EDmedblog

There are few specific exercise prescriptions for heterogeneous groups that can be scientifically supported at the moment, but those with most promise appear to be the following:

• long duration, low intensity exercise for pre-menopausal women

• any form of physical activity (high or low intensity) for younger men

• increased resistance training for seniors

• walking is a simple, low cost, moderate intensity activity easily incorporated into lifestyle

• a greater emphasis on dietary change rather than exercise in the initial stages for the obese

• emphasis on small, additive increases in daily physical activity in the obese

• non-weight-bearing exercise (e.g. Aquarobics, cycling) in the initial stages for the very overfat

• increased emphasis on SPA and ‘incidental’ activity with older people

• shorter cumulative bouts of aerobic activity for the unfit.

Hypothesised prescription parameters for some overfat groupings are tentative and are proposed here as a model for further testing. They are likely to provide a more focused approach to prescription, however, than dealing with all cases of overfatness and obesity as homogeneous.

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The apple shape has been found to be much more potentially dangerous with respect to health than the pear shape, because the fat cells around the abdomen release their fat into the bloodstream more readily than other fat cells. A ‘pot belly therefore—irrespective of total body mass—is likely to be more atherogenic (i.e. cause narrowing of the arteries), diabetogenic (i.e. cause diabetes) and possibly carcinogenic (i.e. cause cancer). In contrast, pear-shaped women have been found to have little increased illness risk (with the possible exception of a slight increase in the risk of varicose veins and arthritis). In health terms therefore, it’s not if someone is fat, but where they are fat that is important—filling up of the fat cells around the waist (as is characteristic of men) is much more dangerous than filling up of fat cells on the lower body (as is more characteristic of women).

There is another important form of fat storage which is now thought to be most important as a predictor of ill-health. Visceral fat (sometimes called ‘intra-abdominal fat’), surrounds the organs or ‘viscera’ of the body, such as the stomach, liver and kidneys etc. Visceral fat is thought to be dangerous because it ‘gives up’ its fat into the portal circulation in the bloodstream, which passes through the liver first. This has a variety of metabolic consequences such as increasing the liver’s production of fat particles and inducing resistance to the effects of the hormone insulin.

Visceral fat can only be seen using special medical imaging techniques but it is also highly correlated with total abdominal fat. In other words, someone with a ‘pot belly’ is more likely to have large visceral fat stores than someone who has a low level of total abdominal fat—although it is still possible for relatively lean people to have quite high visceral fat levels, possibly due again to genetic factors. Visceral fat has recently been explained by health researchers as being the best predictor of health risk. It’s likely that in the future measures will be developed to screen for this in health check-ups, just as screening for blood cholesterol is done now.

The health risks of fat shapes combines both BMI (body mass index) and WHR (waist-to-hip ratio) measures. As can be seen, it’s not just the big person who is at risk. A small person with large abdominal fat stores (i.e. a ‘pot belly’ is also at risk).

Myth-information . Although there are identified body fat shapes with varying health risks, there is no evidence that specific diets have special effects for any one particular body shape, hence there is no support for a ‘body shape’ diet.

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A New Year’s Eve party to welcome 1994 served as the wake-up call that Meredith Willson needed to get serious about slimming down.

“At the time, I weighed more than 300 pounds,” recalls the 43-”§ | year-old Athens, Tennessee, resident. “Someone that I hadn’t seen

in years came up to me and said, ‘What happened to the Meredith I used to know?’ It was a shock—and shock therapy is a good way to get inspired.”

The next day, Meredith set her sights on a rather lofty resolution: to lose 120 pounds in 12 months. It was ambitious, but Meredith was convinced that eliminating red meat and processed food from her diet would do the trick. “Cheese and butter were the toughest,” she says. “Instead of giving them up completely, I switched to fat-free cheese and butter substitutes.” She also began eating more fresh foods—fruits, vegetables, and whole grains.

Meredith read cookbooks that taught her how to make the most of fresh ingredients in her cooking. She also planted a garden chock full of organic produce, including tomatoes, squash, broccoli, asparagus, and eggplant. “The closer you get to the ground, the better off you’ll be, nutrient-wise,” she says. Then, using her homegrown produce plus healthful staples from the supermarket, she spent time each weekend preparing food from scratch. She even made her own pasta, tomato sauce, and baked sweet-potato chips.

Even Meredith couldn’t believe how well her switch from processed foods to fresh worked. “I lost 12 pounds every month— ka-bam, ka-bam, ka-bam,” she says. “I never even hit a plateau.”

In just over a year, Meredith managed to take off 150 pounds. And she has maintained that weight loss ever since.

WINNING ACTIONS

Take a fresh approach to eating. Fresh foods are naturally high in fiber and low in fat—the perfect weight-loss com-

bination. Plus, they have more intense flavors, so you won’t feel compelled to overeat. Among the best fresh foods for weight loss are potatoes, oranges, apples, and grapes. Researchers have identified these as high-satisfaction foods, which means that they keep you full longer.

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