
- what makes it so different from most kinds of exercise
- exactly what benefits one can expect
…in a very detailed clinical fashion (while still remaining very readable).
By “very detailed clinical fashion”, here we mean “one minute of this kind of exercise this many times per week over this period of time will give this many extra healthy life-years”, for example, along with lots of research to back numbers, and explanations of the mechanisms of action (e.g. reducing inflammatory biomarkers of aging, increasing cellular apoptosis, improving cardiometabolic stats for reduced CVD risk, and many things)
There’s also time/space given over to exactly what to do and how to do it, giving enough options to suit personal tastes/circumstances.
Bottom line: if you’d like to make your exercise work a lot harder for you while you spend a lot less time working out, then this book will help you do just that!
Click here to check out Fast Exercise, and enjoy the benefits!
Share This Post
Chili Hot-Bedded Salmon
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
This one can be made in less time than it takes to order and receive a Chinese take-out! The principle is simple: it’s a bed of greens giving pride of place to a salmon fillet in a deliciously spicy marinade. So healthwise, we have greens-and-beans, healthy protein and fats, and tasty polyphenols. Experientially, we have food that tastes a lot more decadent than it is!
You will need
- 4 salmon fillets (if vegan, substitute firm tofu; see also how to make this no-salmon salmon)
- 2 bok choy, washed and stems trimmed
- 7 oz green beans, trimmed
- 4 oz sugar snap peas
- 4 spring onions, sliced
- 2 tbsp chili oil*
- 1 tbsp soy sauce
- 1 tsp garlic paste
- 1 tsp ginger paste
- 1 tsp black pepper
*this can be purchased as-is, but if you want to make your own in advance, simply take extra virgin olive oil and infuse it with [finely chopped, red] chili. This is a really good thing to do for commonly-used flavored oils, by the way—chili oil and garlic oil are must-haves in this writer’s opinion; basil oil, sage oil, and rosemary oil, are all excellent things to make and have in, too. Just know, infusing is not quick, so it’s good to do these in batch and make plenty well before you need it. For now, if you don’t have any homemade already, then store-bought is fine 🙂
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 360℉/180℃/gas mark 6
2) Lay out 4 large squares of foil, and put the bok choy, green beans, and sugar snap peas in a little pile in the middle of each one. Put a salmon fillet on top of each (if it has skin, score the skin first, so that juices will be able to penetrate, and put it skin-side down), and then top with the spring onions.
3) Mix the rest of the ingredients in a small bowl, and then spoon this marinade evenly over each of the fillets (alternatively, if you have occasion to marinade the fillets in advance and let them sit in the marinade in the fridge for some hours before, do so, in which case this step will already be done now, because past-you did it. Yay for past-you!)
4) Fold up the edges of the foil, making each one an enclosed parcel, gently sealed at the top by folding it over. Put them on a baking tray and bake for about 20 minutes.
5) Serve! If you’d like some carbs with it, we recommend our tasty versatile rice recipe.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- We Are Such Stuff As Fish Are Made Of
- Farmed Fish vs Wild-Caught ← don’t underestimate the difference this makes!
- Tasty Polyphenols For Your Heart And Brain
- Brain Food? The Eyes Have It!
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
Share This Post
Related Posts
Owning Your Weight – by Henri Marcoux
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
A lot of diet books—which this isn’t—presuppose that the reader wants to lose weight, and varyingly encourage and shame the reader into trying to do so.
Dr. Henri Marcoux takes a completely different approach.
He starts by assuming we are—whether consciously or not—the weight we want to be, and looks at the various physical and psychological factors that influence us to such. Ranging from food poverty to eating our feelings to social factors and more, he bids us examine our relationship with food and eating—not just in the sense of mindful eating, but from multiple scientific angles too.
From this, Dr. Marcoux gives us questions and suggestions to ensure that our relationship with food and eating is what we want it to be, for us.
Much of the latter part of the book covers not just how to go about the requisite lifestyle changes… But also how to implement things in a way that sticks, and is a genuine pleasure to implement. If this sounds over-the-top, the truth is that it’s just because it honestly is a lower-stress way of living.
Bottom line: if you want to gain or lose weight, there’s a good chance this book will help you. If you want to be happier and healthier at the weight you are, there’s a good chance this book will help you with that, too.
Click here to check out Owning Your Weight, and take control of yours!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
Do we need animal products to be healthy?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Do we need animal products to be healthy?
We asked you for your (health-related) perspective on plant-based vs anima-based foods, and got the above-pictured spread of answers.
“Some or all of us may need small amounts of animal products” came out on top with more votes than the two more meat-eatery options combined, and the second most popular option was the hard-line “We can all live healthily and happily on just plants”.
Based on these answers, it seems our readership has quite a lot of vegans, vegetarians, and perhaps “flexitarians” who just have a little of animal products here and there.
Perhaps we should have seen this coming; the newsletter is “10almonds”, not “10 rashers of bacon”, after all.
But what does the science say?
We are carnivores and are best eating plenty of meat: True or False?
False. Let’s just rip the band-aid off for this one.
In terms of our anatomy and physiology, we are neither carnivores nor herbivores:
- We have a mid-length digestive tract (unlike carnivores and herbivores who have short and long ones, respectively)
- We have a mouthful of an assortment of teeth; molars and premolars for getting through plants from hard nuts to tough fibrous tubers, and we have incisors for cutting into flesh and (vestigial, but they’re there) canines that really serve us no purpose now but would have been a vicious bite when they were bigger, like some other modern-day primates.
- If we look at our closest living relatives, the other great apes, they are mostly frugivores (fruit-eaters) who supplement their fruity diet with a small quantity of insects and sometimes other small animals—of which they’ll often eat only the fatty organ meat and discard the rest.
And then, there’s the health risks associated with meat. We’ll not linger on this as we’ve talked about it before, but for example:
- Processed Meat Consumption and the Risk of Cancer: A Critical Evaluation of the Constraints of Current Evidence from Epidemiological Studies
- Red Meat Consumption (Heme Iron Intake) and Risk for Diabetes and Comorbidities?
- Health Risks Associated with Meat Consumption: A Review of Epidemiological Studies
- Associations of Processed Meat, Unprocessed Red Meat, Poultry, or Fish Intake With Incident Cardiovascular Disease and All-Cause Mortality
- Meat consumption: Which are the current global risks? A review of recent (2010-2020) evidences
If we avoid processed and/or red meat, that’s good enough: True or False?
True… Ish.
Really this one depends on one’s criteria for “good enough”. The above-linked studies, and plenty more like them, give the following broad picture:
- Red and/or processed meats are unequivocally terrible for the health in general
- Other mammalian meats, such as from pigs, are really not much better
- Poultry, on the other hand, the science is less clear on; the results are mixed, and thus so are the conclusions. The results are often barely statistically significant. In other words, when it comes to poultry, in the matter of health, the general consensus is that you can take it or leave it and will be fine. Some studies have found firmly for or against it, but the consensus is a collective scientific shrug.
- Fish, meanwhile, has almost universally been found to be healthful in moderation. You may have other reasons for wanting to avoid it (ethics, environmentalism, personal taste) but those things are beyond the scope of this article.
Some or all of us may need small amounts of animal products: True or False?
True! With nuances.
Let’s divide this into “some” and “all”. Firstly, some people may have health conditions and/or other mitigating circumstances that make an entirely plant-based diet untenable.
We’re going light on quotations from subscriber comments today because otherwise this article will get a bit long, but here’s a great example that’s worth quoting, from a subscriber who voted for this option:
❝I have a rare genetic disease called hereditary fructose intolerance. It means I lack the enzyme, Aldolase B, to process fructose. Eating fruits and veggies thus gives me severe hypoglycemia. I also have anemia caused by two autoimmune diseases, so I have to eat meat for the iron it supplies. I also supplement with iron pills but the pills alone can’t fix the problem entirely.❞
And, there’s the thing. Popular vegan talking-points are very good at saying “if you have this problem, this will address it; if you have that problem, that will address it”, etc. For every health-related objection to a fully plant-based diet there’s a refutation… Individually.
But actual real-world health doesn’t work like that; co-morbidities are very common, and in some cases, like our subscriber above, one problem undermines the solution to another. Add a third problem and by now you really just have to do what you need to do to survive.
For this reason, even the Vegan Society’s definition of veganism includes the clause “so far as is possible and practicable”.
Now, as for the rest of us “all”.
What if we’re really healthy and are living in optimal circumstances (easy access to a wide variety of choice of food), can we live healthily and happily just on plants?
No—on a technicality.
Vegans famously need to supplement vitamin B12, which is not found in plants. Ironically, much of the B12 in animal products comes from the animals themselves being given supplements, but that’s another matter. However, B12 can also be enjoyed from yeast. Popular options include the use of yeast extract (e.g. Marmite) and/or nutritional yeast in cooking.
Yeast is a single-celled microorganism that’s taxonomically classified as a fungus, even though in many ways it behaves like an animal (which series of words may conjure an amusing image, but we mean, biologically speaking).
However, it’s also not technically a plant, hence the “No—on a technicality”
Bottom line:
By nature, humans are quite versatile generalists when it comes to diet:
- Most of us can live healthily and happily on just plants if we so choose.
- Some people cannot, and will require varying kinds (and quantities) of animal products.
- As for red and/or processed meats, we’re not the boss of you, but from a health perspective, the science is clear: unless you have a circumstance that really necessitates it, just don’t.
- Same goes for pork, which isn’t red and may not be processed, but metabolically it’s associated with the same problems.
- The jury is out on poultry, but it strongly appears to be optional, healthwise, without making much of a difference either way
- Fish is roundly considered healthful in moderation. Enjoy it if you want, don’t if you don’t.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
Managing Your Mortality
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
When Planning Is a Matter of Life and Death
Barring medical marvels as yet unrevealed, we are all going to die. We try to keep ourselves and our loved ones in good health, but it’s important to be prepared for the eventuality of death.
While this is not a cheerful topic, considering these things in advance can help us manage a very difficult thing, when the time comes.
We’ve put this under “Psychology Sunday” as it pertains to processing our own mortality, and managing our own experiences and the subsequent grief that our death may invoke in our loved ones.
We’ll also be looking at some of the medical considerations around end-of-life care, though.
Organizational considerations
It’s generally considered good to make preparations in advance. Write (or update) a Will, tie up any loose ends, decide on funerary preferences, perhaps even make arrangements with pre-funding. Life insurance, something difficult to get at a good rate towards the likely end of one’s life, is better sorted out sooner rather than later, too.
Beyond bureaucracy
What’s important to you, to have done before you die? It could be a bucket list, or it could just be to finish writing that book. It could be to heal a family rift, or to tell someone how you feel.
It could be more general, less concrete: perhaps to spend more time with your family, or to engage more with a spiritual practice that’s important to you.
Perhaps you want to do what you can to offset the grief of those you’ll leave behind; to make sure there are happy memories, or to make any requests of how they might remember you.
Lest this latter seem selfish: after a loved one dies, those who are left behind are often given to wonder: what would they have wanted? If you tell them now, they’ll know, and can be comforted and reassured by that.
This could range from “bright colors at my funeral, please” to “you have my blessing to remarry if you want to” to “I will now tell you the secret recipe for my famous bouillabaisse, for you to pass down in turn”.
End-of-life care
Increasingly few people die at home.
- Sometimes it will be a matter of fighting tooth-and-nail to beat a said-to-be-terminal illness, and thus expiring in hospital after a long battle.
- Sometimes it will be a matter of gradually winding down in a nursing home, receiving medical support to the end.
- Sometimes, on the other hand, people will prefer to return home, and do so.
Whatever your preferences, planning for them in advance is sensible—especially as money may be a factor later.
Not to go too much back to bureaucracy, but you might also want to consider a Living Will, to be enacted in the case that cognitive decline means you cannot advocate for yourself later.
Laws vary from place to place, so you’ll want to discuss this with a lawyer, but to give an idea of the kinds of things to consider:
National Institute on Aging: Preparing A Living Will
Palliative care
Palliative care is a subcategory of end-of-life care, and is what occurs when no further attempts are made to extend life, and instead, the only remaining goal is to reduce suffering.
In the case of some diseases including cancer, this may mean coming off treatments that have unpleasant side-effects, and retaining—or commencing—pain-relief treatments that may, as a side-effect, shorten life.
Euthanasia
Legality of euthanasia varies from place to place, and in some times and places, palliative care itself has been considered a form of “passive euthanasia”, that is to say, not taking an active step to end life, but abstaining from a treatment that prolongs it.
Clearer forms of passive euthanasia include stopping taking a medication without which one categorically will die, or turning off a life support machine.
Active euthanasia, taking a positive action to end life, is legal in some places and the means varies, but an overdose of barbiturates is an example; one goes to sleep and does not wake up.
It’s not the only method, though; options include benzodiazepines, and opioids, amongst others:
Efficacy and safety of drugs used for assisted dying
Unspoken euthanasia
An important thing to be aware of (whatever your views on euthanasia) is the principle of double-effect… And how it comes to play in palliative care more often than most people think.
Say a person is dying of cancer. They opt for palliative care; they desist in any further cancer treatments, and take medication for the pain. Morphine is common. Morphine also shortens life.
It’s common for such a patient to have a degree of control over their own medication, however, after a certain point, they will no longer be in sufficient condition to do so.
After this point, it is very common for caregivers (be they medical professionals or family members) to give more morphine—for the purpose of reducing suffering, of course, not to kill them.
In practical terms, this often means that the patient will die quite promptly afterwards. This is one of the reasons why, after sometimes a long-drawn-out period of “this person is dying”, healthcare workers can be very accurate about “it’s going to be in the next couple of days”.
The take-away from this section is: if you would like for this to not happen to you or your loved one, you need to be aware of this practice in advance, because while it’s not the kind of thing that tends to make its way into written hospital/hospice policies, it is very widespread and normalized in the industry on a human level.
Further reading: Goods, causes and intentions: problems with applying the doctrine of double effect to palliative sedation
One last thing…
Planning around our own mortality is never a task that seems pressing, until it’s too late. We recommend doing it anyway, without putting it off, because we can never know what’s around the corner.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: