Put a Tape Measure In Every Christmas Stocking

By Dr. W. Gifford Jones

December 8, 2002

The more and more complicated medicine becomes the greater the need to keep it simple. After all, how many people know the formula on how to measure body mass index (BMI) ? Luckily there's no longer any need to tax your brain on this matter. All you need is a tape to measure abdominal circumference. If your dimensions indicate a pot-belly, it's more important than BMI in gauging cardiovascular risk.

Dr. Shankuan Zhu, a researcher at the Obesity Centre at Columbia University in New York, examined 4,388 males with an average age of 44 and 4,631 females with an average age of 47.

The average BMI for both men and women was 26 which is within the healthy range. The average waist circumference for men was 37.6 inches (96.4 centimeters) and for women 34.4 inches (88.2 centimeters).

Dr. Zhu then tested each person for four important factors that determine the risk of heart disease, good and bad cholesterol, blood pressure and the level of blood sugar. He found that 48.5 percent of men and 50.2 percent of women had one or more of these risk factors present.

This study showed that contrary to recognized medical opinion, waist circumference was more accurate than BMI in pinpointing who was more susceptible to heart disease. The conclusion? Men should not have a waist circumference of more than 35 inches ( 90 centimeters) and women 33 inches (83 centimeters).

Dr. Timo Lakka, a Finnish researcher, also urges pot-bellied patients to take heed after studying 1,800 apple-shaped Finns for 10 years. His studies also showed the tape was more accurate than BMI in assessing cardiovascular risk. In fact, even mild abdominal obesity was associated with an increased risk of heart disease.

But there was an interesting new finding. For years we've told patients that overall obesity is a major risk for coronary disease. It still is. But Dr. Lakka's study showed that abdominal obesity is even more important than overall obesity. Men with only pot-bellied obesity, but who were not overweight, had four times the risk of heart disease than normal weight men and those without pot-bellies.

One does not have to be a Nobel Prize winner to conclude that those with a pot-belly plus overall obesity possess a lethal combination of factors.

One important study published in 2001 has gone largely unnoticed. Researchers at the U.S Army War College studied an elite group of several hundred soldiers selected for advanced training. They were all examined by electron beam computerized tomography (EBCT) which detects the amount of atherosclerosis.

Doctors expected to find very little hardening of arteries in this physically elite group. Only 10 percent were smokers and many had participated in marathon runs. They were shocked to discover the amount of atherosclerosis present.

A more disturbing fact surfaced. These elite soldiers had been subjected initially to electrocardiograms, treadmill tests, cholesterol blood levels and tests of strength. This extensive work-up had not revealed any abnormalities. And yet EBCT found that 20 percent of this elite group had signs of cardiovascular disease!

Dr. Zerel Zoltick, who headed the study remarked, "It's kind of scary. If we're finding atherosclerosis in elite soldiers, what would we find in a not-so-health conscious group?"

If you find it's increasingly difficult to see your feet, there is some good news. Fat cells in the midsection are large and metabolically more active than smaller fat cells in the lower part of the body. This makes it easier to lose weight around the mid-section.

Today with nearly 50 percent of the population either pot-bellied, overweight or both, diabetes has reached epidemic proportions. And 50 percent of diabetics die of heart attack. It's a sad commentary on what's happened to our overindulgent North American lifestyle.

During the months ahead we are going to hear much on how to improve our health care system. The cry will be for more money, but this alone will never solve the problem. It will take a massive improvement in lifestyle, and I can't see this happening. But a good start would be to include a tape measure in every Christmas stocking.

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones

Canada Free Press, CFP Editor Judi McLeod