Carbohydrate-based fat replacers

to heat, pH, shear and salt (Nielsen 1996). There is more than one form available commercially: Slendid®100 and 110 are LM pectins, while Slendid®200 is HM pectin. Slendid® line of products can replace up to 100 per cent of the fat in a wide range of food products including mayonnaise, salad dressings, processed meats, ice cream, processed cheeses, soups and sauces, desserts, and bakery products (Artz and Hansen 1994). The use of Slendid® can reduce the fat content in mayonnaise from 80 per cent to 3 per cent, and in a frankfurter from 25±35 to 3±5 per cent (Nielsen 1996).

Oatrim is a fat replacer developed and patented by the US Department of Agriculture (USDA) in 1991. Oatrim is produced from the partial hydrolysis of oat flour or bran by a-amylase with the 0-glucan contents of 1±10 per cent (Cho and Prosky 1999). Oatrim is a soluble, tasteless powder that can be incorporated into food as a dry powder (4 kcal/g) or as a gel (1 kcal/g). Oatrim is heat stable for baking and can withstand pasteurization processing conditions, but is not suitable for frying (Calorie Control Council, 1996; Van der Slvijs et al. 1999). Oatrim or its gel gives the sensory property of natural taste and fatty texture to foods. Oatrim applications include pasteurized cheeses, dairy products, confectionery, frozen desserts, cereals, baked goods, and meat products (Inglett 2001). ,3-Glucan components in the oatrim have been reported to have a serum cholesterol-lowering effect (Inglett 1997, 2001). Oatrim is licensed for commercialization to ConAgra (Omaha, NE), Quaker (Chicago, IL) and Rhone-Poulenc (Cranbury, NJ).

Z-trim was also developed by the USDA. It is made from the high-cellulose portion of the hulls of oats, corn, rice, soybean, and peas, or bran from corn or wheat (Bollinger 1995; Akoh 1998), and is a tasteless, insoluble and indigestible fiber with zero calories. Z-trim gel contributes fiber, moistness, large water-holding capacity, high viscosity, and smooth texture. These properties make it possible for the reduced fat foods to taste like the traditional foods that are rich in fat. Z-trim has food applications in reduced-calorie cheeses, hamburgers and baked goods, but it is not suitable for deep fat frying (Cho and Prosky 1999).

Polydextrose was invented at Pfizer Inc. in the mid-1970s (Rennhard 1975). Polydextrose has been used primarily as a low-calorie bulking agent, but it is also used as a fat replacer. Polydextrose is made up from randomly cross-linked D-glucose polymers containing a small amount of sorbitol and citric acid (LaBarge 1988). Polydextrose has reducing carbonyl groups that participate in the Maillard browning reaction. It is only partially hydrolyzed by digestive enzymes (Dziezak 1986; Mitchell 1996) and contributes 1 kcal/g, which is quite attractive to health-conscious individuals. However, a laxative effect may be observed from excessive consumption of 90 g/day because a large proportion of polydextrose is excreted intact (Artz and Hansen 1994). Products with more than 15 g of polydextrose per serving must be labeled. Polydextrose is available as a powder with a pH of 2.5±3.5 and a 70 per cent solution with a pH of 5.0±6.0 (Dziezak 1986). Polydextrose is odorless, nonsweet, and highly soluble in water. It exhibits high viscosity when dissolved in water, resulting in creaminess and mouthfeel similar to fat (Dziezak 1986). Polydextrose is commonly used in several food categories, including frozen dairy desserts, baked goods, chewing gums, frostings, salad dressings, puddings, hard and soft candies, spreads, sweet sauces, and syrups (Artz and Hansen 1994). Litesse® is a polydextrose-type product manufactured from Pfizer, Inc. (Mahungu et al. 2002) and may be used as a fat replacer, bulking agent and humectant.

Gums, also often referred to as hydrocolloids, are high molecular weight carbohydrates that have traditionally been used as thickeners, stabilizers, and viscosity enhancers at very low concentrations of 0.1±0.5 per cent to form gels. The type of gum used for a particular food application depends on pH, temperature, and concentration, which can affect viscosity and gel-forming characteristics (Lucca and Tepper 1994). Gums are not used directly as fat replacers, but they are used in formulating low-fat products because they mimic the sensory property of fat such as a slippery and creamy mouthfeel. Agar, alginate, gum arabic, carrageenan, guar gum, locust bean gum, and xanthan gum are frequently used in salad dressings, icings and glazes, desserts, ice cream, dairy products, ground beef, baked goods, soups, and sauces.

Galactomannan gum is most widely used in food products and guar gum and locust bean gum belong to this type. Guar gum is obtained from the seeds of an annual leguminous plant (Cyamopsis tetragonolobus). The locust bean gum, also known as carob galactomann, is the common name for the seeds of the carob tree (Ceratonica siliqua) and has been used as a food source for thousands of years, whereas guar gum was developed and launched recently to the market owing to a lack of locust bean gum (Clegg 1996). Both gums are neutral polysaccharides composed of a linear chain of a-1,4 linked Q-D-mannose to which single a-D­galactose units are attached via a-1,6 linkages (Clegg 1996; Lazaridou et al. 2000). Guar gum and locust bean gum are different in their ratio of mannose to galactose (M:G ratio) and the position of the galactose side chains on the main chain backbone.

Guar gum has a highly substituted structure with an M:G ratio of about 1.8±2.0, whereas locust bean gum has an M:G ratio about 3.5±4.0 (Schorsch et al. 1997). Guar gum is soluble in cold water and produces highly viscous, pseudoplastic solutions (Clegg 1996; Herald 1986). In contrast, locust bean gum is not easily soluble in cold water and needs heating (80ëC) for complete hydration to give a highly viscous solution. Locust bean gum gel is not affected by pH change or ionic strength. Galactomannan is not directly used as a fat replacer and the main function of galactomannan gums in low-fat foods is that they control viscosity by holding water (Setser and Racette 1992). This becomes important as the fat level in foods is reduced. Guar gum and locust bean gum have many food applications, including ice cream, frozen desserts, low-fat cheese products, bakery goods, sauces, and dres­sings. Locust bean gum is preferred in frozen desserts because it retards ice crystal growth. Guar and locust bean gum have a synergistic effect with xanthan gums.

Xanthan gum was discovered about 50 years ago and is produced by fermentation of bacterium Xanthomonas campestris. The main polymer chain consists of 3-1,4 linked D-glucose units identical to that of cellulose but substituted on every second residue with a charged trisaccharide group. This side group consists of two mannose units separated by a glucuronic acid residue (Clegg 1996; Schorsch et al. 1997). Xanthan gum is readily soluble in cold or hot water and exhibits a highly viscous, pseudoplastic rheology. Like galactomannan gums, xanthan gum does not serve as a direct fat replacer, but can be used as a stabilizer in low-fat foods by controlling viscosity and texture. Xanthan gum is stable over a wide range of pH and temperature, whereas other gums lose their viscosity under the same conditions. Such properties persist even at very low concentrations (0.1 per cent) and functions as a very effective stabilizer in low-fat foods such as dressings, sauces and mayonnaises to exploit its weak-gel (Clegg 1996). Kelco (Clark, NJ) has a line of products made from xanthan gum such as Keltrol, Keltrol BT, Keltrol GM, and Keltrol SF.

Long-Chain Polyunsaturated Fatty Acids and Cardiovascular Disease

Fat is an essential component of the diet, and the fatty acids have different roles in the human body. In the 1970s, Danish researchers discovered that Greenland Inuits, who consume large amounts of marine lipids as part of their native lifestyle, had a much lower cardiovascular mortality (10±30 per cent) compared with the Danes, who consume much lower levels of these lipids. These findings triggered new research on the role of the long-chain polyunsaturated fatty acids (LC PUFA) in the development of cardiovascular disease and on the possibilities of utilising the beneficial effects of n-3 LC PUFA by incorporating marine lipids into foods. This post will summarise the latest evidence for the positive effects of n-3 LC PUFA on the prevention of cardiovascular diseases and the proposed mechanisms behind the protective effect of n-3 LC PUFAs. Moreover, the problems associated with using marine oil in foods, especially the problems related to off-flavour formation, will be discussed together with examples of how such problems can be solved.

There are two distinct families of PUFA that cannot be interconverted. The parent fatty acids of the n-6 (linoleic acid) and n-3 (a-linolenic acid) families are essential fatty acids as they cannot be synthesised by the human body. The body is able to synthesise the LC PUFA from the parent fatty acids. However, linoleic acid and a-linolenic acid are competing for the same enzyme systems for the synthesis and, therefore, it is important that there is the right balance between the intake of n-6 and n-3 fatty acids.

The n-6 PUFA are found mainly in vegetable products. The parent n-3 fatty acid a-linolenic acid, is also present in some vegetables (rapeseed, soybean and nut oils), but fish and marine animals are the best sources of the n-3 LC PUFA eicosapentanoic acid (EPA) and docosahexanoic acid (DHA). Low levels of n-3 LC PUFA are also found in meat. The current intake of n-3 PUFA in industrialised countries is only 4±10 per cent of the intake of n-6 PUFA, compared with an estimated ratio of 1:1 about 150 years ago. Therefore, several bodies have issued PUFA guidelines to encourage a more balanced ratio of n-6/ n-3 fatty acids that would optimise the benefits of both fatty acids.

Several large-scale epidemiological studies have demonstrated a negative association between fish consumption and cardiovascular and/or overall mortality. The cardioprotective effect of fish consumption seems to be more prevalent in high-risk populations. Intervention studies in cardiac patients have shown that fish or fish oil supplementation vs. placebo reduced the mortality risk up to 45 per cent. Apparently, fish or fish lipids do not reduce the risk of a new cardiovascular incident, but fewer incidents are fatal. At least half the deaths from coronary artery disease are sudden cardiac deaths with fatal arrhythmia caused by ventricular fibrillation. A number of studies have shown that n-3 LC PUFA prevent arrhythmias and this seems to be an important property of these fatty acids.

Several mechanisms have been suggested to explain the preventive effect of n-3 LC PUFA on cardiovascular diseases. It is now well established that n-3 LC PUFA reduce triglyceride levels by lowering hepatic triglyceride synthesis and by decreasing the release of triglyceride-rich very low-density lipoproteins (VLDLs) into the blood. A high plasma triglyceride level is a cardiovascular risk factor. Hypertension is another important cardiovascular risk factor. High doses of n-3 LC PUFA have been shown to reduce hypertension, probably by influencing membrane fluidity and the balance of the prostanoids that control the constriction and dilation of the small arteries and arterioles.

Numerous studies have shown that n-3 LC PUFA have antiaggregant activity. This is probably due to EPA’s role in the eicosanoid synthesis and its ability to reduce the levels of arachidonic acid (AA) in the membrane. EPA is a precursor of the 3-series prostanoids TXA3 and PGI3 while AA is a precursor of TXA2 and PGI2. TXA2 and TXA3 are both prothrombotic, but TXA3 is less prothrombotic than TXA2. In contrast, PGI2 and PGI3 are equally antithrombotic. Moreover, it seems that EPA and DHA reduce the gene expression of the enzymes involved in eicosanoid synthesis.

The ability of EPA and especially DHA to prevent arrhythmias may be due to their effect on (i) the ion channel (modulation of the ionic currents in heart cells), (ii) adrenoreceptors (DHA decreases the production of the main 0­ adrenic messenger, cyclic AMP, which transmits the message from catecholamins to the heart about the rhythm and force of contraction, (iii) prostaglandins (prostaglandins from EPA are less effective in promoting arrhythmias than prostaglandins from AA5), and (iv) energy production (EPA produces energy at a lower oxygen cost than other fatty acids and this is important in ischaemia where the tissue is deprived of oxygen).

EPA and DHA have inflammatory properties and are similar in action to certain anti-inflammatory agents by inhibiting the production of inflammatory mediators such as prostaglandin E2 and leukotrine B4 derived from leuckocyte and macrophage activation. Because of these properties, n-3 LC PUFA may help to prevent or reduce the symptoms of rheumatoid arthritis and Crohn’s disease. There is also some evidence that n-3 LC PUFA may prevent certain cancer forms, but more research is necessary to support this hypothesis.

The n-3 LC PUFA have a very important role in the brain, retina and nervous tissue as DHA constitutes up to 50 per cent of the phospholipid fatty acids. Therefore, the brain and retina are dependent on a continuous DHA supply for optimal function. DHA is particularly important during the development of the central nervous system in the foetus in the last trimester of the pregnancy, in pre-term infants and also during childhood. Maternal LC PUFA intake under the present dietary conditions seems to be inadequate to keep up with the increased demand for n-3 LC PUFA during pregnancy. Therefore, it has been suggested that pregnant women should increase their intake of DHA and that infant formulas for both pre-term and term infants should contain DHA. Infant formulas with DHA are now available in several countries.

 PUFA recommended dietary allowancesScientific Review Committee Canada, 1990British Nutrition Task Force, 1992Scientific Committee for Food, EU, 1993FAO/WHO Expert Committee, 1994Committee on Medical Aspects of Food Policy, 1991, 1994National Nutrition Council, Norway, 1996The Japanese Society of Nutrition and Food Science, RDA for theHealth Council of the Netherlands0-5 months: 80 mg/kg day above 5 months 1%*0-5 months: 20 mg/kg day DHA above 5 months

*% energy intake.

Source: Anselmino and Hornstra, http://www.nutrivit. co. uk/professional/PDFs/Omega_3%20book.pdf.

Learn the Health Risks Associated with Excess Body Fat

Learn the Health Risks Associated with Excess Body Fat | Health tips img#wpstats{display:none}Health tips empower your best health and live longer!Home pageDiet & FitnessDietDiet tipsFitnessCardioStrengthYogaDiseasesAlphabeticalAids & HivAllergiesBack PainCancerBreast CancerCervical CancerColon CancerLung cancerProstate CancerCholesterolCold & FluDiabetesHeart DiseaseOsteoporosisFamily HealthChild’s healthMen’s healthWomen’s healthNutritionEat rightRecipesMind and BodyBeautySkin careMindAnxietyDepressionHeadachesPersonalityStressWellnessAgingChild’s healthOral careQuit SmokingMen’s healthSleepWomen’s healthMenopause Your Are Here: Health tips ? Diet & Fitness ? Diet ? Fat burn ? Learn the Health Risks Associated with Excess Body FatLearn the Health Risks Associated with Excess Body FatSeptember 25, 2013 - Jean-Paul Marat + - Fat burn - Tagged: Abdominal obesity, Adipose tissue, body fat percentage, body mass index, Metabolism, overweight, Physical exercise, Weight loss - no comments(adsbygoogle = window.adsbygoogle || []).push({});Learn the Difference between Male and Female Fat Patterns
Where you carry your weight has serious health ramifications. The most dangerous type of weight is core body fat (abdominal obesity). People who carry weight more evenly distributed over their entire bodies are less at risk for disease than those who follow the more classic fat distribution patterns. Unfortunately, most men and women store excess weight above and below the waistline where it hurts the body the most.
For a variety of reasons, including hormones and metabolic processes that affect fat storage in particular areas of the body, when men and women first begin to gain weight, they do not store it in the same place. A typical overweight man looks like an apple. He carries his weight above the waist, resulting in the classic bulging abdomen, also known as the beer belly. A typical overweight woman carries her fat below the waist in the hips and the buttocks, resulting in a pear-shaped silhouette.
When obesity sets in, people often develop a reverse fat pattern. A man will not only have a huge belly but will start putting on considerable weight below the waist in the hips and buttocks. Women will not only store fat below the waist but will carry a large amount of abdominal fat, turning them into an apple shape. While being overweight increases health risks, crossing over into a reverse fat pattern is a move toward serious health risks.
Where Do You Carry Your Weight?
Where do you carry your weight? Before you read any further, do a quick visual evaluation of your fat pattern. Put on a swimsuit, stand in front of a full-length mirror, and take a look at where your body stores fat. Be hon­est about what you see. Does your weight distribution follow the classic male or female pattern? Or have you already crossed over into a high-risk reverse fat pattern? Have someone take pictures of you from the front, back, and side. Put them up someplace where you can see them every day such as on your bathroom mirror or refrigerator door. These pictures will become your motivation to stick with this program, and you will use them to evaluate your amazing progress as you drop inches and lose body fat.

When I first started my Fat-Burning Metabolic Fitness Plan, I would have someone videotape a “before” of my clients as they made a 360-degree turn. Then, four, eight, and twelve weeks later we would make a video record of the “afters” and compare the results. You may wish to create some sort of visual record as well, since it really shows you how dramatically your body can change in a relatively short amount of time. Kim Cummins, my executive assistant whose incredible makeover appeared in a recent article of Let’s Live magazine, literally cried when she saw herself on film because she hadn’t realized how much weight she had really gained. “I never real­ized how fat my face had become. It really shocked me.”
Melinda Mabile, another participant in the Let’s Live makeover, was delighted to see the difference in her before and after pictures. Even though Melinda did not lose a great deal of scale weight, she lost a significant amount of inches over her entire body and 7.8 percent body fat. Her waist­line slimmed down noticeably. Her posture improved dramatically from month to month, along with her overall energy level. I watched her develop a vibrancy and sparkle—an attractiveness that comes from greater health and metabolic vitality. Mara told me that she has never felt better in her life.

The Answer: Metabolic Fitness
If you find that you are overfat and suffering from a sluggish metabolism or that you have developed a reverse fat pattern, don’t despair. Over the years I have helped thousands of men and women to lose fat, get in shape, balance their hormones, improve their blood chemistry, and increase their energy level. The four-week program in this website is guaranteed to help you not only lose unwanted fat but to dramatically improve your internal body chemistry—your cholesterol, triglycerides, blood sugar, hormonal balance, and thyroid function. And it will prolong the quality and length of your life. I also offer two additional four-week Fat-Burning Metabolic Fit­ness Exercise Modules and a Maintenance Plan. After four weeks on the basic program, I have found that most people have lost so much fat and increased their metabolism so dramatically that they wish to cash in on their newfound gains and go even further.
In over twenty-five years of work with thousands of top athletes, as well as nonathletic men and women, I have discovered that increasing metabolic fitness is the secret to losing body fat and lowering disease risk factors. Our Fat-Burning Metabolic Fitness Plan is based on three tiers:
Fat-Burning Metabolic Fitness Self-Evaluation: an evaluation to learn how to honestly assess where you are on the fitness scale by measuring factors such as Body Mass Index, body measurements (including the all-important waist measurement), percent of body fat, and blood work, hormonal balance, and stress levelsFat-Burning Metabolic Fitness Nutritional Plan: a low-glycemic meal plan to increase metabolism, reduce body fat, and boost energy levelsFat-Burning Metabolic Fitness Exercise Plan: a gender-specific (intensity management) exercise system designed to trim inches of unwanted fat
Many fat-loss websites give nutritional guidelines but do not feature the kind of high-powered exercise program that I offer on this website. But stud­ies clearly show that eating right must be coupled with exercising right to really pay off. A recent study done by the Human Nutrition Program and published in the Journal of Nutritional Biochemistry clearly proves that while dieting is more effective in causing weight loss, exercise is more effective in reducing fat and building metabolically active lean body mass.
Remember, the choices you make in the area of lifestyle, nutrition, and exercise count toward 75 percent of your health profile. And it is never too late to start improving your health. If you are willing to follow the Fat-Burning Metabolic Fitness Plan set forth on this website, I can guarantee that you will soon be feeling and looking better than you ever have in your life.
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The Classic Female Fat Pattern

The Classic Female Fat Pattern | Health tips img#wpstats{display:none}Health tips empower your best health and live longer!Home pageDiet & FitnessDietDiet tipsFitnessCardioStrengthYogaDiseasesAlphabeticalAids & HivAllergiesBack PainCancerBreast CancerCervical CancerColon CancerLung cancerProstate CancerCholesterolCold & FluDiabetesHeart DiseaseOsteoporosisFamily HealthChild’s healthMen’s healthWomen’s healthNutritionEat rightRecipesMind and BodyBeautySkin careMindAnxietyDepressionHeadachesPersonalityStressWellnessAgingChild’s healthOral careQuit SmokingMen’s healthSleepWomen’s healthMenopause Your Are Here: Health tips ? Diet & Fitness ? Diet ? Fat burn ? The Classic Female Fat PatternThe Classic Female Fat PatternSeptember 26, 2013 - Jean-Paul Marat + - Fat burn - Tagged: Adipose tissue, BMI, body fat percentage, body mass index, cardiovascular disease, Muscle, obesity - no comments(adsbygoogle = window.adsbygoogle || []).push({});
There are many nicknames for female fat. We downplay it by using cute or nonoffensive labels such as saddlebags, chunky body, looking healthy, or dimples in the hips and thighs. Or we try to tame it, cover it up, or hold it in using a whole range of garments from girdles to control-top panty hose to baggy clothing. Entire cosmetic industries have arisen to help women get rid of unsightly cellulite and stretch marks, while attractive women’s fashions in large sizes are making their mark in stores and in fash­ion magazines designed for those with a “generous” figure. Most women wage a lifetime battle with fat, as can be seen by the hundreds of diet books for women that fill bookstore shelves. In fact, at any given time, three out of four women are either trying to lose weight or keep it off.
While I would agree with the self-help authors who tell female readers that the key to self-esteem is to love your body, I believe that a woman should find a balance between accepting her body just as it is and paying serious attention to the significant health risks of being overfat. There is nothing life-affirming about having type 2 diabetes, painful and over­stressed joints, and an increased risk of heart disease after menopause. As we have seen, being overfat also increases the risk of certain types of can­cers. For example, a recent report published by the National Cancer Insti­tute showed that women with a Body Mass Index (BMI) of 30 or greater were twice as likely to develop cervical cancer. Women with the lowest waist-to-hip ratio, indicating a significant accumulation of abdominal fat, were eight times more likely to develop this disease than women with a normal waist-to-hip ratio.
To better understand how a woman’s body fat can become a risk for her, let’s take a look at the physiological and hormonal processes involved in female fat storage.
The Importance of the Body Fat–to–Lean Muscle Ratio
Even though most women equate being overfat with how many pounds they weigh, the scale does not tell the whole story. While scale weight is certainly an important factor and will give you some information about your general health, it is even more important for you to determine your body composition—that is, how many pounds of fat you carry in relation­ship to how many pounds of lean muscle. The following table categorizes body fat percentages for women:
Body Fat (%)                   Level
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14–17                              Good/lean
18–22                              Average
23–27                              Fair/fat
27+                                 Obese
If you compare these figures with the body fat percentages of men, you will see that healthy women tend to carry approximately 10 percent more body fat. This is nature’s way of giving women a small and much-needed fuel surplus for pregnancy, breast-feeding, and child rearing.
Most women believe that it is inevitable that their body fat–to–lean muscle ratio will rise as they age and experience the hormonal changes associated with menopause. In fact, the tables you see in some health books, on the Internet, or in your doctor’s office will reflect this belief, allowing for a higher “healthy” percentage of body fat in older people. But women do not have to settle for a higher fat percentage as they reach midlife and their later years. The amount of body fat is directly related to diet, exercise, lifestyle, and hormonal balance.
While it’s unlikely that a seventy-year-old woman is going to have 14 percent body fat, she shouldn’t be content to settle for an unhealthy amount of fat. It is never too late to improve your body composition through a good nutritional and exercise program. And, I might add, it’s never too early. In recent years in my Fat-Burning tips, I have been seeing women in their twenties and thirties with a high per­centage of body fat. One thirty-eight-year-old female client who is 5 feet 8 inches and weighed 158 pounds didn’t really consider herself to have a weight problem until we tested her and she saw that her body fat was 34.5 percent, which made her technically obese.
In contrast, since I work with many world-class female athletes, I often see clients whose larger, more muscular bodies cause them to weigh more than the average woman of their height and frame size. In their case, however, they have a very low percentage of body fat and a higher-than­average percentage of lean muscle. A good example would be a female body builder or a competitor in any type of sport where strength is required.

The Classic Female Body TypeBy now it should be clear that the most important issue is not just how fat you are but if your level of body fat is within the healthy range. Where do you carry your fat and when does fat become a problem?
The classic female body type is the gynoid shape—that is, fat storage below the waist in the hip and buttocks areas, causing a pear-shaped sil­houette. Since weight below the waist presents less of a health risk than abdominal fat, an overweight woman actually has a lower risk than an overweight man for certain illnesses such as heart disease. An article in the British Medical Journal states, “Recent studies have also shown that a preferential accumulation of body fat in the glutofemoral region [hips and thighs], commonly found in premenopausal women and initially described by Vague [a French physician] under the term ‘gynoid obesity’ is not a major threat to cardiovascular health.”
Learn the Dangers of the Reverse Fat PatternAll bets are off, however, when a woman begins to develop what I have described as a reverse fat pattern—that is, fat in the abdominal region. Although many people think of cardiovascular disease as a man’s disease, it kills more than half a million women per year. It just affects women ten to fifteen years later than the average high-risk male. A woman’s risk for heart attack gradually increases following menopause precisely because that is the time when she is most likely to be storing excess fat in the abdominal region. One of the reasons is that her body is producing less of the hormone estrogen, which has a positive effect on fat mobilization.
Even though women have their first heart attacks later than men, they are more likely to die from them. Within one year of having an attack, 25 percent of men die, but 38 percent of women die. According to a recent article in Health Day News, women are also more likely than men to be physically disabled by a stroke and/or to have speech difficulties, visual impairment, and difficulty chewing and swallowing. On average, women’s hospital stays were longer by three days. These are all good motivations to lose that excess abdominal fat.
Women are also less likely to experience the traditional chest pains that warn of heart problems in men. Instead they will complain of abdomi­nal discomfort, nausea, vomiting, fatigue, and shortness of breath. The American Heart Association warns that even though heart attacks are more likely to kill women after they turn sixty-five because they have lost much of the protective value of estrogen and other hormones, coronary events kill 20,000 younger women each year because they do not recognize the gender-specific symptoms of heart problems. Of course, the more obese a younger woman is and the more weight she carries in her abdominal area, the more at risk she will be.
A woman with a reverse fat pattern, whatever her age might be, is also at greater risk for developing type 2 diabetes; certain types of cancer; problems with weight-supporting joints in her hips, knees, and ankles; and foot problems because of the greater constrictive design of women’s footwear.
In my Fat-Burning tips, I work with many women who have a reverse fat pattern caused by being overfat. Many of them suf­fer from significant hormonal imbalances. The primary hormones affected are estrogen, testosterone, progesterone, and human growth hormone (HGH). A significant number of these morbidly obese women also experi­ence the symptoms of hypothyroidism.
Cushing’s SyndromeIn rare cases the appearance of the reverse fat pattern in women can be caused by Cushing’s syndrome. Dr. Richard Milani, the vice chairperson of the Department of Cardiology at the Ochsner Heart and Vascular Insti­tute, New Orleans, Louisiana, says that Cushing’s syndrome is a relatively rare hormonal disorder caused by prolonged exposure to high levels of cortisol, a hormone produced by the adrenal gland. It usually results in abdominal obesity with sparing (thin or slender) of the arms and legs. There is often rounding of the face and thickening of the fat pads around the neck. Additionally, there are pronounced pink-purple stretch marks as well as thin and fragile skin. Women usually have excess hair growth on their face, chest, abdomen, and thighs. Irritability, anxiety, and depres­sion are common. There are various causes of excess cortisol production including tumors that secrete or stimulate cortisol production. Cushing’s syndrome can also be caused by prolonged use of high doses of pred­nisone. This condition can be evaluated by blood tests, and treatment is based on the cause in a given individual.
Further Dangers of Abdominal Fat: Metabolic Syndrome XOverfat women often exhibit one or more of a whole cluster of symptoms that doctors call Metabolic Syndrome X. These include a waist circumfer­ence of 35 inches or more, triglycerides greater than 150 mg/dl, HDL (good cholesterol) less than 50 mg/dl, a fasting glucose greater than 110 mg/dl, and blood pressure greater than 135/85 mm/Hg. Anyone who has three or more of these symptoms is diagnosed with metabolic syndrome X. In future post, I include a questionnaire to help you determine whether you have this syndrome. It is important because this combination of symptoms can be a strong indicator that you are at risk within the next ten years for a major cardiovascular event such as heart disease.
The Pros and Cons of the Waist-to-Hip RatioSince women naturally store excess fat in the hips and thighs, traditionally one of the best indicators of whether you are overfat is your waist-to-hip ratio. In future posts I show you how to accurately measure your waist-to­hip ratio. I have found, however, that when a woman begins to exhibit a reverse fat pattern with abdominal fat, this measurement can often become inaccurate.
In a recent article published in the British Medical Journal, Dr. Jean-Pierre Despres of the Quebec Heart Institute pointed out the weakness of the waist-to hip ratio as a reliable indicator of risk for disease in women who have adopted a male fat pattern. Such individuals tend to keep gaining fat equally in the waist and the hips while their ratio remains within the “safe” range. His conclusions were based on a twenty-year study that found that once a woman begins gaining weight above the waist, her waist-to-hip ratio is no longer an accurate determination of how much body fat she is carrying: “Simultaneous increase in waist and hip measurements means ratio is stable over time despite considerable accumulation of vis­ceral adipose tissue…. Thus, waist circumference provides crude index of absolute amount of abdominal adipose tissue whereas waist:hip ratio provides index of relative accumulation of abdominal fat.”
For this reason, even though the waist circumference has been consid­ered the gold standard for predicting obesity in men and the waist-to-hip ratio the gold standard for women, the waist circumference is a vitally important evaluation tool for both genders. A waist circumference of 35 inches or more spells trouble for women.
The British Medical Journal article also points out that when a woman experiences the reverse fat pattern, especially before menopause, it can indicate that she is a candidate for hypertriglyceridemia, which indicates an increase in the level of triglycerides in the blood, again increasing her risk for cardiovascular disease.
Gender Differences in Fat MobilizationA cell receptor can be thought of as the parking space in which a hormone sits and does its work of turning cell function off and on. The two main types of cell receptors where epinephrine, a fat-mobilizing hormone, can “park” and act on the cell are called alpha receptors, which inhibit the breakdown of triglycerides (a.k.a. the storing of fat), and beta receptors, which stimulate the burning of fat.
Research has shown that both men and women have more beta recep­tors in the abdominal area, meaning that fat is easier to lose in that part of the body. But women have more alpha receptors in the hip and thigh areas than men, which explains why they tend to store more fat in those areas and why it is harder for them to lose fat.
Another factor contributing to gender differences in fat storage may be the concentration of lipoprotein lipase (LPL) in various tissues. LPL, which also regulates the mobilization of free fatty acids, is located in the walls of blood vessels throughout the body. Women have a greater concen­tration of LPL in the hips and thighs and a smaller concentration in the abdominal area than men.
The female hormone estrogen may have a positive effect on fat mobi­lization because it inhibits the fat-storing action of LPL, enhances the pro­duction of the fat-mobilizing hormone epinephrine, and stimulates the production of human growth hormone (HGH), which inhibits the storage of excess glucose by the body’s tissues and increases the mobilization of free fatty acids from adipose tissue.
Kim Cummins: Watching the Inches Melt OffI was scheduled to do three makeovers for an article in Let’s Live magazine and was looking for people willing to undergo my Fat-Burning tips. One day at lunch while I was watching my executive assistant, Kim Cummins, having a margarita, fried soft-shell crabs, and ice cream, I was suddenly hit with the inspiration that she would be the perfect candidate. When Kim had come to work for me five years earlier, she weighed 140 pounds, but since then she had gained 36 pounds, mostly because of lifestyle choices such as eating a lot of fried foods and fast foods. The joke when we went out for a meal together with clients or athletes was always “Don’t eat the way Kim does; eat the way Mackie does,” and “See, Kim’s eating the disaster meal, but I want you to eat the Mackie Meal.”
Kim would always laugh at me because she was young (she had just turned thirty) and felt that she could get away with anything without it adversely affecting her health. Kim ate whatever she pleased and never exercised. I remember a couple of years ago when we both had our resting metabolism tested. Kim teased me because hers was greater than mine: “See, my metabolism is a better fat burner than yours.” I said, “But Kim, my body fat is 6 percent. You can joke around now, but someday in the future your lifestyle is going to come back to haunt you.”
Sure enough, when my doctor gave her a health evaluation at the start of my Fat-Burning tips, she had some unpleasant sur­prises. Her body fat was 35.1 percent, her LDL (bad cholesterol) was high at 154.2 (ideally it should be between 100 and 129), and her waistline was 36 inches (remember, anything above 35 represents significant health risks). Kim knew that abdominal fat was a big strike against her. Most alarming was her C-reactive protein, which was 6.56 (the normal range is between 0 and 0.3). C-reactive protein at this level is an indicator of inflammation, which points toward a greater risk of heart attack. “My blood work was my wake-up call,” she told me. “I was only thinking of doing the program before this. I thought it would be fun to work with a trainer and look good in my swimsuit when I went to Miami for my vaca­tion. But the results of the blood work really decided me.”
Kim never ate breakfast but ate a large lunch and dinner. It was a bit of a challenge for my nutritionist to get her on the Fat-Burning Metabolic Fitness Nutritional Plan with enough fiber because she did not like vegetables and hated breakfast foods. Kim said, “If you can make spinach taste like ice cream, I’ll eat it. Otherwise, forget it.” I told her that if she would learn to eat fiber-rich vegetables, she would see a rapid decrease in her body fat. She even agreed to go to a hypnotist to see if she could overcome her aver­sion to vegetables, but to no avail.
In spite of this obstacle, we managed to find a food plan with which Kim felt comfortable, and she began eating three large meals and two snacks a day. At first it was a challenge for her to eat all that food, but she was so determined to follow the plan that she actually set an alarm clock to remind her to stop work and grab a snack. She knew it was important for her to eat at least every four hours to boost and stabilize her metabolism.

Evaluate Your Health and Fat Patterns

Evaluate Your Health and Fat Patterns | Health tips img#wpstats{display:none}Health tips empower your best health and live longer!Home pageDiet & FitnessDietDiet tipsFitnessCardioStrengthYogaDiseasesAlphabeticalAids & HivAllergiesBack PainCancerBreast CancerCervical CancerColon CancerLung cancerProstate CancerCholesterolCold & FluDiabetesHeart DiseaseOsteoporosisFamily HealthChild’s healthMen’s healthWomen’s healthNutritionEat rightRecipesMind and BodyBeautySkin careMindAnxietyDepressionHeadachesPersonalityStressWellnessAgingChild’s healthOral careQuit SmokingMen’s healthSleepWomen’s healthMenopause Your Are Here: Health tips ? Diet & Fitness ? Diet ? Fat burn ? Evaluate Your Health and Fat PatternsEvaluate Your Health and Fat PatternsSeptember 26, 2013 - Jean-Paul Marat + - Fat burn - Tagged: BMI, body fat percentage, body mass index, High-density lipoprotein, Low-density lipoprotein, Muscle, obesity, Weighing scale - no comments(adsbygoogle = window.adsbygoogle || []).push({});
Usually being overfat is something that creeps up gradually with age. One of the last things my team and I always do when we evaluate people who enroll in my Fat-Burning tips is take front-, back-, and side-view “before” photographs so that they can really and truly see what they look like and compare these images with their “after” photos. For most, it is a great surprise to suddenly perceive an overweight person on the film because our inner image of ourselves is usually much thinner, leaner, and younger. I have had clients express shock or even burst into tears when they really looked at these pictures. It is truly as if they were seeing themselves for the first time.
While I find it important to help my clients establish an accurate per­ception of their outward appearance, it is also important to help them establish an accurate perception of their internal health. Knowing that you are bulging over the belt of your pants or your skirt does not tell you any­thing about your cholesterol, triglycerides, or percentage of body fat ver­sus lean muscle.
Are You as Healthy as You Look?
I often work with men and women who everyone else would consider healthy because they are elite athletes at the height of their profession, and they are paid huge salaries to play their sport. A highly respected NFL lineman, 6 feet 5 inches, came into my program weighing 328 pounds. He had a BMI greater than 36, a 51.7-inch waist, and a total cholesterol of 227. His HDL was low at 29. Since his triglycerides were 467, we couldn’t get an accurate reading on his LDL because, as my doctors tell me, exces­sively high triglycerides almost always skew the LDL reading. His glucose was 120, just 6 points below the diabetic classification. The real shocker was his blood pressure, which was 190/120. We found out that he had stopped taking his blood pressure medicine and failed to tell either his trainer or the team doctor. If he had not come to us for help, it is highly likely that in the near future he would have had a stroke right there on the field. And this man was considered to be a world-class athlete.
The appearance of health is not always the same as true health. Some­times the way a person looks can be very deceiving, especially in the case of someone who is fairly slim and exercises regularly. I once worked with a thirty-three-year-old world champion athlete. With a body fat of 9 per­cent, this man was certainly not overweight. But when we evaluated him, we found that he had an abnormal stress test, an elevated total cholesterol of 260, and an LDL of 190. When we took his family history, we discov­ered that there was a lot of heart disease present. If this man had continued to ignore his cholesterol for ten more years, he would have ended up with damage to his arteries, resulting in cardiovascular problems.
Learn How to Accurately Evaluate Your Health
With all of the confusing information in the media and in diet and fitness books these days, people really do not have a good idea of what constitutes a healthy body. Our parents never taught us—they didn’t grow up eating processed foods, living a physically inactive lifestyle, and facing the kinds of daily stressors that we face—and the great majority of us do not have wellness programs in our workplace. Nor do we understand how to monitor our health and risk factors as we grow older. Somehow we have developed the misconception that staying vigorous and healthy is an intu­itive process.
That is why it is so important to have the proper tools for health evalu­ation. During my thirty years of experience with thousands of clients as a performance enhancement and fitness consultant, I have come to clearly understand the definitions of good health and poor health because I have seen these scenarios played out so many times. And the dozens of top med­ical professionals with whom I have worked in my Fat-Burning tips and the Ochsner Clinic Foundation have helped to acquaint me intimately with the science behind state-of-the-art health care and health evaluation.
The Fat-Burning tips questionnaires presented on this website are simple and straightforward guides to help you understand how overfat you are and how healthy you really are, both inside and out. Some people will find that they might not have to lose an enormous amount of weight, but they will need to lower their cholesterol, raise their HDL, reduce their overall body fat, develop healthy eating habits, and/or learn how to exercise properly. Others will discover that they are seriously overfat and will face life-threatening health risks such as heart disease and type 2 diabetes unless they change their lifestyle.
The Fat-Burning tips Self-Evaluation in this post covers two main areas:
How you measure up. This includes common indicators of risk fac­tors such as high scale weight, body fat percentage, BMI, and waist measurement.Your overall body measurements, which will help you see where you are holding your fat. These measurements will be retaken at the end of the basic Fat-Burning tips (and every four weeks after that if you continue with Modules 2 and 3) to help you quantify how much body fat you are actually losing and how hard and lean you are becoming.
You are only as strong as your weakest link. But be assured that the lifestyle, nutritional, and exercise programs offered on this website have worked for thousands of overfat men and women.
I suggest that you make a photocopy of the Fat-Burning tips Self-Evaluation Questionnaire so that you can keep a record of your progress. As you work your way through each section of this post, you will learn how to fill in the blanks. I describe why each of these criteria is an important indicator of overall health and how you can use them to build an accurate picture of how you measure up. In subsequent posts I will help you to evaluate your lipid profile and glucose levels, your level of human growth hormone and your thyroid function, and your stress levels.
The Fat-Burning tips Self-Evaluation Questionnaire
Age ____
Gender ____
Height ____
Scale Weight ____ lb.
% Body Fat ____
Fat ____ lb.
Lean Muscle ____ lb.
Body Mass Index ____
Overall Body Measurements:
Arm ____ in.
Forearm ____ in.
Chest ____ in.
Waist ____ in.
Abdomen ____ in.
Hips ____ in.
Thigh ____ in.
Calf ____ in.
Waist-to-Hip Ratio ____
How Do You Measure Up? Learn the Six Basic Health CriteriaHealth Criterion #1: Scale Weight
Weight gain has become a problem of epic proportions in our society. In 1905, only 5 percent of the population was obese, but that figure has been growing at an alarming rate. In the last decade alone, obesity has risen 8 percent. About 97 million people over age twenty—that is, 60 percent­ are either overweight or obese. Of that number, 12.5 million are severely overweight, and 2 million are morbidly obese. These people are at great risk for life-threatening health conditions such as heart disease, stroke, diabetes, and some types of cancer.
You need to know your scale weight to complete the Fat-Burning tips Self-Evaluation Questionnaire. To get an accurate scale weight that you can track over the twelve weeks of this program, it is important to have access to a fairly good scale—either a good bathroom scale or one at your gym. Ideally, you should weigh yourself nude first thing in the morning before you have eaten breakfast. If you weigh your­self with clothing at the gym or at a doctor’s office, you might deduct 1 or 2 pounds for shoes and clothes.
Health Criterion #2: Body Fat
Your scale weight does not tell the whole story—far from it. A bodybuilder might weigh 250 pounds on the scale but have a total body fat of 8 percent. Someone might not be that much overweight according to the scale but may carry an unhealthy amount of body fat for his or her age. Men or women with big bones and a large frame will naturally weigh more than those with small bones and a delicate frame. To really understand how overfat you are, you need to calculate how many of your scale pounds rep­resent body fat. This chart defines healthy and unhealthy body fat percent­ages for men and women:
BODY FAT PERCENTAGE
LevelMenWomenAthletic<11 data-blogger-escaped-air="" data-blogger-escaped-bese22="" data-blogger-escaped-fat18="" data-blogger-escaped-lean11="" data-blogger-escaped-ood="" data-blogger-escaped-p="" data-blogger-escaped-verage15="">It used to be that men and women past age fifty were expected to be out of shape and carrying a larger amount of body fat. Some charts in doc­tors’ offices or magazine articles will even allow greater amounts of “healthy” body fat for men and women who are middle-aged or older. I do not really follow those guidelines because experience has shown me that people in their fifties, sixties, or even seventies do not have less of a capac­ity to lose body fat and build lean muscle than younger people. An article in the Canadian Journal of Applied Physiology reports that studies on sar­copenia (loss of lean muscle mass with aging) unequivocally show that older muscle tissue has the same, if not an even greater capacity, to respond to a vigorous bout of resistance exercise than younger muscle does.
Age is not the issue; metabolic fitness is the issue—that is, how effi­ciently your metabolism burns fat, which is based on how much lean muscle you have, what and how often you eat, how much and at what intensity you exercise, and how balanced your body’s hormonal systems are, especially those hormones that regulate the burning of nutrients as fuel or cause their storage as fat.
Three Techniques for Measuring Body Fat
There are several popular methods for measuring body fat. Following are three of the most popular:
1.    Hydrostatic weighing, in which a person’s mass is measured both in and out of a tank of water, is considered to be the gold standard for measuring body fat. This test is based on the assumption that lean tissue is denser than fat—that is, lean tissue will sink and fat tissue will float. This test costs between $100 and $150 and can be performed at your local health club, hospital, university, or well­ness center. Some mobile units may even charge as little as $45 for this service.2.    Skin fold measurement with a caliper involves measuring subcuta­neous (under-the-skin) fat with a caliper at certain points on the body. Since this test has been around for quite some time, you can get it done at YMCAs, health clubs, dietitians’ offices, physical therapy centers, and universities.3.    Anthropometric measurement is a test you can do at home. This test is based on the assumption that fat is distributed at certain sites on the body such as the neck, wrist, and waistline. Muscle tissue is usually found at sites such as the biceps, forearm, and calf.
The following two anthropometric tests—one for males and one for females—will help you ascertain your percentage of body fat. These for­mulas are from Philip L. Goglia’s book, Turn Up the Heat: Unlock the Fat-Burning Power of Your Metabolism, and have a plus or minus error rate of 5 percent. All you need is a cloth tape measure and a calculator.
AT-HOME BODY FAT TEST FOR MALES
Step 1: Taking Measurements
Height in inches ____Hips in inches ____Waist in inches ____Weight in pounds ____
Step 2: Determining Your Percentage of Body Fat
Multiply your hips (in.) ____ x 1.4 = ____ minus 2 = ____ (A)Multiply your waist (in.) ____ x 0.72 = ____ minus 4 = ____ (B)Add A plus B = ____ (C)Multiply your height (in.) ____ x 0.61 = ____ (D)Subtract D from C, then subtract 10 more: (C – D) – 10 = ____ % fat
Your answer will be your approximate body fat percentage if you are a male.
AT-HOME BODY FAT TEST FOR FEMALES
Step 1: Taking Measurements
Height in inches ____Hips in inches ____Waist in inches ____Weight in pounds ____
Step 2: Determining Your Percentage of Body Fat
Multiply your hips (in.) ____ x 1.4 = ____ minus 1 = ____ (A)Multiply your waist (in.) ____ x 0.72 = ____ minus 2 = ____ (B)Add A plus B = ____ (C)Multiply your height (in.) ____ x 0.61 = ____ (D)Subtract D from C, then subtract 10 more: (C – D) – 10 = ____ % fat
Your answer will be your approximate body fat percentage if you are a female.
You do not necessarily have to get your body fat tested to know that your body composition is improving. If you have been exercising and eating properly and your clothes begin to feel looser, if you find yourself taking in your belt a notch or two, or if you observe increased strength and muscularity, you will know that you are losing fat and gaining lean muscle.
Calculate Pounds of Body Fat and Lean Muscle
The final step is to take your total weight and calculate how many pounds of fat you carry and how many pounds of lean muscle. Use the following two formulas:
Total weight (lb.) × percent body fat = total pounds of fat
Total weight – total pounds of fat = total pounds of lean muscle
For example, if you are a woman weighing 200 pounds and you find that you have 35 percent body fat, calculate the number of pounds of fat you carry using the following formula:
200 lb. × .35 (% body fat) = 70 pounds of fat
To calculate your pounds of lean muscle, use the following formula: 200 lb. – 70 lb. of fat = 130 pounds of lean muscle
Health Criterion #3: All-over Body Measurements
As you work through this Fat-Burning tips, your all-over body measurements, which I will ask you to take every four weeks, will be another indication that you are losing fat and building lean muscle. You will become leaner and trimmer.
To take accurate all-over body measurements, follow these instruc­tions. I have provided drawings for both men and women to help you to accurately measure each area of your body.
Arm: With your arm to the side of your body, measure the circumfer­ence midway between the shoulder and the elbow.
Forearm: With your arm hanging downward and slightly away from your trunk and your palm facing forward, measure at the maximum forearm circumference between the wrist and the elbow.
Chest: For a woman, measure across the widest part of the chest marked by the nipples. (For older women with very large hanging breasts, this might be slightly higher. See illustration for guidance.)

For a man, measure the widest area of the chest across the nipples.
Waist: Measure at the narrowest part of the torso, above the belly button and below the rib cage.
Abdomen: Measure at the level of the belly button.
Hips: Measure at the maximum circumference of the hips or buttocks region, whichever is larger.
Thigh: With your legs slightly apart, measure at the maximum circumference of the thigh.
Calf: Measure at the maximum circumference between the knee and the ankle.
Health Criterion #4: Why Waist Circumference Is So Important
In both men and women, one of the most important and accurate indicators of obesity, the potential for cardiac disease, and other health risks is the circum­ference of the waist. This is because an increased measurement in the waist always indicates an increase in abdominal fat (and the ratio of body fat–to– lean muscle in general). For a woman, who naturally carries her fat in her hips and thighs, an increased waist measurement indicates a reverse fat pattern.
Since fat is three times the size of lean muscle tissue, it is possible for scale weight and BMI to remain the same with aging yet for the waist to increase as lean muscle is lost and fat storage is increased through inactiv­ity and poor nutritional habits. One doctor I know had a 7-inch increase in his waistline after retirement even though his scale weight did not change.
In the book It Can Break Your Heart, Dr. J. Pervis Milnor III and coau­thors write that a waistline greater than 35 inches in a woman and 40 inches in a man increases the risk for developing higher cholesterol levels, which lead to coronary disease, and type 2 diabetes. According to the National Heart, Lung and Blood Institute, a man whose waistline is 42 inches or greater is more likely to have erectile dysfunction than his leaner counterparts.
Of course, a waist measurement of 35 inches in women or 40 inches in men is not always an absolute indicator of health risks. You should take into consideration factors such as height, body type, and bone structure. A 35-inch waistline on a woman who is 5 feet 11 inches tall with a large frame would represent less of a health risk than the same waist circumfer­ence on a woman who is 5 feet 2 inches tall with a small frame.
Health Criterion #5: Calculate Your Waist-to-Hip Ratio
The value of the waist-to-hip ratio is that it helps to give you a more accu­rate idea of where you carry your fat. When fat is stored around and above the waist, it results in a higher risk for diabetes, heart disease, and some types of cancers. The person with upper body fat distribution (the apple shape) loses fat more quickly than the person with lower body fat distribu­tion (the pear shape), but a smaller amount of fat stored above the waist is more dangerous than a larger amount of fat stored below the waist.
To get this ratio, measure your waist at its narrowest circumference and your hips at their widest. Then divide your waist measurement by your hip measurement. For example, if you have a waist of 30 inches and a hip measurement of 42 inches, your hip-to-waist ratio is 0.71.
My waist measurement is ____. My hip measurement is ____. My waist-to-hip ratio is ____.
RANGE OF WAIST-TO-HIP RATIOS
Excellent         Good         Average          High        Extreme
Male<0 data-blogger-escaped-.85="" data-blogger-escaped-p="">0.85–0.90.91–0.950.96–1.0>1.0Female<0 data-blogger-escaped-.75="" data-blogger-escaped-p="">0.75–0.80.81–0.850.86–0.9>0.9
Keep in mind that this measurement does not tell you anything about your total body weight or body composition. It just gives you an indication of where your excess fat is located and therefore your health risk relative to fat deposition.
Women must especially watch this ratio during and following menopause when hormonal fluctuations, poor nutrition, and lack of activ­ity can result in abdominal weight gain, leading to a reverse fat pattern. The National Cancer Institute has shown that a woman with a lower than normal waist-to-hip ratio is eight times more likely to get cervical cancer than a woman with a normal ratio.
Used alone, this ratio can be deceiving in some people. As we have seen, once abdominal obesity sets in, especially as a reverse fat pattern, the waist-to-hip ratio can become skewed because at this point both genders are gaining weight above and below the waist. So as the waistline goes up, the hips go up, often in tandem. This is just another reason why no single method of measuring fat storage is infallible. It is important to look at the bigger picture when evaluating your health and fat patterns.
Health Criterion #6: Body Mass Index
The Body Mass Index or BMI is another important tool to help ascertain how overfat you are. Sometimes the BMI can be misleading. For example, a 240-pound bodybuilder who is 5 feet 11 inches would have a BMI of 34, which would appear to put him in the very highest risk category. But if that same person has only 8 percent body fat, this changes the entire story.
However, for most readers of this website, a high BMI will be a red flag predicting many health risks. For example, a recent study published by the American College of Sports Medicine has shown a direct correlation between a high BMI and increased levels of C-reactive protein. High CRP is an accurate indicator of inflammation in the body, which increases the risk of a first cardiac event (heart attack), even after adjustments have been made for risk factors such as age, smoking, and body weight. Exercise and increased levels of physical activity, which result in weight loss and low­ered BMI, have been shown to reduce a person’s level of CRP. So while the BMI is not an infallible standard by which to measure how fat you are, taken together with other factors it is a useful tool for helping to create an accurate health profile and can serve as an early warning system for heart disease.
BMI is defined as your weight in kilograms divided by your height in meters squared. To save you the trouble of converting pounds to kilograms and inches to meters, I have done the math for you. Simply look up your BMI in the chart provided. Your height can be found in the left-hand col­umn and your weight (in pounds) runs along the top of the chart. Your BMI is where both points intersect. Because people between 5 feet and 5 feet 2 inches tall generally have a lighter frame, we have included a different chart for them.
Interpret Your BMI
If your BMI is below 20. Unless you are an athlete with a very high ratio of lean muscle–to–body fat, a BMI this low might mean that you are too thin and are possibly compromising your immune system.If your BMI is between 20 and 22. This range is associated with liv­ing the longest and having the lowest incidence of serious illness.If your BMI is between 23 and 25. These numbers are still within the acceptable range and are associated with good health.If your BMI is between 26 and 30. Now you are entering the zone where there are serious health risks. A BMI this high puts you at risk for developing heart disease, stroke, type 2 diabetes, and some kinds of cancers. You should definitely lower your weight through diet and exercise.If your BMI is over 30. This is the worst-case scenario where you are definitely putting yourself at risk for all of the diseases mentioned above. It is imperative that you begin to lose weight and exercise.BODY MASS INDEX1001101201301401501601701801902002102202302402502602702805’0?202224262729313335373941434547495153555’1?192123252728303234373941434547495153555’2?192022242628293133353637394143444648501201301401501601701801902002102202302402502602702802903005’3?212325272830323436373941434446485051535’4?212224262829313334363840414345464850525’5?202223252728303233353738404243454748505’6?192123242627293132343637394042444547495’7?192022242527283031333536383941424446475’8?182021232426272930323435373840414344465’9?181921222425272830313334363738404143445’10?171920222324262729303233353637394042435’11?171820212224252728293132343536383941426’0?161819202223242627293031333435373839416’1?161719202122242526282930323334363738406’2?151718192122232426272830313233353637396’3?151618192021232425262829303133343536386’4?151617182021222324262728293032333435376’5?141517181920212324252627293031323334366’6?14151617192021222324252728293031323435
According to a study done in the New England Journal of Medicine, having a BMI over 25 may cause your life span to decrease significantly. If your BMI is higher than 30, your life span may decrease even more sharply. Studies show that 59 percent of American men have a BMI over 25 and almost as many women. For those who have a BMI over 35, health care costs are likely to be more than twice those of individuals with a BMI between 20 and 25. Treatment of diabetes, hypertension, and cardiovascu­lar disease count for much of this spending.
Compare Your BMI and Waist Measurement
As we have seen, BMI can be skewed by factors such as frame size and the percentage of lean muscle that you carry on your frame. One tool that I have found useful in deciding whether your BMI is in the healthy range is the comparison between BMI and waist measurement. Here is a chart that compares ranges of BMI with waist measurements in men and women.
RELATIONSHIP BETWEEN BMI AND WAIST MEASUREMENTSHealth CategoryBMIMen’s Waist (in.)Women’s Waist (in.)Normal18.5–24.934.3–38.531.1–36.1Overweight25–29.938.6–42.836.2–40.4Obese I30–34.942.9–48.740.5–45.2Obese II>-35>-48.8>-45.3
If both your BMI and your waistline fall into the same category, you can be fairly certain of the health classification.
Bo Walker: The Inches Melted Off and the Numbers Went Down
Let’s take a look at a client of mine who completed the Fat-Burning tips as part of a makeover I did for Let’s Live magazine: a forty-year-old radio personality named Bo Walker. When Bo first came into my program, he carried 250 pounds on his 5-foot 10-inch frame, had a body fat percentage of 34.5, a BMI of 35.85, a waist measurement of 48, and a waist-to-hip ratio of 1.0. As you can see, all of these figures put him into the very highest risk category.
Bo was concerned about his health because he and his wife had a young child. “I knew I was headed in the wrong direction. My father had died at a very early age, fifty-nine years old, from a heart attack and com­plications with diabetes. I knew that if I continued on this path and stayed in the 250 weight range—or worse—I was probably headed for the same fate. I wanted my kid to know who I am and I wanted to live long enough to enjoy my life with my wife.” Bo was also facing the stress of having just lost his job.
Over the course of twelve weeks, Bo saw dramatic changes in his overall body measurements. I have included some of his statistics to demonstrate his total transformation.
BO WALKER’S MEASUREMENTSDate5/1/20035/17/20035/31/20036/26/20037/12/20038/1/2003% Body Fat34.5027.8024.8023.2023.2020.80BMI35.8534.733.9133.4133.4132.4Weight250242236.5233233226Girths: Left/RightBicep–Left151413.751413.7513.5Bicep–Right141413.7513.7513.7513.75Forearm–Left11.7511.75121211.75Forearm–Right1212121212Thigh–Left27272525.525.523.5Thigh–Right27262525.252523.75Calf–Left1615.515.2515.2515Calf–Right16.516.516.2516.2516Hips46.547.545.754544.7542.75Waist4847.546.545.754543.75Shoulders5452.7552.55352Chest494947.7546.546.545.25
As you can see, Bo lost 24 pounds and his body fat dropped 13.7 points, from 34.5 percent to 20.8 percent. If we plug this into the formula I gave you, he started out carrying 86.5 pounds of fat and 163.5 pounds of lean muscle. At the end of 12 weeks, he was carrying only 47 pounds of fat and 179 pounds of lean muscle—a dramatic change. If you interpret these figures from a slightly different perspective, in terms of conversion from fat to muscle, Bo lost 39.5 pounds of fat and gained 15.5 pounds of lean muscle. Quite impressive!
All of Bo’s other measurements decreased as well. His BMI dropped from 35.85 to 32.4 and his waistline shrunk from 48 to 43.75, a loss of 4.25 inches. His hip measurement dropped from 46.5 to 42.75, a loss of 3.75 inches, resulting in a waist-to-hip ratio of 1.0, which is identical to his for­mer ratio. This is a perfect example of the shortcomings of looking only at this measurement, as discussed earlier in this post. As I explained, when taken alone, the waist-to-hip ratio is not a reliable indicator of health risk. When a man has developed a reverse fat pattern, as Bo did, at first the waist and hips will shrink in tandem with one another as the body is normalizing.
In extreme cases of the reverse fat pattern, such as Douglas Daniels, the waist-to-hip ratio will actually increase before it goes down. The reason is that the hips are not a normal place for a man to store fat. The rule is that the last fat gained is the first to be lost.
Bo still has a distance to go, but he looks and feels better than he has in years, which is a strong motivator for him to continue with the plan. Your body could also look great after only four weeks on the Fat-Burning tips.
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Oxidative stress biomarkers and the role of lipid oxidation in cardiovascular disease

A general problem in studing oxidative stress in biological systems and in the evaluation of the effects of AO in vivo, i.e. in patients, concerns the strategies for reliable measurements of oxidative parameters. Several markers and methods have been used for the assessment of the generation of oxidation products (markers of oxidation) of various biomolecules in vitro, in ex vivo systems and in vivo. The in vitro measurements, although quite effective in the assessment of the antioxidant potential of a given compound in a controlled system, are not greatly predictive of the possible activities in vivo. It should also be added that since different antioxidants act through different mechanisms and different oxidative substrates may yield different types of products, assays should be aimed at measuring various oxidative products using different substrates (Halliwell, 1995).

Ex vivo measurements are often also used in connection with the evaluation of oxidative processes in pathological states, but again in some cases some artefactual modification may occur during the collection of the samples (e.g. cells, plasma preparation). The in vivo assays are made directly on samples collected without any manipulation, e.g. urines, but although they reflect processes occurring in the organism, they do not imitate the site(s) of these events. Measurement of isoprostanes, non-enzymatically produced oxidative metabolites of arachidonic acid, is considered, with the above-mentioned limitations, a valid indicator (biomarker) of lipid peroxidation. Increments of this marker have been observed in conditions in which enhanced lipid peroxidation may be predicted (in people who smoke, or have diabetes or hyper-cholesterolemia) (Pratico et al., 2001).

Concerning specifically the measurements of lipid peroxidation markers, ideal assays should have the following features (Halliwell, 1999):

In vitro (susceptibility of substrates to oxidation under controlled conditions) Substrates/markers:

Substrates = lipids: fats, oils, lipids in membranes and lipoproteins Markers: TBARS, conjugated dienes, lipid peroxides, oxygen uptake, fall of PUFA and vitamin E, isoprostanesSubstrates = Proteins: ±SH groups, amino-acid residues, etc.

Markers: electrophoretic mobility. adduct formation, carbonyl content, etc.

A. Substrates = Nucleic acids: DNA bases, deooxyguanosine

Markers: mass spectrometry (MS) of high performance liquid chromatography

(HPLC) of modified bases, electrophoresis of damaged 5'-GG-3' doublets, `comet

assay’ for DNA bases.

A. Substrates = sugars: ribose and deoxyribose in DNA

Markers: oxidation products

Ex vivo (evaluations on samples, e.g. blood, or cells, obtained from animals/humans without further treatments, except those made in vivo)

Antioxidant/oxidant status, antioxidant capacity, antioxidant levels and activities of AO enzymes, levels of negatively charged LDL (a fraction with different chromatographic behaviour in HPLC systems), antibodies against modified LDL, ex vivo assays of DNA oxidation, ex vivo assays of protein oxidation

In vivo (determinations in biological samples collected non-invasively)

Lipids/lipoprotein oxidation): urinary levels of isoprostanes, hydrocarbons in expired air

DNA damage: urinary levels of modified DNA bases

Quantitation of major products of the peroxidation process.Low coefficients of variation of analyses.No interference by other biomolecules.Methods: Chemically reliable (e.g. mass spectroscopy, MS or high performance liquid chromatography, HPLC) or validated.Possibly not confounded by oxidized lipids ingested with the diet.Assess steady-state levels of peroxidation products and total rates of ongoing lipid peroxidation.Parameters measured should be stable on storage and not produced artefactually.

Measurement of valid biomarkers of oxidative processes should be promoted before conducting studies on the effects of antioxidants in human studies (Mayne, 2003).

A vast literature over the past two decades has been produced, devoted to the possible involvement of oxidative stress and of ROS-derived products in various

pathological states. To some extent the published information is speculative, owing to major conceptual and analytical difficulties in the assessment of oxidative processes in vivo and in the evaluation of their real contribution to pathologies. Uncontrolled free radical production has indeed been advocated as a factor in a number of diseases: atherosclerosis, arthritis, diabetes, pulmonary diseases, cancers, Alzheimer’s disease, lateral amyothrophic sclerosis, neuritis, hepatitis and senile cataracts, but most of the attention has been devoted to the possible involvement of lipid/lipoprotein oxidation in atherogenesis and in cardiovascular disease, CVD (Steinberg, 1997, Berliner and Heinecke, 1996).

As to the issue of oxidative stress and atherosclerotic CVD, certainly rather convincing evidence has been produced in in vitro studies, showing that LDL that have been exposed to oxidative stress (oxLDL) through various mechanisms (exposure to chemicals, to physical factors or to cellular processes) are highly atherogenic. Atherogenesis induced by oxLDL has been shown to activate a sequence of events, involving several types of circulating cells (monocytes, platelets) and cellular components (e.g. smooth muscle cells, SMC) and present within the vessel walls (macrophages).

There are, however, still several issues to be defined. First, LDL are rather etherogenous molecular complexes, with significant individual differences in macro- and micro-components, including a number of lipophilic compounds that are associated to them, and it is difficult to identify and quantify all the products generated after exposure to oxidative stress, which may contribute to atherogenesis. Second, in vitro LDL oxidation is generally carried out in conditions that maximize the oxidative process, e.g. removal or depletion of hydrophilic and amphiphilic antioxidant compounds that are normally present in plasma, exposure to strong pro-oxidant factors that are difficult to compare quantitatively with in vivo free radical generating systems. Therefore the final products, i.e. oxidized LDL, cannot be easily compared with oxLDL possibly

generated in vivo. In vitro studies have also convincingly shown that several types of antioxidants are able to prevent LDL oxidation induced by various agents, but the use of AO, mainly in the form of supplements, in clinical studies has not shown significant protection against CVD. Although some of these issues are considered in detail in other posts, it is worth underlining some the strong and the weak points in the overall relationships between oxidative stress and CVD.

There is evidence that lipoproteins (LP) with some of the general features of oxLP produced in vitro, evaluated with the use of the typical markers of oxidation (see further), are present in atherosclerotic plaques. On the other side, it is not completely clear whether oxLDL are generated within the vessel wall exposed to high oxygen fluxes, from previously accumulated particles, or whether they are deposited in the vessel walls after being produced in the circulation, i.e. whether the presence of oxLDL is a secondary or an associated process, rather than a causative event.

For monocytes, again, the accumulated reactive material could be produced in a secondary process. In addition, the recognition by antibodies has several limitations: poor characterization of the oxLDL used as antigens for the preparation of the antibody, and eventual (epitope) differences between the artificially produced oxLDL and those generated in vivo. In addition there may be some lack of specificity and poor quantitative responses in the reaction.

Some of the previously mentioned limitations may apply to the presence of autoantibodies against oxLDL in sera of atherosclerotic patients. There is also some evidence that antioxidant consumption may slow the progression of the disease. This, however, is a rather controversial aspect. In essence, the difficulties in the evaluation of the outcome of the studies concern the form and doses of administration of the AO and in the selection of the people to be treated.

In addition to the role of oxidized LDL in the atherogenetic process, a number of studies have been devoted to assess the involvement of oxidative stress in several CV conditions and functions, as discussed in the following reviews: endothelial functions (Cai and Harrison, 2000; Lum and Roebuck, 2001; Matsuoka, 2001; Terada, 2002), neutrophil activation (Kaminski et al., 2002), macrophage involvement (Jessup et al., 2002), smooth muscle cell function (Bomzon and Ljubuncic, 2001), vascular ageing (Yu and Chung, 2001), congestive heart failure (Mak and Newton, 2001), arterial hypertension (Zalba et al., 2001) and diabetes (Bayraktutan, 2002). However, as already discussed, most of the evidence is derived from in vitro models, animal studies or ex vivo situations, i.e. in somewhat artefactual conditions where some of the processes may be amplified. It is therefore rather problematic to assess and quantify the actual role and relevance of oxidative stress in CVD.

Based on all the direct and indirect evidence in support of the hypothesis that free radical-mediated processes and specific products arising from them may play a role in CVD, great interest has been devoted to the possible protective effects of AO in the diet, or as pure compounds, on biomarkers and on clinical endpoints in population studies.

A vast number of studies have been carried out since 1990 on various aspects of the issue of AO protection: they range from epidemiological investigations to controlled trials and have involved a great number of participants. In reality, early observations on the relationships between dietary antioxidant vitamins and disease date back to the 1930s (Seventh-Day Adventists) and the 1950s (Mormons) (reported by Enstrom et al., 1992), and the whole area has been recently reviewed systematically (Asplund, 2002). This review is based on the following inclusion criteria: human studies only, published after 1989, reporting only original data, obtained in case-control, cohort or randomized controlled trials; related to AO vitamins only; mainly reporting on morbidity and mortality of clinically meaningful manifestations of ischaemic heart disease or stroke. The following contexts have been considered: primary prevention of various endpoints (ischaemic heart disease, stroke or combined cardiovascular events), the effects on intermediary endpoints (e.g. blood lipids and blood pressure), studies on secondary prevention in patients with manifest CV disease.

The main conclusions are: in observational studies (case-control or cohort design) people with high intake of AO vitamins by regular diet or as food supplements generally have a lower risk of myocardial infarction and stroke than low consumers. In randomized controlled trials, however, AO vitamins as food supplements have no beneficial effects in the primary prevention of myocardial infarction and stroke, with some report also of adverse events. In addition, in contrast with the initial favourable reports on AO in the secondary prevention of CVD, recent reports apparently failed to show beneficial effects. Some of the negative findings on the effects of AO vitamins, however, may be attributed to pitfalls in the design of the experiments: inadequate characterization of subjects under investigation in terms of ongoing oxidative stress, inappropriate formulations and dosages, especially in comparison with the situation in natural sources: single compounds rather than mixtures, concentrations too high (possibly pro-oxidant) or too low (ineffective), administered as a bolus (capsules or tablets) rather than in the context of foods (better absorption, protection vs. oxidation of dietary components, balance between various ingredients with maintenance of natural structural and functional relationships).

In summary, some relationship exists between intakes/plasma levels of some risk factor for vitamin C (reduction of cholesterol and blood pressure with high intakes/levels), for vitamin E (reduced platelet adhesiveness with high intakes) and for multivitamin supplementation (reduced platelet aggregation), but correlations are generally weak and the area has not been investigated in detail. For case-control studies there is some support for low plasma concentrations of beta-carotene, and possibly of vitamin E, being linked to increased risk of myocardial infarction. The same does not apply to vitamin C. Altogether, owing to rapid changes in plasma AO vitamins during CV events, the data must be interpreted with caution. Concerning cohort studies, people with high intakes of AO vitamins (regular food or food supplements) have a modest reduction of risk for CV events. Plasma levels of carotene and vitamin C are stronger predictors of future CV events than dietary intakes.

Primary prevention in healthy subjects: 1 out of 8 studies has shown protective effects with beta-carotene vs. retinol on a limited number (1203) of subjects. 1 study with beta-carotene show enhanced risk of lung cancer in smokersSecondary prevention of CVD in patients with manifestations of the diseaseOut of 14 studiesIn 5, reduction of CV eventsIn 9, no effectIn 1 increase of CV events (beta-carotene).

The effects of dietary supplements of AO in the primary and secondary preventions of CVD in randomized controlled trials are summarized above. The general conclusions from these studies are as follows:

People affected by ischaemic heart disease and stroke, and populations with high occurrence of CVD often have low intakes/plasma levels of AO vitamins (causal or unfavourable lifestyle factors?).In case-control or cohort studies, people with high intakes of AO vitamins (food or supplements) have a low risk of myocardial infarction and stroke.In randomized controlled trials, AO vitamins as supplements have no beneficial effect on risk for MI or stroke (not recommendable for prevention).Some support from observational studies that low intakes of fresh fruits/ vegetables may confer a high risk for CVD.

Diets, however, especially those rich in fruits and vegetables, contain several factors or mechanisms other than AO or AO other than vitamins, exerting protective effects on various systems (Halliwell, 1999). The issue of the effects of bioactive compounds in foods and their role in the prevention of CV disease is therefore quite complex, since a large number of potentially health beneficial substances have been described (Kris-Etherton et al., 2002).

Flavonoids in particular have been investigated in relation to possible health benefits (Ross and Kasum, 2002), owing to their potential antioxidant and free-radical scavenging activities observed in vitro. Human feeding studies have shown that their absorption and bioavailability are higher than originally believed, but their overall function in vivo has yet to be clarified, whether antioxidant, anti-inflammatory, enzyme inhibitor, enzyme inducer, inhibitor of cell division, or some other function (Rice-Evans, 2001). Epidemiological studies exploring the role of flavonoids in human health have been inconclusive: some studies support a protective effect of their consumption on CVD and cancer, other studies demonstrate no effect and a few studies suggest potential harm (Ross and Kasum, 2002). Additional selected classes of bioactive compounds with antioxidant and other types of potentially healthful activities are the large groups of phenolics that are present in edible fluids — obtained from fruits of plants exposed to stressful conditions, such as grapes and olives ­ which, since the beginning of recorded history, have been part of the diet of populations living in certain areas, such as the Mediterranean basin, i.e. wine and olive oil. A vast literature is available on the properties of these compounds (German and Walzem, 2000; Visioli et al., 2002), although the impact of their consumption on health through the diet has not yet been fully assessed.

Compounds           Examples                        Sources

Flavonoids

Flavones             Apigenin, luteolin             Parsley, thyme, celery

Flavonols            Quercetin, myricetin         Onions, broccoli, apples, cherries,

berries, tea

Flavanones         Naringenin, hesperedin     Cirtus foods, prunes

Catechins            Epicatechin, gallocatechin Tea, apples, cocoa

Anthocyanidins    Pelargonin, malvadin        Cherries, grapes

Isoflavones         Genistein, daidzein           Soya beans, legumes

Phytoestrogens

Lignans,                    Enterolatone, coumestrolk         Flaxseed oil, clover
coumestran

Resveratrol                                               Grapes, red wine, peanuts

Lycopene                                                 Tomatoes, tomato products

Organosulphur              Allicin, diallyl sulphide                 Garlic, onion, leek
compounds

Isothiocyanates            Phenethyl benzyl,                       Cruciferous vegetables
sulphoranes

Monoterpenes        d-Limonene, perillic acid   Essential oils of citrus fruit, rice

bran oil, cherries, mint

Plant sterols          Sitostanol, stigmasterol    Tall oil, soybean oil, rice bran oil

Olive oil                Hydroxytyrosol, oleuropein Olives, virgin olive oil