Thursday, December 18, 2014

America, we have a weight problem


From page A10 | December 11, 2013 |

So what if you need to lose a few pounds? If you’re overweight but your metabolic readings are normal, you might think there’s no compelling health reason to get in shape.

But new research, published last week in the Annals of Internal Medicine, suggests you need to think again. There is no such thing as fit and fat. If you are fat, you are at substantially greater risk for a heart attack or a stroke.

Researchers at the Mount Sinai Hospital in Toronto’s Lunenfeld-Tanenbaum Research Institute reviewed the records of 61,386 individuals. They found that even in people with normal blood pressure and cholesterol, there is a 24 percent added risk for premature death or a cardiovascular event compared with people in the healthy weight range.

Dr. Ravi Retnakaran, an endocrinologist and a co-author of the study, said, “Our research findings challenge the myth that there is such a thing as healthy obesity if people maintain normal-range readings of cholesterol, blood glucose and blood pressure.”

Obviously, when a person is disabled by or dies from a heart attack or a stroke, it’s a personal crisis for him and his family. But in a nation where our medical costs are borne by third parties and passed on to the rest of us — this is true with or without Obamacare — the fact that we are so fat and unhealthy is a matter of public concern. Fat people cost us all a lot of money.

According to the Centers for Disease Control, 69.2 percent of adults age 20 and over in the United States are overweight. More than half of that group are obese.

For research purposes, it makes sense to classify people by weight categories: underweight; healthy; overweight; obese; very obese and very, very obese. Yet for most rational individuals, one honest look in the mirror tells the story. You know if you need to lose weight.

Scientists use the body mass index to categorize us. The BMI scale goes back to the mid-19th century. But it became popular 40 years ago when Ancel Keys, a Minnesota physiology researcher who developed K-ration meals for the U.S. Navy in World War II, published a widely read article that showed that BMI was a good substitute for body fat measurement.

All you need to figure BMI is a person’s weight and height. The formula (in the English system) is your weight in pounds divided by the square of your height in inches times 703. I weigh 184 pounds and I am 74 inches tall. So my BMI is 23.6. That puts me in the healthy category among adults.

A BMI below 18.5 is underweight, above 25 is overweight and over 30 is obese. The CDC says that 35.9 percent of American adults have a BMI above 30.

One problem with using BMI for an individual, however, is that there are body types for which that scale is misleading. A good example is a heavily muscled body builder.

Franco Columbu, who twice won the Mr. Olympia competition, is a case in point. Columbu is 5-foot-5 and he weighed 185 pounds as a competitor. That means his BMI was 30.8. Yet Columbu was never obese. The Sardinian Strongman had a svelte waist and looked like a Greek god.

A better tool than BMI for an individual is waist-to-height ratio. It’s also simpler to calculate. You measure your waist at your belly button — no sucking in your gut — and you divide that by your height. My waist (34 inches) to height (74 inches) ratio is 0.46.

For males, the healthy range is 0.43 to 0.52. Overweight is 0.53 to 0.62. Obese is 0.63 and up. For females, the healthy range is 0.42 to 0.48. Overweight is 0.49 to 0.57. Obese is 0.58 and up.

In 2011, the CDC produced a short video called “The Obesity Epidemic.” One of the researchers appearing in the program, Latetia Moore, says, “There is no single or simple solution to the obesity epidemic. It’s going to take solutions at many levels in order to resolve the epidemic.”

That may be true for our nation as a whole. But it’s also the case that if you, as one person, are overweight or obese, you should immediately do one thing that will bring certain benefits: stop eating foods with added sugar or other sweeteners.

Yes, it is important to exercise and eat fruits and vegetables and lean proteins. But none of those will do you so much good as quickly as cutting all added sugars out of your diet.

If you are fat, you don’t need to reduce your added sugar consumption. You need to eliminate sweets entirely. It’s analogous to an alcoholic. He doesn’t need to cut back on booze. He needs to totally exclude it from his life.

I cannot promise that after a month you will be perfectly healthy. But I have never heard of anyone who has cut sugar out of his diet and has not lost a lot of weight and felt better as a consequence.

— Rich Rifkin is a Davis resident; his column is published every other week. Reach him at



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