Monday, April 19, 2010

Pear or Apple - Which are you?

Here is the latest email from Dr. Jacobs.

The Fairy Tale of Spot Reduction: Can You Turn an Apple into A Prince?

Once upon a time, in a land far away, there was a genie who granted wishes, a frog who turned into a prince when kissed, and a daughter who could spin straw into gold. In our household, these stories are part of my children’s bedtime routine, but when did fairy tales find their way into fitness? With billions of dollars spent annually on weight loss in America, it is no wonder that myths have been presented as truth when a fortune is at stake.

Our 14-week program is well underway and a commonly asked question is, “How can I get rid of my love handles and have a flatter stomach?” Many people mistakenly think that by doing hundreds of sit-ups a day, they can obtain a flat stomach. The reality is that there is no such thing as spot reduction. By working a specific muscle group, you will strengthen that muscle (this is known as the Principle of Specificity), but you will not be able to reduce the amount of fat in a specific targeted area of your body. It is not possible to turn fat tissue into muscle tissue. To lose fat, you must burn more calories than you consume. Energy expenditure can vary for individuals with disabilities. In a recent article released this month in Medicine & Science in Sports & Exercise, Collins, et al, present a compendium of energy expenditure of 27 commonly performed activities in individuals with spinal cord injuries. A compendium of physical activity for non-disabled individuals was previously developed by Ainsworth, et al, in addition to the compendium of energy expenditure for children developed by Ridley and Olds.

A successful exercise program which includes cardiovascular exercise and resistance training will increase muscle mass and decrease fat stores throughout your body. For more information on understanding weight loss, see this month’s Weight Smart Column, click here.

Genetics play a role in where your body stores fat. Typically, men gain more weight in their abdominal regions and women tend to gain weight in their gluteal regions. This is commonly referred to as the apple- vs. pear-shaped body type. There are exceptions to this rule and it is not always possible to determine your body shape by looking in a mirror. Simply measure your waist circumference and your hip circumference, and then calculate your waist-to-hip ratio.

To determine your body shape, follow these steps:
• Using a tape measure (a cloth one such as one that a tailor might use), measure your waist at the level of your navel and your hips at their widest point. Make sure you place the tape measure directly on your skin; do not measure over your clothes. Be sure the tape is tightly wrapped on your skin, but be careful not to pinch the skin together.

• To ensure accuracy, measure your waist and your hips several times each and get the average of the measurements for both your waist and your hips.

• To determine your waist-to-hip ratio, divide the average waist measurement by the average hip measurement. You can do measurements in either inches or centimeters, as long as you use the same increment for both waist and hip.

Avg Waist Measurement ÷ Avg Hip Measurement = Your Waist-to-Hip Ratio.

For Men: If the ratio is less than 1, a hip and leg fat storage pattern (pear shape) is indicated. If the ratio is 1 or greater, an abdominal storage pattern (apple shape) is indicated.

For Women: If the ratio is 0.8 or less, a hip and leg pattern (pear shape) is indicated. If the ratio is greater than 0.8, an abdominal storage pattern (apple shape) is indicated.

What does your body shape say about your health?

If you are apple-shaped, you are more likely to experience insulin-related metabolic problems and are at a greater immediate risk for high blood pressure, elevated triglycerides, high cholesterol, heart disease, and diabetes. Intra-abdominal fat (IAF) that occurs in the apple shape is closely associated with Type 2 diabetes as well as insulin resistance. This kind of abdominal or centralized fat is also associated with increased risk of ovulatory dysfunction, sleep apnea, and hormonal cancers (e.g., breast cancer). If you are pear-shaped, it is important to address the issue now because as time progresses, fat will accumulate above your waist line and your risk for chronic disease will increase in a similar fashion.

Other risk factors related to developing chronic disease include:
1. Poor diet
2. Lack of physical activity
3. Waist circumference of 28.5-35.0 inches or greater for women and 39.5- 47.0 inches or greater for men
4. A Body Mass Index (BMI) greater than 25.0
o To determine your BMI, click on here.
5. Blood pressure of 120-139/80-89 (prehypertensive) or 140/90 or greater (hypertensive)
6. Fasting blood glucose (blood sugar) ≥ 100
7. Cholesterol (total cholesterol >200), and
8. Family history.

Take a moment to create a list numbered 1 to 8 to assess your risk factors. This list can be a very useful tool to establish your health promotion plan. If you are unsure about some of these risk factor measurements and have not had a complete physical within the last year, see your doctor to determine your risk.

•Collins, E. G., Gater, D., Kiratli, J., et al. (2010). Energy cost of physical activities in persons with spinal cord injury. Med Sci Sports Exerc. 42(4):691-699.
•Ainsworth, B. E., Haskell, W. L., Whitt, M. C., et al. (2000). Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 32(9 Suppl):S498-516.
•Ridley, K. & Olds, R. S. (2008). Assigning energy costs to activities in children: a review and synthesis. Med Sci Sports Exerc 40(8):1439-46.

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