Good news: midlife health is about more than a waist measurement. Here’s why
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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.
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Caffeine: Cognitive Enhancer Or Brain-Wrecker?
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The Two Sides Of Caffeine
We asked you for your health-related opinions on caffeine itself, not necessarily the coffee, tea, energy drinks, etc that might contain it.
We have, by the way previously written about the health effects of coffee and tea specifically:
As for our question about caffeine itself, though, we got the above-depicted, below-described, set of results:
- About 59% said “caffeine is a safe stimulant and cognitive enhancer”
- About 31% said “caffeine is a moderately safe recreational drug”
- About 8% said “caffeine’s addictive properties make it de facto bad”
- One (1) person said “caffeine will leave you a trembling exhausted wreck”
But what does the science say?
Caffeine is addictive: True or False?
True, though one will find occasional academics quibbling the definition. Most of the studies into the mechanisms of caffeine addiction have been conducted on rats, but human studies exist too and caffeine is generally considered addictive for humans, for example:
See also:
Notwithstanding its addictive status, caffeine is otherwise safe: True or False?
True-ish, for most people. Some people with heart conditions or a hypersensitivity to caffeine may find it is not safe for them at all, and for the rest of us, the dose makes the poison. For example:
❝Can too much caffeine kill you? Although quite rare, caffeine can be fatal in cases of overdose; such circumstances are generally not applicable to healthy individuals who typically consume caffeine via beverages such as tea or coffee.❞
this paper, by the way, also includes a good example of academics quibbling the definition of addiction!
Caffeine is a cognitive enhancer: True or False?
True, but only in the case of occasional use. If you are using it all the time, your physiology will normalize it and you will require caffeine in order to function at your normal level. To attain higher than that, once addicted to caffeine, would now require something else.
Read more: Caffeine: benefits and drawbacks for technical performance
Caffeine will leave you a trembling exhausted wreck: True or False?
True or False depending on usage:
- The famously moderate 3–5 cups per day will not, for most people, cause any such problems.
- Using/abusing it to make up for lost sleep (or some other source of fatigue, such as physical exhaustion from exertion), however, is much more likely to run into problems.
In the latter case, caffeine really is the “payday loan” of energy! It’ll give you an adrenal boost now (in return, you must suffer the adrenal dumping later, along with lost energy expended in the adrenaline surge), and also, the tiredness that you thought was gone, was just caffeine’s adenosine-blocking activities temporarily preventing you from being able to perceive the tiredness. So you’ll have to pay that back later, with interest, because of the extra time/exertion too.
Want to make caffeine a little more gentle on your system?
Taking l-theanine alongside caffeine can ameliorate some of caffeine’s less wonderful effects—and as a bonus, l-theanine has some nifty benefits of its own, too:
Enjoy!
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Chaat Masala Spiced Potato Salad With Beans
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This is an especially gut-healthy dish; the cooked-and-cooled potatoes are not rich with resistant starches (that’s good), the beans bring protein (as well as more fiber and micronutrients), and many of the spices bring their own benefits. A flavorful addition to your table!
You will need
- 1 lb new potatoes, boiled or steamed, with skin on, quartered, cooled ← this is a bit of a “mini recipe”, but we expect you can handle it
- 5 oz blanched broad beans
- 2 oz sun-dried tomatoes, chopped
- ¼ bulb garlic, crushed
- 1 tbsp extra virgin olive oil
- 2 tsp amchoor
- 2 tsp ground cumin
- 2 tsp ground coriander
- 1 tsp ground ginger
- 1 tsp ground asafoetida
- 1 tsp black pepper, coarse ground
- 1 tsp red chili powder
- 1 tsp ground turmeric
- ½ tsp MSG or 1 tsp low-sodium salt
- Juice of ½ lemon
And then…
- To garnish: finely chopped cilantro, or if you have the “cilantro tastes like soap” gene, then substitute with parsley
- To serve: a nice chutney; you can use our Spiced Fruit & Nut Chutney recipe
Method
(we suggest you read everything at least once before doing anything)
1) Mix all the ingredients from the main section, ensuring an even distribution on the spices.
2) Add the garnish, and serve with the chutney. That’s it. There was more work in the prep (and potentially, finding all the ingredients) today.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Our Top 5 Spices: How Much Is Enough For Benefits? ← we scored all five today!
- Lycopene’s Benefits For The Gut, Heart, Brain, & More ← don’t underestimate those sun-dried tomatoes, either!
Take care!
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How much weight do you actually need to lose? It might be a lot less than you think
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If you’re one of the one in three Australians whose New Year’s resolution involved losing weight, it’s likely you’re now contemplating what weight-loss goal you should actually be working towards.
But type “setting a weight loss goal” into any online search engine and you’ll likely be left with more questions than answers.
Sure, the many weight-loss apps and calculators available will make setting this goal seem easy. They’ll typically use a body mass index (BMI) calculator to confirm a “healthy” weight and provide a goal weight based on this range.
Your screen will fill with trim-looking influencers touting diets that will help you drop ten kilos in a month, or ads for diets, pills and exercise regimens promising to help you effortlessly and rapidly lose weight.
Most sales pitches will suggest you need to lose substantial amounts of weight to be healthy – making weight loss seem an impossible task. But the research shows you don’t need to lose a lot of weight to achieve health benefits.
Using BMI to define our target weight is flawed
We’re a society fixated on numbers. So it’s no surprise we use measurements and equations to score our weight. The most popular is BMI, a measure of our body weight-to-height ratio.
BMI classifies bodies as underweight, normal (healthy) weight, overweight or obese and can be a useful tool for weight and health screening.
But it shouldn’t be used as the single measure of what it means to be a healthy weight when we set our weight-loss goals. This is because it:
- fails to consider two critical factors related to body weight and health – body fat percentage and distribution
- does not account for significant differences in body composition based on gender, ethnicity and age.
How does losing weight benefit our health?
Losing just 5–10% of our body weight – between 6 and 12kg for someone weighing 120kg – can significantly improve our health in four key ways.
1. Reducing cholesterol
Obesity increases the chances of having too much low-density lipoprotein (LDL) cholesterol – also known as bad cholesterol – because carrying excess weight changes how our bodies produce and manage lipoproteins and triglycerides, another fat molecule we use for energy.
Having too much bad cholesterol and high triglyceride levels is not good, narrowing our arteries and limiting blood flow, which increases the risk of heart disease, heart attack and stroke.
But research shows improvements in total cholesterol, LDL cholesterol and triglyceride levels are evident with just 5% weight loss.
2. Lowering blood pressure
Our blood pressure is considered high if it reads more than 140/90 on at least two occasions.
Excess weight is linked to high blood pressure in several ways, including changing how our sympathetic nervous system, blood vessels and hormones regulate our blood pressure.
Essentially, high blood pressure makes our heart and blood vessels work harder and less efficiently, damaging our arteries over time and increasing our risk of heart disease, heart attack and stroke.
Losing weight can lower your blood pressure.
Prostock-studio/ShutterstockLike the improvements in cholesterol, a 5% weight loss improves both systolic blood pressure (the first number in the reading) and diastolic blood pressure (the second number).
A meta-analysis of 25 trials on the influence of weight reduction on blood pressure also found every kilo of weight loss improved blood pressure by one point.
3. Reducing risk for type 2 diabetes
Excess body weight is the primary manageable risk factor for type 2 diabetes, particularly for people carrying a lot of visceral fat around the abdomen (belly fat).
Carrying this excess weight can cause fat cells to release pro-inflammatory chemicals that disrupt how our bodies regulate and use the insulin produced by our pancreas, leading to high blood sugar levels.
Type 2 diabetes can lead to serious medical conditions if it’s not carefully managed, including damaging our heart, blood vessels, major organs, eyes and nervous system.
Research shows just 7% weight loss reduces risk of developing type 2 diabetes by 58%.
4. Reducing joint pain and the risk of osteoarthritis
Carrying excess weight can cause our joints to become inflamed and damaged, making us more prone to osteoarthritis.
Observational studies show being overweight doubles a person’s risk of developing osteoarthritis, while obesity increases the risk fourfold.
Small amounts of weight loss alleviate this stress on our joints. In one study each kilogram of weight loss resulted in a fourfold decrease in the load exerted on the knee in each step taken during daily activities.
Losing weight eases stress on joints.
Shutterstock/Rostislav_SedlacekFocus on long-term habits
If you’ve ever tried to lose weight but found the kilos return almost as quickly as they left, you’re not alone.
An analysis of 29 long-term weight-loss studies found participants regained more than half of the weight lost within two years. Within five years, they regained more than 80%.
When we lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering several physiological responses to defend our body weight and “survive” starvation.
Just as the problem is evolutionary, the solution is evolutionary too. Successfully losing weight long-term comes down to:
losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight
making gradual changes to your lifestyle to ensure you form habits that last a lifetime.
Setting a goal to reach a healthy weight can feel daunting. But it doesn’t have to be a pre-defined weight according to a “healthy” BMI range. Losing 5–10% of our body weight will result in immediate health benefits.
At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can register here to express your interest.
Nick Fuller, Charles Perkins Centre Research Program Leader, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Chicken or Fish – Which is Healthier?
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Our Verdict
When comparing chicken to fish, we picked the fish.
Why?
To understand the choice, we have to start a bit earlier on the decision tree. For most people most of the time, when it comes to a diet high in plants or high in animals, the plant-centric diet will generally be best:
Do We Need Animal Products To Be Healthy?
When it comes to animal meats, red meat is a fairly uncontroversial first thing to strike off the list:
…with pork and some other meats not being much better.
But chicken? Poultry in general appears to be quite health-neutral. The jury is out and the science has mixed results, but the data is leaning towards “it’s probably fine”.
See for example this huge (n=29,682) study:
this same paper shows that…
❝higher intake of processed meat, unprocessed red meat, or poultry, but not fish, was significantly associated with a small increased risk of incident CVD, whereas higher intake of processed meat or unprocessed red meat, but not poultry or fish, was significantly associated with a small increased risk of all-cause mortality❞
So, since poultry isn’t significantly increasing all-cause mortality, and fish isn’t significantly increasing all-cause mortality or cardiovascular disease, fish comes out as the hands-down (fins-down?) winner.
One more (this time, easy) choice to make, though!
While fish in general (please, not fried, though!) is generally considered quite healthy, there is a big difference (more than you might think, and for reasons that are quite alarming), between…
Health Risks & Nutrition: Farmed Fish vs Wild-Caught
Enjoy, and take care!
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Simple Wall Pilates for Seniors – by Grace Clark
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While the cover illustration makes this look a little too simple, in fact there’s a lot of value in this book, with exercises ranging from things like that on the cover, to the “wall downward dog”. But the actual exercises (of which there are 29) themselves are only a part of the book (taking about 70 pages of it with clear illustrations).
There’s also a lot about important Pilates principles to apply, such as breathing, correct body alignment (if you don’t already do Pilates, you will not have this, as Pilates alignment is quite specific), flexibility, balance, stability, coordination, range of motion, isometric exercise considerations, endurance, and more.
Unlike a lot of “…for seniors” books, this is not a watered down barely-does-anything version of the “real” exercises, but rather, would present most the same challenges to a 20-year-old reader; it’s just that the focus here is more on matters that tend to concern an older rather than younger demographic. That 20-something may be busy building their butt, for instance, while the 80-year-old is building their bones. No reason both shouldn’t do both, of course, but the focus is age-specific.
The author guides us through working up from easy things to hard, breaking stuff down so that we can progress at our own pace, such that even the most cautious or enthusiastic reader can start at an appropriate point and proceed accordingly.
She also talks us through a 28-day program (as promised by the subtitle), and advice on how to keep it going without plateauing, how to set realistic goals, how to tailor it to our abilities as we go, track our progress, and so forth.
The style is clear and instructional, and one thing that sets this apart from a lot of Pilates books is that the education comes from an angle not of “trust me”, but rather from well-sourced claims with bibliography whose list spans 5 pages at the end.
Bottom line: if you’d like to progressively increase your strength, stability, and more—with no gym equipment, just a wall—then this book will have you see improvements in the 28 days it promises, and thereafter.
Click here to check out Simple Wall Pilates For Seniors, and experience the difference!
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The End of Stress – by Don Joseph Goewey
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So, we probably know to remember to take a deep breath once in a while, and adopt a “focus on what you can control, rather than what you can’t” attitude. In this book, Goewey covers a lot more.
After an overview of how we have a brain wired for stress, what it does to us, and why we should rewire that, he dives straight into such topics as:
- Letting go of fear—safely!
- Number-crunching the real risks
- Leading with good decisions, and trusting the process
- Actively practicing a peaceful mindset (some very good tips here)
- Transcending shame (and thus sidestepping the stress that it may otherwise bring)
The book brings together a lot of ideas and factors, seamlessly. From scientific data to case studies, to “try this and see”, encouraging us to try certain exercises for ourselves and be surprised at the results.
All in all, this is a great book on not just managing stress, but—as the title suggests—ending it in all and any cases it’s not useful to us. In other words, this book? It is useful to us.
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