Issue Date: June 4, 2006
Guys and Guts
You don't need "six-pack abs," but doctors now know a fat gut is far deadlier than once thought, raising your odds for getting heart disease and diabetes. So, men, take control now.
Someday, we all may look back fondly on the old days of fat. "When I was young, we were stocky! Big-boned! Sturdy! And we liked it!"
About this special report
To prepare for National Men's Health Week June 12 to 18, USA WEEKEND collaborates with "Men's Health," the No. 1 men's lifestyle magazine, for this must-read report.
|
Like most things, though, fat has gotten more complicated. Our knowledge of how it works and what it does to us is growing. Like we do with all vicious health maladies, we're learning. In fact, what has happened in obesity research has mirrored what happened in recent years with cholesterol, says David Katz, M.D., associate professor of public health at Yale University School of Medicine. "First we had a one-size-fits-all measure: cholesterol. Now we talk about LDL, HDL and triglycerides. That's happening with obesity, too. Some obesity is bad for health. Some is much less bad for health."
You no doubt have heard these numbers before: Two-thirds of Americans are overweight or obese. And in the last half of the 20th century, technology, engineering and sheer consumer demand have transformed the food manufacturing industry. It now produces more food for less money. For a few years now, we at "Men's Health" magazine have referred to this phenomenon as "the plague of plenty." As a society, we've never been so well-fed and yet so unhealthy.
That's the cause. The effect hangs over the belts of millions of American men: fat.
But this isn't your grandfather's "stocky" or "sturdy" fat. This is visceral fat. Put simply, it's fat inside your gut, surrounding and invading your vital organs, as opposed to subcutaneous fat, which lies just under the skin, on top of muscle.
Subcutaneous fat gives you "saddle bags" and "granny arms."
Visceral fat, or central obesity, gives you a "spare tire" or "beer gut."
If you wanted to measure their health risks with Hollywood nicknames, subcutaneous fat might be called Gollum -- ugly and annoying, not an immediate risk. But visceral fat? The Terminator.
Yes, it's that bad -- especially for men, who tend to store fat in their bellies more than women. And with visceral fat, forget about the bathroom scale as a diagnostic tool. Try the mirror instead. A recent study from Queen's University in Ontario showed that body weight alone no longer tells you how big your health risk is. You need to look at "where" you carry your fat: The more that settles in your midsection, the worse.
And this is just one of many recent studies unmasking the same culprit -- visceral fat. Thanks to all this new information, doctors are discovering how this substance attacks your body and raises your risk for hypertension, diabetes and heart disease.
Go to top
The deadly skills of visceral fat
Why is visceral fat so bad? Two reasons. One, it surrounds and inhibits the function of the most important organs in your body. It's especially cruel to your liver. And two, it sets off a wicked metabolic chain reaction in your body that's hard to reverse.
Here's what happens: You eat more food than you should. Your body stores the excess calories as fat, hopefully to be used as energy later. This process goes back to the caveman era, when a guy might not eat every day. His body socked away energy stores for days when food was scarce. (That's really all fat is -- excess fuel waiting to be burned.)
Today, food is everywhere. We eat it. And the body stows away fat, starting in the liver.
Why the liver? Efficiency. It's the hub of energy metabolism. "Your body puts the fat close to the metabolic machinery," says Louis Aronne, M.D., clinical professor of medicine at Weill Medical College of Cornell University. "That's like having coal next to the furnace. Putting the fat in your skin would be like putting the coal three blocks away and up a flight of stairs."
As fat increases and insinuates itself into the tissue, it slows down the liver's response to insulin, a hormone that tells the body to move fuel (fats and carbohydrates) into cells. As a result, your pancreas must produce more insulin to get the liver to respond. That's insulin resistance, the start of a chain reaction that leads to high blood pressure, rising triglyceride and cholesterol levels in the blood, and what doctors call metabolic syndrome.
If things don't change, then ... Bang! Your pancreas says, "Enough already." It can't continue to produce those levels of insulin, so it shuts down production. "It just poops out," Yale's Katz says. Suddenly you don't have the insulin you need to keep your blood sugar in check. So blood sugar levels skyrocket.
You guessed it: You now have type 2 diabetes.
Go to top
Now for some good news
Visceral fat is not indestructible. In fact, Aronne says, studies have shown that even modest weight loss -- 5% to 10% of your total weight -- can dramatically reduce your risk of type 2 diabetes. "No matter who you are, the first fat you're going to lose is from your abdomen," he says. "You're mobilizing fat in the liver, and that fat makes all the difference."
Katz concurs. "You've got this tendency to put fat in places like your liver, where it wreaks metabolic havoc, ultimately culminates in diabetes, which puts you at high risk of heart disease. And a little bit of weight loss through prudent diet and exercise can mobilize that fat right out of your liver and fix the whole damn thing."
Ah, yes, the prudent diet. If it were easy, there wouldn't be an obesity problem. Luckily, you can get huge benefits from a few small changes.
First, up your fiber intake. "Soluble fiber slows the entry of fats and glucose into the bloodstream," Katz says, "which means your body requires less insulin." Add these high-fiber foods to your daily diet: oatmeal, apples, berries, beans.
And, yes, be mindful of your caloric intake -- you shouldn't pig out on healthful foods, either.
Studies also have shown that healthier monounsaturated fats -- like in olive oil and avocados -- can help with insulin resistance.
Finally, avoid anything made with white flour and sugar, which spike your blood sugar. When in doubt, make sure the package says "100% whole grain" and check the label for fiber content. The U.S. recommended daily intake of fiber is 25 to 35 grams.
Go to top
Exercise: the best tool of all
Beyond what you put into your body, the most important thing is what you put out. Exercise remains the best weapon against visceral fat, bar none. In a study of 175 people, Duke University Medical Center researchers found the greatest gains in visceral fat in the group that did not exercise. In fact, their visceral fat increased nearly 9% in only six months. The study also found that a light exercise program -- such as a 30-minute walk six times a week -- can stop visceral fat from forming. Work out harder, and you'll lose it.
Minus exercise, "visceral fat goes up significantly and ... quickly," says Cris Slentz, Ph.D., an exercise physiologist and senior researcher at Duke, and the study's lead author. "It's a grim picture. Once you have diabetes, it's considered the equivalent of having heart disease -- it's a high, high risk factor for consequent heart disease and heart failure."
Is that enough to motivate you to work out? Hope so.
You don't have to do much. If formal exercise is too daunting, any activity will do (see sidebar, left), from mowing the lawn -- ahem, with a push mower --to playing pickup basketball. A sustained 30-minute effort and an honest sweat are the only requirements, gents.
Look at exercise goals not in terms of getting a six-pack, but as in preventing an unhealthy future. "Think five years down the road," Slentz says. "If you had started exercising today, you wouldn't need to lose 20 more pounds. You would have prevented that 20 pounds from getting on in the first place."
That's always been the challenge, hasn't it? It's the simple math (exercise + healthful eating = weight loss) that gives us the fits.
But if you don't shape up your diet and exercise, fat will continue to accumulate in your midsection. Your most vital organs will be overtaxed. Your health will be compromised. Your life will be shortened. Math doesn't get any simpler than that.
Written by Mike Zimmerman. Reporting by Sarah Baldauf.
Go to top
Is your belly killing you? Measure your risk.
How do you know if you have visceral fat? Well, a big belly is your first clue. But obvious obesity isn't the only sign. The quickest, easiest and most fundamentally accurate gauge without scanning machines is to measure your waist. All you need is a tape measure.
Risky waist sizes
Men: 40 inches or more
Women: 35 inches or more
Source: National Cholesterol Education Program
|
So what's a risky measurement? For American men, it's a waist of 40 inches or more, says the National Cholesterol Education Program.
And men, give yourself an honest measure. Aronne notices that guys tend to cheat. "We ask men who come in, 'What do you think your waist is?' And they'll say, '38. I've worn a 38 belt since high school.' Then we measure, and it's 52." Look: Your belt size is not your waist size. You have to measure over the top of your hip bones and across the belly button.
Even if you're skinny, you're not off the hook. Men who aren't necessarily overweight can still be "overfat." Katz says: "They have a Kermit the Frog body. Kermit may have a visceral fat problem. Overall, he's pretty thin, but that little potbelly? Even if your waist is less than 40 inches, it's worth looking into." Talk to your doctor.
The key: Know your waist measurement as well as you know your weight. In this game, it's all in the waist. Buy a tape measure. Use it.
Go to top
Get rid of your gut
Easy ways to add exercise to your routine
A daily walk. As researchers from Duke University have found, simple walking will control visceral fat gain. It's also the easiest way to get activity into your daily life. Stand up. Take a step. Take another. Keep going. Walk to the newsstand for the morning paper. Go around the block three times after lunch. Push the baby stroller as the sun sets. Hike a trail on the weekend. Just leave the car keys on the table every once in a while.
Cardio. OK, pick one: jogging, cycling, swimming, hoops, soccer, flag football, tennis, dodgeball, volleyball, ultimate Frisbee, lacrosse, street hockey or a friendly game of kick the can. Don't trust yourself to stick with it? Try this trick: Volunteer as a referee in a youth basketball or football league. You have to show up, and you have to keep up. It guarantees you a good sweat several times a week. None of this requires a gym membership. It's summer, my friend, and you're fresh out of excuses.
Weight training. Research has repeatedly shown the benefits of weight-training for multiple muscle groups: higher testosterone levels, higher resting metabolism (so you burn more calories just going about your daily business) and, the best benefit of all, beach muscles. You don't have to go all-out Arnold. Buy a pair of dumbbells to start.
Visit menshealth.com for free online fitness tips. Or watch video demonstrations of dozens of exercises at menshealth.com/fittv.
Cover photograph by John Hamel, Rodale
|
