Why you should keep your waist size in check

Adding a few pounds around the midsection during adulthood seems innocuous enough. It has its own catchy moniker - middle-age spread - and was once a sign of prosperity and success. Today it's a sign of trouble. Abdominal fat, also called visceral fat, contributes more to health problems such as heart disease and diabetes than fat around the hips and thighs.

A study in the July 2007 Diabetes Care showed that men and women whose waists spread over a nine-year period had corresponding increases in the metabolic syndrome. This constellation of risk factors - high blood pressure, resistance to insulin, and worrisome cholesterol levels - seriously increases the chances of developing heart disease and diabetes. A six-year study of nearly 73,000 women in China, published in the spring of 2007 in the Archives of Internal Medicine, shows that those with larger waists were more likely to die prematurely than those with smaller waists.

Measuring your waist offers useful information you can't get from stepping on the scale. Many people lose muscle and add abdominal fat as they go through midlife, and such changes may not affect weight. An expanding waistline, though, can warn of trouble brewing inside the body. National guidelines sound warnings when waist circumference is greater than 40 inches for a man or 35 inches for a woman.

Your waist circumference isn't your belt size. To measure your waist, wrap a flexible measuring tape around your abdomen where the sides of your waist are narrowest. This is usually even with your navel.

Use your waist as a kind of low-tech biofeedback device: A waistwise expansion over the years should be a wake-up call to re-evaluate your diet and physical activity level. Exercise can help a lot, so as we approach the New Year, consider your resolutions and work on getting rid of some visceral fat.

Have you noticed your waist expanding as you age? If so, what have you done to keep it in check?

JulieK. Silver, M.D., is an assistant professor in the Department ofPhysical Medicine and Rehabilitation at Harvard MedicalSchool. She is also theChief Editor of Books for Harvard Health Publications.

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