The Battle of the Bulge

Dr. Sarfaraz K Niazi (e-mail: niazi@niazi.com)

The connection between being overweight and disease is overwhelmingly convincing. What is my ideal weight? This is the most oft asked question. New discoveries show that we are asking the wrong question. The right question is how much fat do I have in my body? And that builds the connection between living longer and tight belts.

Your ideal weight is what keeps your healthy and happy. Notice the two h's--health and happiness. Overweight, we feel labored, exhausted and bogged down; trimmed down, we move around quickly, stay healthier and feel bubbly--happy. Happy people also have less heart disease--the main reason why people want to stay lean and trim. However, the new theory behind losing weight is based on body fat composition rather than body weight. Good hard bones are desirable and add to body weight. Well built muscles are needed and add to body weight. Both of these tissues are good tissues and if they add weight to body, there is nothing wrong with it.

The problems arise when we begin accumulating fats. Circulating through arteries they ends up in wrong places-like blocking breathing of heart causing heart attacks. So, the problem lies not in excessive weight but in wrong kind of body tissue adding to total weight. We should strive to reduce percent body fat not just body weight.

Simpler formulas are now available to calculate how much you should weigh and how much of it is the wrong type of weight--the fat. Let us begin with the "hundred minus" strategy. Take you height in centimeters, subtract hundred from it. That's your target weight in kilograms. Better yet, reduce it by 5% (by multiplying the value by 0.95) and that's where your scale should tip: Ideal weight (Kgs) = (height in cm - 100) x 0.95

Now let us take example of a person 5'6 or 165 cm tall. The ideal weight according to the above formula is: 62 Kgs. Now let us estimate what part of this 62 Kg is body fat.

A variety of very complex methods using different body measurements and body density calculations are used but the simplest method remains the "midriff" technique. Although people accumulate fat in different parts of body, most fat tends to accumulate in the middle part of the body. (An adult is defined as a person who has stopped growing at both ends and has begun growing in the middle.) Your waist size tell the story vividly.

Percent body fat is = 90 - 0.8 (height-girth), measurements in cm

Percent body fat is = 90 - 2 (height-girth), measurements in inches

(Where girth is waist measurement at umbilical level. For women add 9 to percent fat calculated.)

For our 5'6 volunteer with a waist size of 30 inches the body fat is 18% if this were a male and 27% if this were a female. For men, the ideal range is 16 percent fat; for women, it is 25 percent. For the 5'6" person weighing 62 Kgs the ideal waist size (girth) should be 29 inches for men. For women, though they are allowed higher body fat, the girth size is same because of different distribution of fat in the body. The difference between the chest size and waist should be 10 inches for women and 5 inches for men. (The chest size should preferably be larger.)

We can see why with same weight, different people would have different percent body fat and that's what causes problem in determining the correct height-weight proportion. What we need to keep track of is our percent body weight as fat and if we can control it, the rest will fall in line also. The waist size is a good indicator. The ideal waist size is :height in inches-37 or height in cm-93. Of course people have different shapes, pear shaped, apple-shaped and no shapes at all. These calculations will not always work but for most, this gives a good starting point.

Coming back to the question of what proportion of your body weight is fat, we come a very simple formula: every inch or every 2.5 cm added to waist above the ideal size puts an additional 2% fat in your body. If your waist is close to the ideal size, it amount to 16% fat for men and 25% fat for women of proportioned sizes. Five extra inches to waist amount to 26% fat in men and 35% in women.

Ironically, yet keeping with the Nature's sardonic plan of serendipity, the risk of heart disease increases by the same percentage as increase in body fat. A person with a waist 10 inches more than what it should be has a 20% higher risk for heart disease. It does not mean, however, that all fat men die early; they just seem to have greater tendency to early demise.

Our goal should be to reduce body fat to ideal level. And that comes from knowing the proportions of expansion in the middle. It is much simpler to keep track of your waist than to worry about how you are tipping the scale.

Loss of weight should not come at the risk of losing muscles or bones. Aerobic exercises such as walking, running, swimming, etc., are excellent tools for conditioning and losing weight since you exercise your large muscles (legs). But these exercises do not give you the muscle build up. That can only come from resistant type exercises such as pushing weight or other similar exercises. How much to push your body when it begins to create new muscles is easy to know. When you exercise a muscle hard it goes into what scientists call anaerobic breathing producing lactic acid that accumulates in the muscles causing fatigue and pain. Stretch your routine to where it may begin to hurt; do not over do it. Slowly, you will build sufficient muscular strength to do more and grow muscles. This should add weight to your body but this is the good tissue. It is good because it also helps you keep your weight down. Calories are burned by muscles. If you do not have enough muscles, you will have difficulty losing weight. Ironically as you lose weight, muscles also go with it and with that the total burn out decreases. Body senses famine and slows down metabolism further reducing burn out of calories and you hear the most desperate cry of dieters: It doesn't seem to work any more. The key is to keep exercising; not only to lose calories or build muscles but to keep your body motor revved up a bit higher so it can keep burning calories.

Belt tightening has long been advised as a measure of prudence; when it comes to preventing disease, people with tighter belts end up enjoying a few extra heart beats. Narrow waists continue to be in vogue again.