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Waist Away 

In my new book, The Fat-Burning Bible: 28 Days of Foods, Supplements and Workouts that Help You Lose Weight, I present some key information about classic fat patterns and reverse fat patterns in both men and women and what can be done to combat them. In this month's column I will discuss the female pattern and next month will explore the male pattern. In a third column, I will offer some additional advice from my new book, which is due in bookstores in January 2005.

The classic fat pattern in a woman is that of a gynoid, pear-shaped body. Most of the excess fat is distributed below the waist -- in the hips and buttocks. In the classic male fat pattern, most of the excess fat is in the abdominal region. While studies published in prestigious medical journals don't consider gynoid obesity in women to be a major threat to cardiovascular health, serious problems may arise when women develop a "reverse fat pattern." In this scenario, the excess fat may accumulate in the female abdominal region before or after menopause.

Although cardiovascular disease is generally thought of as a male ailment, the truth is it kills more than half a million women a year. It generally comes later in life for women than it does for men, but when it does, the percentage of fatalities is significantly higher. A woman's risk for heart attack gradually increases following menopause. That is when she is most likely to store excess fat in the abdominal region. One of the reasons for this is that her body is producing less estrogen, a hormone that aids fat mobilization.

A woman with a reverse fat pattern, regardless of age, also carries a greater risk of type 2 diabetes, certain cancers -- particularly cervical cancer -- and pain in joints below the waist that are bearing the weight of the excess fat. In some more extreme cases, overfat women may be vulnerable to Metabolic Syndrome X, which is a whole cluster of symptoms that includes a larger than normal waist circumference; elevated levels of triglycerides, fasting glucose and blood pressure; and a lowered level of good cholesterol.

When considering one's overall body structure, there is more to take into account than just scale weight. For example, there is your Body Mass Index (BMI), which basically is your weight-to-height ratio. If you weigh more than is normal for someone of your height, your BMI may be in a category that puts you at risk for heart disease, stroke, type 2 diabetes and certain types of cancer. You must qualify the BMI, if elevated, with your percentage of total body fat, since athletic-oriented individuals might show a high BMI but have a perfectly normal body fat level. In addition, you also need to consider where the body fat is stored. For instance, a woman should have a waist measurement of less than 35 inches to reduce her risk to certain disease processes.

As women age, and especially during and after menopause, they tend to develop higher levels of fat. In past years, conventional wisdom attributed this to the natural consequences of aging, but we now know this may not be true. The amount of body fat a woman carries is directly related to diet, exercise, lifestyle and hormonal balance.

Following a comprehensive body composition evaluation, a medical screening and metabolic testing, my comprehensive weight management program develops a plan to help individuals lose excess body fat and weight. This plan includes a balanced and healthy meal plan, exercise regimens and motivational training that focuses on taking the weight off without starving. In my upcoming columns I'll explain how this is done through my "Fat-Burning Metabolic Fitness and Nutrition Plan." &127;

Mackie Shilstone is Ochsner Clinic Foundation's performance enhancement expert. He is the author of Lose Your Love Handles (Perigee Books) and Maximum Energy for Life (John Wiley & Sons). His next book, The Fat-Burning Bible (John Wiley & Sons) is due out in January 2005. He can be reached at (504) 842-9110 or through his Web site www.mackieshilstone.com

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