Question: My partner wants to get his weight down to a healthy level. He’s approaching 40, 1.9m and about 116kg. He has slim legs but carries weight around his stomach. He often complains of swollen feet and ankles, and his blood pressure is on the high side of normal. Would you suggest we contact a nutritionist?
Answer: If we want to live a long, happy life, then we need to recognise sooner rather than later that “prevention is better than cure”, a point aptly made about 500 years ago by Catholic priest Desiderius Erasmus. Your partner is heading down the right path with plans to improve his weight.
With a body mass index (BMI) over 30, he falls into the category of obese, which may explain his swollen feet and ankles; being overweight or obese is a common cause of this condition. Unfortunately, being overweight also increases the risk of heart attack, stroke, cancer, diabetes and many other medical conditions. But worse than this, his excess abdominal weight is a particular cause for concern, as fat stored in the abdominal region further increases the risk of these medical conditions.
Unlike the subcutaneous fat stored on hips and thighs, abdominal fat is largely made up of visceral fat. Several theories have been proposed to explain why visceral fat deposited in the abdominal region is such a health risk. One is based on the relatively recent discovery that visceral adipose tissue (VAT) is more than just a lump of fat, but is actually biologically active and behaves much like an organ.
For example, VAT releases hormones that affect our health, so an excessive amount of this body fat may disrupt the normal balance of hormones. VAT also releases other signalling molecules, such as cytokines, which are part of our immune system. Certain cytokines promote inflammation, so excessive VAT may promote chronic low-grade inflammation and contribute to an increased risk of cardiovascular disease.
There are major differences in the amount of visceral fat present in each gender (pre-menopause): men have twice as much VAT as pre-menopausal women. Interestingly, this difference in fat deposits explains much of the greater risk of cardiovascular disease for men than for pre-menopausal women. VAT also differs by ethnicity; for example, Asians are particularly susceptible to visceral fat deposits.
Still, the who and how of VAT is by-the-by; the fact remains – abdominal obesity is a health risk. Therefore, men should aim for a waist circumference less than 100cm (39 inches) and women less than 90cm (36 inches). It’s also recommended that men have regular cardiovascular disease (CVD) risk assessments from 45 years of age, and women from 55 years of age. High risk groups, such as people who are overweight or smoke, should begin these assessments 10 years earlier.
Given your partner’s age, weight, abdominal size and slightly elevated blood pressure, I’d strongly recommend he visit his GP or the practice nurse for a CVD risk assessment immediately to get a better picture of his overall risk. The good news is a healthier diet and regular physical activity will help greatly.
A significant improvement to our health can result from the loss of even a small amount of excess weight. According to the National Heart Foundation, losing 5-10% of our body weight can:
- lower blood pressure;
- improve sleep patterns;
- improve energy levels;
- improve blood cholesterol levels;
- improve blood glucose (sugar) control; and
- lower the risk of heart attack or stroke.
A dietitian or registered nutritionist can then help your partner develop healthier eating habits.
Note: whereas a registered nutritionist promotes nutritional health and well-being and the prevention of nutrition-related disorders and ill health, a dietitian performs these preventative health functions and is also clinically trained to provide nutritional therapy for existing health conditions, such as cardiovascular disease. Contact details for dietitians and registered nutritionists are available through the relevant professional bodies:
Email: firstname.lastname@example.org, or write to “Nutrition”, c/o Listener, PO Box 90783, Victoria St West, Auckland 1142.