Weighing Weight’s Weight on Cholesterol: Examining the risk of excess pounds, Determining who’s fat, Choosing a healthful weight and Listing exceptions to the weight/cholesterol rules.

Weighing Weight’s Weight on Cholesterol

In This Chapter

� Examining the risk of excess pounds

� Determining who’s fat

� Choosing a healthful weight

� Listing exceptions to the weight/cholesterol rules

Some Americans worry about global warming. Others suspect that the real threat to North America isn’t the rising temperature but the rising poundage of several hundred million well-padded citizens. If the trend continues, they say, the whole darned continent may soon sink. Okay, maybe that’s an exaggeration, but according to Health, United States 2006, the 30th edition of an annual Centers for Disease Control and Prevention report on trends in health stats:

� Compared to 1960/1962, the percentage of overweight American adults ages 20 to 74 remained pretty much the same in 2003/2004, but the percentage of obese adults rose from 13 percent to 34 percent.

� The percentage of overweight children ages 6 to 11 more than doubled between 1976/1980 and 2003/2004, rising from 7 percent to 19 percent. Among adolescents ages 12 to 19, the percentage of those who were overweight more than tripled, rising from 5 percent to 17 percent.

In Canada, where the percentage of obese adults nearly doubled between 1978/1979 and 2004, things are pretty much the same. Check out these factoids from Statistics Canada’s 1996/1997 to 2004/2005 National Population Health Survey:

� From 1996/1997 to 2004/2005, Canadian adults, men as well as women, grew steadily heavier. Every two years, younger adults ages 18 to 33 gained more weight than did adults ages 34 to 49. Adults ages 50 to 54 also gained, but they gained less than the younger folks.

� The average weight gain among adult men rose from 10 pounds in 1996/1997 to 11 pounds by 2004/2005. Among women, the average gain rose from 9.9 pounds to 10.5 pounds.

While all this extra weight may not tilt the planet, it may certainly be a predictor of health problems, especially for people who work to control their cholesterol, which, come to think of it, is pretty much the title of the book you hold in your hands.

Presenting the Health Risks Posed by Extra Pounds

Many people want to lose weight to look better. Others want to gain weight for the same reason. But reaching a healthful weight — and staying there — is more than a matter of vanity. It’s also about being healthy. Years and years of scientific studies and surveys have produced irrefutable evidence that excess pounds often equal higher risk of morbidity, doctor-speak for illness, and mortality, doctor-speak for you-know-what — the big D (d-e-a-t-h).

To be precise, the message from your good friends at the American Heart Association (AHA) is that being overweight raises your risk of five of the top-ten leading causes of death in the United States, Canada, and Europe:

� Cancer (some types)

� Diabetes

� High blood pressure

� Stroke

Wait! That list shows only four kinds of big trouble. The missing fifth item is, you guessed it, coronary heart disease, which you may know by its alias, heart attack. Table 7-1 lists several other weight-related problems that, although not in the big five, can certainly make you extremely uncomfortable.

Connecting cholesterol with weight

You don’t have to be enormously overweight to experience a connection between your higher weight and a higher risk of heart disease. Being as little as 20 percent over your suggested healthy weight — which I get to in a minute — raises your total cholesterol and your “bad” LDLs while lowering your “good” HDLs. (To brush up on this coronary alphabet soup, check out LDLs and HDLs in Chapter 2 and Chapter 3.)

But don’t despair. Losing weight reverses the equation. Diet and exercise away those extra pounds, and your not-so-hot LDLs will start to fall while your hot-stuff HDLs begin to rise.

Gaining is the same as losing in this arena

Toting around too many pounds is hard on your heart and blood vessels, but gaining weight is worse because it forces your body to adapt to new, stressful conditions. Think about it. When you gain weight, you make more tissue. The tissue needs oxygen, so you have to make more blood, which carries oxygen. The extra blood stretches the chambers of your heart, which must work harder to push the blood out into your body where the extra volume of blood stresses your blood vessels. Anyone hear a diagnosis of high blood pressure in the near future?

As a result, the AHA, which ¥’s your heart, wants you to know that simply preventing weight gain is the most important factor in preventing your cholesterol level from rising as you grow older. Imagine! As you grow older, not gaining weight keeps your cholesterol level in check more effectively than a low-fat diet, cholesterol-lowering drugs, or exercise. And you don’t have to go on a crash diet to see the benefits. According to the AHA, even a modest weight loss — say 5 to 10 percent of your total weight — lowers total cholesterol. Pretty encouraging stuff, huh?

By the way, several similar studies show that gaining weight also increases levels of triglycerides (check out Chapter 2), another risk factor for heart attacks. Hey, a two-for-one special: Controlling weight controls both your cholesterol and your triglycerides. What a bargain.

Figuring Out Who’s Fat

Up to this point in this chapter, I have used the word overweight seven times, but I haven’t defined it. So let me do that right now.

One way to decide whether someone’s overweight is to see what he or she looks like. Right? Wrong.

Actress Lillian Russell, the femme fatale during the late 19th and early 20th centuries, weighed in at a hefty 230 pounds. One hundred years later, Nicole Richie or Eva Longoria tips the scales at, oh, maybe, 98 pounds. Your great- grandparents would have rushed these skinny merinks (great-granny’s word for v-e-r-y thin) to the doctor for a weight-gain tonic. Today, it may be Russell whom people would want to ship off to the doctor.

Clearly, judging whether an individual is overweight or thin by appearance is subjective. It depends on who’s doing the lookin’ and the cultural standards that person applies. Conclusion: The eyeball test isn’t a reliable method for determining healthful weight. You need something a tad more scientific.

Luckily, modern nutrition offers some reasonably rational options to decide who’s overweight. These options include

� Body shape

� Weight charts

� Body composition

Evaluating body shape

All healthy adults have some body fat. Women generally have proportion- ately more body fat than men who, in turn, have proportionately more muscle tissue than women. Where a person stores the fat tissue he or she accumulates is gender-related. Men are most likely to pile excess fat around the middle (abdomen). The result is a body type called an “apple.” Women usually store excess fat around their hips, buttocks, and upper thighs, a pattern called a “pear.”

A more scientific name for the apple/pear shape descriptions is the waist/hip ratio, a measurement of the relative size of the waist and hips. To find your ratio, follow these steps:

1. Run a tape measure around your waist.

2. Run a tape measure around your hips.

3. Divide the measurement of your waist by the measurement of your hips.

For example: waist (29 inches) ÷ hips (39 inches) = a waist/hip ratio of 0.74

A woman whose waist/hip ratio is higher than 0.8 or a man whose waist/hip ratio is higher than 0.95 — both apple shape numbers — may be at higher risk of weight-related health problems, including heart attacks.

However, it’s only fair to point out that the BMI-plus-waist circumference described below is considered far more reliable than the apple/pear waist- to-hip ratio alone.

Charting a healthful weight

In 1990, the U.S. Department of Agriculture and Department of Health and Human Services included a weight chart in that year’s edition of the Dietary Guidelines for Americans:

� The new chart numbers were weight goals, not ideal weights.

� The weight goals were based on the entire population of the United States.

� The weight charts were unisex with a single set of weight goals for men and women of the same height.

� Best of all, the new weight goals were divided into two age groups — one set for people ages 19 to 34 and the other for people ages 35 and older.

Table 7-2 shows the 1990 Dietary Guidelines for Americans weight charts for adult men and women. People with small, lighter bones and proportionately more fat tissue than muscle tissue (fat weighs less than muscle) are likely to weigh in at the low end. People with large, heavier bones and proportionately more muscle than fat, are likely to weigh in at the high end. As a general (but by no means invariable) rule, women have smaller frames and less muscle than men, so they weigh less than men of the same height and age.

For ten years, weight charts remained fairly friendly and forgiving. Then boom! The Dietary Guidelines for Americans 2000 tossed out the higher weights for older people. As of the new millennium, the healthy weights for everyone, young or old, woman or man, were the weights for people between the ages of 19 and 34 from the 1990 Dietary Guidelines for Americans, which you can still find in Table 7-2. Pretty skinny thinking, if you ask me.

Then boom! — again. The Dietary Guidelines for Americans 2005 tossed out all weight tables in favor of the body mass index chart.

Indexing your mass

In 1990, just as the Dietary Guidelines for Americans published its pleasantly elastic two-tier weight chart, the National Heart, Lung, and Blood Institute introduced the first federal guidelines on how to identify, evaluate, and treat people with excess poundage.

The most interesting section was the introduction of a new weight measurement: body mass index (BMI). BMI is a unisex measure of weight relative to height, a number — such as 24 — that serves as a predictor of your risk for weight-related illnesses, such as diabetes, high blood pressure, heart disease, stroke, gallbladder disease, and arthritic pain. The higher your number, the higher your risk. So, what’s your number? Keep reading.

Calculating your BMI

The original equation used to calculate BMI was set up in kilograms for weight (W) and meters for height (H): BMI = W÷H2. But if you’re partial to pounds and inches, you can calculate BMI in pounds and inches as long as you add one extra step. The equation looks like this:

BMI = W÷H2 × 705

To get your own BMI, plug your numbers into the BMI equation. For example, if you’re 5'3" tall and weigh 138 pounds, the equation for your BMI looks like this:

BMI = W÷H2 × 705

[138÷(63 × 63)] × 705

(138÷3969) × 705

24.5

Hate math? Eyes glazing over? Just run your finger down Table 7-3, which does the math for men and women from 4'11" to 6'4" tall, starting with a weight of 91 pounds. To use the table, find your appropriate height in the column labeled Height. Move across to your weight. The number at the top of the table is the BMI at your height and weight.

Using BMI to predict health

Based on health statistics and death rates provided by the World Health Organization, the Centers for Disease Control and Prevention’s National Center for Health Statistics characterize the various categories of BMI as follows:

� Underweight: BMI lower than 18.5.

� Normal: BMI of 18.5 to 24.9. (A minimal risk of weight-related health problems.)

� Overweight: BMI of 25 to 29.9. (A moderate risk of weight-related health problems. For reference, BMI of 25 is about 10 percent over ideal body weight.)

� Obese: BMI of 30 to 39.9. (High risk of weight-related health problems.)

� Extremely obese: BMI over 40. (The highest risk of weight-related health problems.)

BMI is a valuable health predictor for most men and women between the ages of 19 and 70, but it’s not for everyone. BMI isn’t a reliable guide for the following:

� Women who are pregnant or nursing. Weight gain is temporary and does not reflect a true weight/height relationship.

� People who are very tall or very short.

� Professional athletes or weight trainers. Very muscular people, such as boxer Laila Ali or the great gang of guys at the World Wrestling Federation, can have a high BMI but not be fat.

Making Lifestyle Changes

The rules of the weight-loss road are fairly simple and entirely sensible. After you decide that you really do need to lose a little weight, the following list of do’s and don’ts can make life bearable — and less weighty.

Waist not

The size of your waist may affect the riskiness (or lack thereof) of your BMI. To get the relevant number, measure your waist circumference (the distance around your natural waist just above

the navel). If your BMI is higher than 25, a waist circumference equal to or higher than 35 inches for a woman or 40 inches for a man puts you into a “high risk” — that is, overweight — category.

Counting those dreaded calories

Repeat after me: A healthful weight-loss regimen isn’t a starvation diet. Keep these calorie requirements in mind when you’re working to lose weight:

� Women require a food plan that provides at least 1,200 calories a day.

Top limit for weight loss: 1,500 calories.

� Men require a food plan that provides at least 1,500 calories a day. Top limit for weight loss: 1,800 calories.

You probably noticed that I describe a totally unfair fact of life: Men and women — even when they’re exactly the same weight and height — require different amounts of calories to stay healthy. A man’s body has proportion- ately more muscle tissue than a woman’s body. Muscle tissue is “active” tissue that burns calories. Therefore, men need about 10 percent more calories each day, even when they’re losing weight.

Ingesting your daily vitamins and minerals

Your weight-loss food plan (have you noticed that I’m subtly substituting “food plan” for “diet?”) should provide all the essential nutrients. Exactly what nutrients you need and how much of them are spelled out in excruciat- ing detail in your copy of Nutrition For Dummies, 4th Edition (Wiley). (Don’t have one? Get one. I wrote it. It’s goooooood.)

Another good guide to vitamins and minerals is the ingredients label on any reputable brand of one-pill-a-day supplements. Or you can bookmark this page, turn to Chapter 16, and check out one of the totally excellent nutritional Web sites you find there.

Are you back? Good. I want to spend a minute covering why you should avoid fad diets, or as I like to label ’em, funny food plans. You know the ones I mean. These diets often base their recommendations on, oh, maybe one study, and it’s often a dubious one. Seventeen overweight hamsters in Ohio lost weight after three months on a diet of nothing but apricots, peaches, and clam juice. Here are a few ways to spot fad diets:

� These diets are never endorsed by reputable organizations such as the American Heart Association or the American Dietetic Association. Instead, they use testimonials from people who may mean well but have no real nutrition expertise (like the Northeastern Ohio Hamster Owners Association).

� The diet plans go against generally accepted nutritional advice. (I’m no hamster expert, but I’m guessing that these furry creatures need nutrients other than those supplied by apricots, peaches, and clam juice.)

30 + 30 = ??

The perfect example of a silly food plan is the one that promises to take off 30 pounds in 30 days, a formula chosen presumably because some months do have 30 days and the numbers sound good together.

According to the American Society of Bariatric Physicians (weight loss experts), this promise is an empty one because:

� To lose 1 pound of body weight, you must cut out 3,500 calories.

� To lose 30 pounds in 30 days, you must cut out 105,000 calories (30 × 3,500 calories =

105,000 calories).

� If you normally get 2,800 calories a day — more than most American women and

some men eat every day — you only take in 84,000 calories in 30 days.

� If you were to stop eating entirely for 30 days, you would still need to get rid of another 21,000 calories to reach the 105,000 mark.

Any volunteers?

Forget the pound a day business. A slow but steady loss of 5 pounds in that same 30-day period means cutting just 17,500 calories (5 × 3,500 calories = 17,500 calories). Divide 17,500 by 30, and you come up with 580 calories a day, a reduction most serious weight-loss programs can handle.

Now can I see a show of hands from volunteers?

Do yourself a favor. Fight fad diets. Who wants to eat 50 grapefruits a day anyway? You should be eating a variety of healthy, tasty foods while you’re eating less.

Making the menu marvelous

A healthful food plan, even one designed to take off pounds, includes many different foods. Yes, broccoli is packed with anti-cancer phytochemicals (com- pounds found naturally in plants), plus vitamin A, vitamin C, the heart- healthy B vitamin folate, carbohydrates, and dietary fiber. But man (and woman) can’t live by green florets alone.

Food variety is important to weight loss. Food is meant to be enjoyed — yes, even low-calorie food. When your weight-loss menu is interesting and tastes good, sticking to it is less of a chore. Besides, human beings are omnivores, which means they have digestive tracts equipped to handle foods from plants and animals. Although vegetarianism certainly can be a healthful choice, maybe even a moral one for folks who don’t want to consume animals, your body has the ability to metabolize and use all kinds of food: meat, dairy, grains, fruits, and veggies. Why not go for it?

Living happily ever after

Here’s one from the depressing-but-true file: Most people who take off weight put it back on again within three years. The only way to succeed at losing weight — which means taking it off and keeping it off — is to change your mind along with your menu. The goal isn’t a quick 10 pounds off your hips. The goal is a lifelong healthful weight.

To reach this goal, organizations such as the American Heart Association, the American Diabetes Association, and the American Dietetic Association, their international counterparts, and all the relevant governmental agencies across the globe offer pretty much the same prescription: Eat less, eat a variety of foods, get the nutrients you need, step up your exercise time, and take the time you need to lose pounds safely.

Boring? Yup. Sensible? Yup. A way to succeed? Without a doubt.

Tossing Out the Scales

Now that I’ve spent an entire chapter talking about weight and how weight gain may adversely affect your cholesterol levels and, by implication, your risk of heart disease, I’m slamming on the breaks. I’m going to reverse engines and back-peddle a bit to mention those special times when weight doesn’t seem to matter at all. The truth is that most people pick up pounds as they grow older, and many manage to stay healthy anyway.

One way to explain this seemingly odd situation among an older population is to suggest that people who’ve experienced weight-related illnesses have already gone to their reward. The ones left standing (or sitting) are older folks whose general health is so good that weight is irrelevant. A second possibility is that individual human beings really are individuals with unique bundles of genes and possibilities. Trying to make these unique individuals fit into strict, predictable categories is like trying to map the stars in the sky. It works, but only up to a point.

For example, the experts who invented BMI admit that its value in predicting weight-related health risks depends to some extent on age. In your 30s, a lower BMI is clearly linked to better health. In your 70s (and later), no convincing evidence supports the idea that BMI and/or weight itself makes a difference. In fact, some recent studies suggest that a higher BMI (below the obesity mark, of course) is protective for women of a certain age. In between, the relationship between BMI — or weight — and health is, well, in between — more important early on, less important later in life.

The inescapable conclusion? Human beings are more diverse and complicated than any weight and health charts. Case closed.