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As waistlines grow, so do health risks

They are the ones everyone loves to hate: people who can eat everything in sight without putting on weight. Like everything else, how big your belly is or how wide your hips are depends on your genes, gender and age. What you eat and how active you are counts too, but we’ll assume for a moment that we have identical lifestyles and activity (or inactivity) levels. Sanchita Sharma explains

health and fitness Updated: Dec 04, 2011 01:31 IST

They are the ones everyone loves to hate: people who can eat everything in sight without putting on weight. Like everything else, how big your belly is or how wide your hips are depends on your genes, gender and age. What you eat and how active you are counts too, but we’ll assume for a moment that we have identical lifestyles and activity (or inactivity) levels.

by and large, men tend to store fat on their bellies and pre-menopausal women in their hips and thighs. Fat-storage patterns for women become similar to men after menopause, which is roughly around the age of 50 years.

Irrespective of age or gender, however, as waistlines grow, so do health risks. Central obesity — storing fat around the waist — raises risk of heart attacks and diabetes, with Indians at high risk because of their genetic predisposition to sport potbellies.

Both fat composition and distribution varies between Indian and Caucasians, with Indians tending to have more visceral and subcutaneous fat than white counterparts. Since most abdominal fat is either visceral (surrounding the abdominal organs) or subcutaneous (lying between the skin and the abdominal wall), stomachs are where most of us in India pack in unwanted weight.

One reason for the cause of the great Indian belly is the thrifty or starvation gene hypothesis, first proposed by geneticist James Neel in 1962. According to Neel, civilisations dependent on agriculture for survival experienced alternating periods of bumper harvests and famine.

To adapt to these extreme changes in calorific needs, these populations developed a ‘thrifty gene’ that triggered their bodies to store more fat during times of plenty so that they would have fat reserves to fall back on during times of famine. Several studies analysing body composition in newborns have shown that babies in India and the subcontinent are born with higher subcutenous fat, less skeletal muscle mass and smaller bones as compared to Caucasian children.

Subcutaneous fat is an established risk factor such as insulin resistance, which is a precursor to diabetes. Insulin-resistance, along with a cluster of metabolic risk factors, constitutes “Syndrome X”, a term used to describe a cluster of disorders that includes hypertension, high triglycerides (blood fats), high bad cholesterol, and low good cholesterol. Syndrome X strikes people in India at a younger age, sometimes two decades earlier than the global average. As a result, we develop health problems even when we have lower levels of belly fat than Caucasians. This means we need to have smaller waistlines than the internationally accepted cut-offs of what constitutes healthy waist circumference , which, if you look around, we clearly don’t have.

As compared to Caucasians who are safe at waist circumference cut-offs of 36.7 inches for men and 30.2 inches for women (action level 1, when weight gain should be avoided and activity levels maintained); and 39.8 inches for men and 34.3 inches for women (action level 2, weight needs to be lost); Indians need to shed inches if their waist size crosses 30.4 inches for men and 28.1 inches for women (action level 1), and 35.1 inches for men and 30.2 inches for women (action level 2).

The recommended waist-to-hip ratio is 0.95 for men and 0.80 for women in India, irrespective of action levels.

Narrower waists are healthier, no doubt, but pear-shaped women can rest easy cocooned in the belief that their hips will shield them from heart attacks. The shield crumbles after menopause, so it’s best to ensure you have as little fat on you as possible.