The Best Early Health Warning Sign

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The size of your waistline is the best early health warning sign and you don’t even need to go to the doctor to find out. Belly fat is a better predictor of many chronic diseases that stalk Indians than even general obesity.

Belly Fat is the First Sign of Trouble. Many of us (Indians/South Asians) have a normal overall body weight however a shocking number of us (42% of adult urban Indians) have too much body fat.

Indians tend to store that fat around their belly and this is one of the factors that puts us at 200%- 500% higher risk than the general population for a range of troubling conditions including:

Waist Circumference (Women) Waist Circumference (Men)Source: http://care.diabetesjournals.org/content/26/5/1380.long

 How Do I Know If I Have Too Much Belly Fat?

 There are two ways to measure belly fat:Belly Fat

  1. Waist Circumference (WC) – measured at the smallest part of your waist.
  2. Waist to Hip ratio – your waist circumference divided by the measure of the wide
    st part of your buttocks.

A waist size of more than 90 cms ( ~35 inches) in men and more than 80 cms ( ~31 inches) in women are considered unhealthy for Indians and increases your risk for diabetes & heart disease. 

A waist to hip ratio above .9 in men and .85 among women are considered unhealthy.

A recent study conducted in the Bay Area by DNA’s medical partners analyzed data on ~1,000 men and women of Indian/South Asian ethnicity. The study found  that the group of  men with high cardiac and insulin risk had an average waistline of  93 cms (just 3 cms above the healthy  range!) compared to waistline  of 87 cms for the group of men who had  normal /low risk.

The same study found that the group of  women with  high cardiac/insulin risk had an average waistline of 87  cms compared to waistline  of 79 cms for the women in the group with  markers in the normal/low risk zone.

This shows that a few inches drift of your waistline in the wrong direction may be a powerful indicator of “cracks” in your metabolic health.  

Why is Abdominal Fat So Dangerous for Indians?

The BMI and waist circumference cut off points for being classified as overweight are lower for South Asians than for other ethnicities because the medical community recognizes that a small amount of excess fat puts Indians at a higher risk for diabetes and heart disease.

There are two types of fat in the abdomen: subcutaneous fat and visceral fat. Subcutaneous fat is the soft, flabby fat that sits just under your skin. Visceral fat is the deep fat that surrounds your organs.  Visceral fat causes a host of health issues by releasing hormones, fatty acids, and inflammatory compounds.

South Asians not only tend to have more visceral fat than Caucasians, but that fat seems to be more harmful for South Asians. South Asians with more visceral fat tend to have higher:

  • Triglycerides
  • Blood insulin
  • Blood glucose
  • Blood pressure
  • LDL cholesterol (specifically the small LDL cholesterol, which is particularly harmful)

Are There Any Hidden Risks Even If I Am Thin? – Yes!

Even thin people can have visceral fat  – a body type sometimes called “skinny-fat”Skinny Fat
means that you can have a normal BMI, waist circumference, and waist to hip ratio and still be at risk for diabetes, heart disease, and metabolic syndrome. This phenomenon is particularly common among Indians.

If you are thin, BMI and waist circumference alone may not tell you how much visceral fat you have, it’s important to get your metabolic markers checked. High triglyceride levels help identify people who have visceral fat.

Why Isn’t It Enough to Look at the Numbers on Your Scale?

In medicine, the primary measure of body weight is body mass index (BMI). BMI is a ratio of weight (kg) to height (m2). In Indians, a BMI of 23.1 or more is considered overweight, and a BMI of 25 or more is considered obese. BMI is a strong indicator of your risk, but it has limitations because the calculation includes fat, muscle, organs, and bones.

Because muscle is denser than fat, muscle weighs slightly more than fat. That can skew the numbers on your scale and, consequently, your BMI. It’s like comparing a baseball with a foam ball. The two could be the same size, but the baseball (muscle) weighs more than the foam one (fat).

If you and your friend are the same size and height, but you have more muscle and your friend has more fat, you may actually weigh more and have a higher BMI even though you are in better health. If your friend starts exercising and building more muscle, his body weight (and therefore, his BMI) might go up even though his health would be improving. Simultaneously, his waistline would likely shrink.

BMI also doesn’t tell you about your fat distribution. There are a lot of Indians who have a belly that is too big but still have a normal BMI, because they have thin arms and legs. Belly fat increases your risk whether or not you are generally overweight, so it’s important to also take a look at your waist circumference.

A 2009 consensus paper in India advised that when assessing your health and risks, BMI and waist circumference should both be taken into consideration. If either number is too high, you should follow up with your doctor and get your metabolic markers checked to better evaluate your risk.

What Can You Do To Lose Waist and Shrink Your Belly?

Belly FatAfter reading this blog, perhaps, some of you may measure your waist  and decide you need some waist loss. Regardless of what cards your genes have dealt you, you can dramatically improve your health by changing what you eat and inculcating positive lifestyles habits like sleep and exercise.

The best way to mange your waist is to get your health markers checked and adopt a meal matrix/nutrition plan specific to your metabolism. (more on this in later blogs).

Given many South Asians have unique metabolic issues, you should carefully evaluate nutritional advice, especially fad of the month advices or superlative headlines like “Why is Coconut Oil Good For You? The Healthiest Oil for Cooking” or nutritional advice/analysis that  do not incorporate South Asians’ risk or your personalized  metabolic issues and risks.

Many waist loss/weight loss suggestions focus on decreasing carbohydrates in our meals and replacing them with fat or protein. Numerous studies  provide  evidence that  low-carb diet can be  more effective for weight loss and improving cardiovascular disease risk factors than a low-fat diet. Restricting carbohydrate, may be a good option for persons seeking to lose weight and reduce cardiovascular risk factors. However, here are words of caution as you reduce your carb intake and increase your fat intake…

  1. All fats are not the same,  just like all carbs are not the same. Trans Fats are  extremely toxic and should be kept to zero grams!
  2. Limit your intake of Saturated Fat to  7-20% of total daily calories. A 2009 study conducted by AIIMS, Obesity & Cholesterol Disorders, Diabetes Foundation (India) and  Fortis Hospital reviewed multiple research  and  state that  intake of saturated  fat  is  related  to increased insulin metabolic issue.
  3. Recently there has been a lot of buzz about the benefits of ghee or coconut oil.  Caution! Evidence still suggests that the effect of  increased saturated fat on  your health and weight loss is either unhealthy or at best the results are inconclusive.  I love ghee, but butter, ghee or  coconut oil are Saturated Fats so consume it in moderation i.e  no more than 1- 1.5 tablespoons of ghee per day.
  4. Replacing butter, ghee or coconut oil  with  olive oil,  certain kinds of  low omega -6 vegetable oils, and eating more nuts, fish, and avocados improves your insulin health and  reduces abdominal fat

  5. Yes if you are healthy (for sure), have a low cardiac risk and you are insulin sensitive, based on your markers, you can  perhaps enjoy  more saturated fat than someone who has a  risky waistline or is pre-diabetic/diabetic. (more of this to come in later blogs)
  6. AND please make sure as you increase your fat intake you are adequately (actually aggressively!) CUTTING back  on your carbohydrate intake. I will devote a full blog on this topic  over the coming weeks. 

DNA Take Home

  1. Belly fat is particularly dangerous for Indians. Just a small amount of excess circumference can put you at risk.
  2. A waist size of more than 90 cms ( 35″) in men and more than 80 cms (31″) in women are considered unhealthy.
  3. Being thin doesn’t mean you are in the clear, so get your metabolic markers checked.
  4. Your metabolic markers will help you decide what you should and shouldn’t be eating. Nutrition can help!
  5. MORE unsaturated fat, LESS saturated  fat and NO trans fats
  6. Cut back on carbohydrates and sugar
  7. Eat more vegetables
  8. Plant protein may also promote a healthier weight level than animal protein
  9. Eliminate processed foods, sodas, and fried snacks
  10. Exercise regularly

Your metabolism is unique. Understand it! The first step towards nutritional health is to understand your metabolic risk factors, which you can find out through a simple blood draw. Once you know your metabolic markers, you’ll gain the knowledge and power to make healthier food decisions. You are not what you eat – You are what your body does with what you eat. In future blogs  we will continue to tell you more about these chronic conditions and also explain what you should and shouldn’t be eating to optimize your health, based on your personal risk factors.

I’d like to invite you, my readers, to please  forward articles or research you may want to share.  If you have questions on a topic related to South Asian nutritional health, please Ask DNA. DNA will tap into its network of  experts from the field of nutrition, medicine, health, Ayurveda and share answers and  findings based on best scientific evidence available in a simple, actionable, objective, unbiased  fashion.

Stay Informed, Stay Healthy!

Ranjan Sinha

3 COMMENTS

  1. I find your posts very informative and useful. The presentation of data is balanced and in the Indian context. Keep up the excellent work!
    With best wishes,
    Manoj Patel

  2. I had read many articles on health issues. But many I couldn’t understand as they were from either USA or Europe. As this is Indian & you ppl clearly mention about the Indian conditions. This will be very helpful for us Indians. More to you later.

    • Sunil,

      I have included waist measurements that are considered healthy for Indians vs. a Caucasian population and referenced food that we eat as South Asians.. Please let us know if you have any specific questions by using the ASK DNA option on our Blog.

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