- Overweight vs overfat: Is your scale lying to you?
- The secret life of belly fat
- Fat and aging
- What should you do about visceral fat?
- Are you ‘overfat’? Here are the best ways to tell
- The high-tech approach
- … and the low-tech
- How to measure if your body is healthy
- What Is Overfat and What Does It Mean for Our Health?
- Overfat Refers to a Specific Type of Fat
- What is Overfat Doing to Our Health?
- What Can We Do About It?
- What Does “Overfat” Mean?
Overweight vs overfat: Is your scale lying to you?
For decades, the body mass index (BMI) has been the gold standard for gauging obesity-related heart disease risk. But this handy tool doesn't always tell the whole story. It extrapolates your body fat percentage your height and weight (see www.health.harvard.edu/bmi-calculator).
But the formula can't assess how or where your body stores its excess fat — a distinction that is crucial for cardiovascular health.
By some estimates, the BMI misclassifies nearly 50% of people who are at higher disease risk from excess fat, meaning that you can be overfat even when you're not overweight.
The secret life of belly fat
Some people are genetically programmed to have a lot of fat tissue under the skin, which is deployed to store extra food energy during times of scarcity. But other people have very few of these designated fat cells, explains Dr. Christos Mantzoros, professor of medicine at Harvard-affiliated Beth Israel Deaconess Medical Center.
In individuals who lack an adequate quota of available fat storage cells (or people whose fat tissue is already filled to capacity), fat particles travel in the bloodstream and congregate in the liver, muscles, and other organs, which normally have no fat.
This also leads to the accumulation of visceral or “belly” fat — a pattern of fat distribution that is particularly hazardous to your health (see “Who is prone to visceral fat?”). Visceral fat is associated with insulin resistance and other metabolic irregularities.
“It also triggers the release of inflammatory substances that damage the arteries and help set the stage for cardiovascular disease,” says Dr. Mantzoros.
|The tendency to accumulate visceral fat is governed by genetic, ethnic, and gender differences. For example, people who inherit two copies (one from each parent) of a mutation in a gene involved in fat metabolism are more ly to have higher amounts of visceral fat than people with just one copy. Those without any copies of the gene mutation are less ly to develop heart disease — even if they become obese. Natives of India and South Asia have a higher-than-average propensity for abdominal obesity. And white men and black women tend to accumulate more visceral fat than black men and white women.|
Fat and aging
With age, people tend to lose muscle tissue, especially the type of specialized muscle fibers that produce quick bursts of speed and power.
Fat frequently accumulates within the remaining muscle tissue, causing your body fat percentage to increase even when your weight remains constant. This scenario is closely linked to bodywide inflammation and diabetes risk.
It may also explain why your BMI measurement doesn't provide a true reflection of your health risks.
Evidence suggests that waist circumference and waist-to-hip ratio are better indicators of metabolic health than BMI.
Even among people with the same BMI, those who have a large waist (defined as more than 40 inches for men and 35 inches for women) have a significantly higher risk.
In addition, people who tend to carry their weight in their hips and thighs (a “pear” shape) have lower waist-to-hip ratios and are less prone to heart disease than people with abdominal obesity (an “apple” shape); see “Measuring your midsection.”
|To measure your waist accurately, exhale and wrap a measuring tape around your bare abdomen just above your navel (belly button). Don't suck in your gut or pull the tape tight enough to squeeze the area.To compute your waist-to-hip ratio, first measure your hips by putting the tape measure around the widest part of your buttocks. Keep the tape measure level. Then, divide your waist size by your hip size.|
|Measurements that signal high risk||Waist (inches)||Waist-to-hip ratio|
|Women||35 or more||0.9 or more|
|Men||40 or more||1.0 or more|
What should you do about visceral fat?
People with abdominal obesity — even if they're not overweight — can lessen their heart disease risk with regular exercise and healthy eating habits.
“Reducing the total amount of fat in your body frees up storage space for fat particles in places that are associated with less metabolic risk,” says Dr. Mantzoros.
That's why losing as little as 7% of your total weight helps lower heart disease risk: the most dangerous visceral fat disappears first.
Image: © Goodshoot/Thinkstock
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Are you ‘overfat’? Here are the best ways to tell
About 90% of men and 50% of children in developed countries are “overfat”, according to a new study published in Frontiers in Public Health. Most people will be alarmed by these figures … and the fact that a new term (“overfat”) seems to have emerged overnight. What happened to “overweight” and “obese”? Are there different ways of measuring body fat?
Being overweight or obese is normally classified using the body mass index (BMI) system. But BMI is controversial because it doesn’t actually take the amount of a person’s body fat into account, just their total body weight and their height.
This means that short, heavily muscled people can be classified as obese.
If body fat is measured instead of body mass, then it is thought that around 70% of people are “overfat”, or carrying enough excess body fat that it could impair their health.
Although body fat is essential for normal health, in excess it is a risk factor for a number of diseases, including type 2 diabetes, heart disease and some cancers. This means that measuring body fat is very important because it allows us to predict a person’s risk of developing one of these diseases.
It has been shown that BMI fails to identify around half of people with excess body fat, making its use questionable. This means that many normal weight (BMI of 20-24.9) but overfat people may be unaware of the risks that their body fat poses to their health.
When measuring body fat, there are a number of factors that have to be taken into account, and these factors influence which method is used. These include accuracy, invasiveness, cost, availability and ease of use.
The reason BMI is still universally used by healthcare professionals is that it is cheap, non-invasive, and easy to understand and explain.
This can also be said, however, of other methods that can better discriminate between body weight and body fat.
Other methods also exist that are significantly more accurate at estimating body-fat levels, but these are often impractical or expensive to use.
The relationship between overfat and disease. Maffetone, Rivera-Dominguez and Laursen
The high-tech approach
The best way to accurately assess the amount of body fat a person has is to use imaging technology to scan inside the body. These scans include well-known imaging techniques such as MRI or CT scans, but also lesser known techniques, such as dual-energy X-ray absorptiometry or DEXA scans.
The DEXA scan uses X-rays to give highly accurate measurements of the total weights of fat, lean tissue and bone minerals. This level of information and accuracy makes DEXA stand out among methods of estimating body fat. Importantly, though, there are relatively few DEXA scanners available worldwide and their cost is prohibitive – both to buy and to run.
Other sophisticated technologies exist which are much cheaper and more readily available than imaging, but at a cost to their accuracy. Bioelectrical impedance analysis (BIA) is a non-invasive, low-cost and increasingly common approach for measuring the composition of the body, including body-fat percentage.
This method uses the natural property of electrical resistance that body fat exhibits.
Usually, a multi-frequency electrical impulse will be passed through the body between electrodes and an algorithm estimates the level of resistance the percentage of body fat presents.
Unfortunately, this method underestimates body fat and is easily biased by eating, drinking or exercise. Although BIA is cheap and available, it is not a gold standard measurement due to its accuracy issues.
… and the low-tech
Beyond high-tech methods, there are simple, non-invasive and cheap ways to estimate body fat that have been shown to be very good at predicting cardiovascular disease risk. These methods are measuring the circumference of the waist with a tape measure and comparing it either to the circumference of the hips (waist-to-hip ratio) or height (waist-to-height ratio).
For waist-to-hip ratio, a diagnostic point of 0.9 for males or 0.85 for females for obesity has been suggested by the World Health Organisation. For example, a woman with a 34 inch (86.4cm) waist and 40 inch (101.
6 cm) hips has a waist–to-hip ratio of 0.85. Waist-to-hip ratio has been shown to be better than BMI at predicting cardiovascular disease.
This method is simple and cheap and, as long as the tape measure is placed at the correct locations, provides good data.
Measuring in the right places is important for an accurate result.
When considering all the factors listed above, possibly the best method for estimating body fat is waist-to-height ratio, the method that was used in the study mentioned earlier that determined that up to 90% of men in the developed world are overfat.
The standard way to measure waist-to-height ratio is similar to waist-to-hip, only this time you substitute your height for your hip circumference. A healthy ratio should be 0.5, so your waist circumference should be half your height. For example, a six foot tall man (183cm) with a 36 inch (91.
5cm) waist has a waist-to-height ratio of 0.5.
Frontiers in Public Health
Although this method has existed for some time, a newer way of measuring waist-to-height has evolved. This method divides waist size by the square root of height and has been suggested to be the best measure of fat-derived disease risk of all because it gives a reading that works for pretty much everyone, independent of how tall or short they might be.
Waist-to-height ratio has also recently been suggested as being better than BMI at predicting heart disease, while a meta-analysis of studies suggested that waist-to-height ratio is a better screening tool for cardiometabolic disease (diabetes, heart disease and stroke) than waist circumference or BMI.
Getting the message across that BMI isn’t the be-all and end-all of metabolic health is important, and for this a clear message is needed. Unless significant steps are made to improve the accuracy of BIA or reduce the cost of DEXA, measurements waist-to-height ratio are ly to be the best hope of accurately estimating just how overfat we really are in the coming years.
These measurement based tests are incredibly cheap and easy to perform and are backed by a wealth of published data that shows that they outperform BMI. The time for them to be universally adopted by healthcare professionals is long overdue.
How to measure if your body is healthy
It seems the incidence of overfat is everywhere. Paul Laursen’s recent study suggests that in the top 30 industrialized countries there are more people who are ‘overfat’ than there are obese and overweight people globally. Shockingly, up to 90 percent of US males and 80 percent of US females are overfat.
It seems incredible – even people who look slim and fit can apparently be classified as being overfat, which would make it a new normal, and perhaps suggest that we may be over-diagnosing. Not so, according to Laursen, who argues overfat is a much better measure of overall health and life-expectancy than the old BMI model.
So we sat down with him to find out more.
EMMA HOGAN: If the majority of us are in the same boat, what’s the point in even putting a name on it?
PAUL LAURSEN: The point in knowing about overfat is that it creates awareness and gives people the opportunity to do something about it. By finding out whether you’re in the overfat category you can establish whether you’re increasing your risk for a bunch of downstream diseases, and ultimately the risk of earlier death.
Falling into the overfat category means you’ll probably have an underlying systemic level of inflammation, and a lower quality of life – you know, a lack of physical ability and more potential for injury. And then there are all the scarier issues, such as cancer, cardiovascular disease and dementia.
If you’re in the overfat category you’re just increasing your risk of suffering from them sooner in your life rather than later.
We’re not necessarily talking about fat you can actually see or pinch around your middle,so how do you know if you’re overfat?
The model for measuring overfat has purposely been kept very simple, so that everyone can use it as a measure and find out if they’re at risk. You can assess yourself using your waist to height ratio – if you measure your waist size, multiply that by two, and it is larger than your height, then there’s a good chance that you fall into the overfat category.
this measure, there’s ly to be a lot of people who previously thought they were fit and healthy, yet are now lumped in with those who are seriously obese. How should these people handle this new information?
It all comes down to the individual – if an individual can help themselves and get a little more educated on the issue, they could potentially improve their own chances of lengthening their life, improving their quality of life.
But surely there are degrees of overfatness? Should we be identifying those who are more at risk than others?
You can see those who are at the most risk. If they have a large amount of fat deposition in the abdominal region, around the organs, that’s the dangerous fat.
You can establish a more precise degree of overfat with a DXA, that’s a dual-energy X-ray absorptiometry scan that can measure body fat percentage. Basically you sit in this little tube and it scans you using X-rays. It’s the current gold standard marker of body fat percentage and there are plenty of clinics offering DXR scans.
The price point is coming down a lot, you can get them for as little as US$50. Our most recent studies indicate the general ball park cut off for body fat percentage is around the 30 percent mark for females and the 17 percent mark for males.
So if you have a DXA scan and your body fat percentage is above this you might want to have a look at making some changes.
So you’re saying that gauging overfat is something we should be doing instead of worrying about our BMI?
The BMI measurement is so poor because it misclassifies individuals. So many people can step on the scale and they can be within a normal BMI – you know, their weight divided by their height squared winds up being okay – but it’s just actually measuring weight. And weight can mean a bunch of different things.
After all, if you’re someone with osteoporosis, then all of a sudden you have light bones. Or if you’re an elite athlete, chances are your muscle will make you obese on the BMI scale. Take the All Blacks [New Zealand's world champion rugby team], elite athletes who are true specimens of health – yet BMI these guys are obese.
I mean seriously, does that make any sense?
We got this wrong a long time ago, and now we need to back the truck up and start again to understand what matters, and measure what matters.
One of my key mantras is, understand what matters and then measure what matters. We know what matters to your health is your level of visceral fat. And now we’re measuring what matters, which gives us your level of overfatness. Weight is kind of irrelevant.
So what matters is visceral fat, or belly fat? What about other areas of fat, love handles for example?
It’s the fat deep in the middle area, around the organs, that is problematic – although love handles are also fat, which is an issue.
When love handles form it’s just fat looking for other places to go. There’s a reason it’s going there, to get rid of the excess glucose that’s sitting in your bloodstream.
That glucose is a toxin, and it’s your body’s job to get rid of that and get that level down.
How can we cut the fat?
The big one is sugar. I mean it’s pretty well established that sugar is a big problem – it’s the modern day cigarette. In a very simple model, too much sugar winds up causing too much inflammation and too much visceral fat disposition, which leads to the downstream consequence of disease manifestation. Finding out ways of getting sugar your life has got to be the very first step.
So cutting sugar is the start. Where does exercise fit in?
Diet is the more powerful modifier of your level of overfat, or your level of disease risk.
You can exercise till the cows come home and you can still have a certain amount of inflammatory or visceral fat, even athletes can be overfat.
Of course exercise is still very important, I am definitely not discounting that. And those who are exercising are going to have a better tolerance for any issues that are coming into their diet.
If even athletes can be at risk of overfatness we can assume that there are a lot of people who exercise every day and think they’re fit and healthy, but they’re still at risk?
You got it! Absolutely. I mean you can go into just about any gym and see people working as hard as they can on that treadmill, or whatever machine.
They might be pushing a lot of power or moving quite quickly – but that simply indicates fitness, which is different to being healthy.
We often put fitness and health together, but fitness is the act of being able to achieve a physical task; health is the symbiosis of all your physiological systems that are working in harmony.
So by raising awareness of the term overfat you’re hopeful that it will raise the health of the planet?
We’re just trying to help society a little bit and create more awareness. It’s not a pretty picture when you look at the burdening health costs in the world. I mean, we can’t afford this for too much longer.
The world’s health centers and governments are going to be crippled, largely because the food industry that has created a system that is difficult to navigate.
Essentially, we’ve got to get processed sugar and processed food the mainstream diet.
Paul Laursen is a Canada-based AUT Adjunct Professor, performance physiologist and endurance coach.
He has published over 100 refereed manuscripts in moderate-to-high impact exercise and sports science journals and is considered an expert in the topic of overfat.
He is also a 17-time Ironman finisher who spent seven years leading the Performance Physiology Team at High Performance Sport New Zealand for the London and Rio Olympic cyclists.
WHAT IS VISCERAL FAT? AND WHY IS IT SO VICIOUS?
- There are lots of names for visceral fat – abdominal adiposity, android obesity, central obesity, hypertriglyceridemic waist, belly fat… Essentially, it’s the fat that sits around your middle.
- But visceral fat is not the type of fat you can pinch. It accumulates well beneath your skin, sitting reach deep within your abdominal cavity.
- It is a gel- fat that wraps around your abdominal organs – your liver, pancreas and kidneys.
- Visceral fat is considered the most toxic, dangerous type of fat as it provokes inflammation and interferes with the body’s normal functions.
- Scientists are finding that excess abdominal fat upsets the balance and functioning of your body’s hormones.
- Visceral fat produces immune system chemicals called cytokines that can increase the risk of cardiovascular disease.
- Too much visceral fat has been linked to everything from increased risk of coronary heart disease, cancer and diabetes to depression, arthritis and sexual dysfunction.
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What Is Overfat and What Does It Mean for Our Health?
Posted on September 07 2017
If you’ve been paying attention to the news recently, you may have seen reports of a study indicating that 90% of American men and 76% of the world’s population are “overfat.
” You may be asking yourself, what is overfat? How is it similar or different from being obese or overweight? While there’s no need to be unduly alarmed by this new study, it is important to consider it as it may have serious health implications.
Overfat Refers to a Specific Type of Fat
Obesity is measured in many ways, but one of the most common methods is through the Body Mass Index (BMI), which is calculated by dividing a person’s weight by their height.
Obesity is a condition associated with having large amounts of excess body fat. It can cause a number of health issues and has been considered an epidemic in our society since the 1990s.
There are a number of genetic, environmental, and lifestyle factors that contribute to obesity.
When someone is overweight, they are simply considered above the weight that is normal for their age, height, and body type. They may or may not be obese. The most common causes of being overweight are poor diet and a lack of physical exercise.
Overfat refers specifically to an excess level of abdominal fat (fat around the midsection). The qualification is not dependent upon a person’s weight. In fact, it is possible to be overfat even if you are within your normal weight range. It is most common in men, as they tend to store more fat in their abdominal areas, but as many as 80% of women are overfat in countries most affected.
What is Overfat Doing to Our Health?
Abdominal fat is largely considered to be the most detrimental type of fat in our bodies. It is mostly visceral fat, which means it resides deep in the body and has a more direct effect on our organs and bodily functions. Subcutaneous fat is the kind you can pinch with your fingers, and while it is cause for concern, it is not considered as much of a health risk.
According to the Harvard School of Medicine, “visceral fat has been linked to metabolic disturbances and increased risk of cardiovascular disease and type 2 diabetes. In women, it is also associated with breast cancer and the need for gallbladder surgery.”
So, what is overfat science going to change about our health? Not much, actually. The health risks of being overfat have always existed. We just have a better understanding of what being overfat means and how we can fight it.
What Can We Do About It?
The good news is this type of fat responds very well to healthy changes in diet and lifestyle. It is not typically the “stubborn” type of fat that people have difficulty with when they are attempting to lose weight. Reducing sugars, eating more lean protein, and replacing simple and refined carbohydrates with complex ones can help.
And even regular, moderate physical activity can help control weight and reduce your visceral fat. In other words, many of the methods we typically use to lose weight already can also help with our overfat issue.
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What Does “Overfat” Mean?
If you’ve spotted the alarming headlines that claim almost 90% of men and 75% of women in the developed world are “overfat” you’re probably wondering what overfat means and how it’s different to being overweight or obese.
The simplest definition of being overfat is carrying too much body fat. Regardless of your overall weight, if your body fat percentage is too high, you are overfat, and that’s linked to a higher risk of heart disease and type 2 diabetes. The risk is especially high if the excess fat is around your belly area – which it often is.
Being overweight or obese, on the other hand, refers to the Body Mass Index (BMI) categories which are height and weight. This can lead to people being labelled obese when in fact they are in cracking shape – any musclebound hunk will be too heavy for their height and considered unhealthy under BMI.
You can also fall in a healthy BMI range and still carry dangerous levels of excess fat, for instance a tall person with a pot belly that’s otherwise skinny.
That’s why we’ve got this new term – it’s a more useful individual measure of your health (BMI remains very useful for scientists working at the population level).
The new research that has pushed the term overfat into the limelight was published in the journal Frontiers of Public Health. It found that the percentage of people that are overfat in the developed world is distressingly high, with 86.6% of men in the UK considered overfat.
If you’re prodding at your stomach right now trying to work out if that’s you, a simple way to check if you are carrying too much fat around your midriff is the string test.
Measure your height with a piece of string, then take that length, fold it in half and see if it’s long enough to go around your waist, keeping the string halfway between your hip bone and your lowest rib.
If it isn’t long enough, then you are in the at risk group.
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Simpler still is to keep an eye on your waist circumference, something we covered during Men’s Health Week. Measure just below the belly button and if it’s over 94cm (37in) that’s bad and if it’s over 102cm (40in) you’re in the high risk zone.
If you want a more exact picture of the amount of fat in your entire body then you can measure your body fat percentage at home with callipers or smart scales, but the results can be a bit mixed in terms of accuracy.
A healthy body fat percentage for men aged 20-39 is generally considered to be between 8% and 20%, and for men aged 40-59 it’s 11%-22%.
If you’re especially worried about your body fat percentage it might be worth looking into a more exact measurement than you can get at home through hydrostatic weighing or DEXA, although these methods can be expensive.
It’s probably savvier to do the string test instead and put the money you saved towards a pair of running shoes or a gym membership.
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