Measure for Measure If you've been thinking ahead to the new year, and you're preparing yourself for a 2007 regimen of dieting and exercise to reduce weight, in addition to making weight-loss your goal, you might significantly improve your heart health by focusing on your waistline measurement as well. Worldwide waist A couple of years ago I told you about the INTERHEART study, which the editors of The Lancet called the most robust study ever conduced on heart attack risk factors. Late last year, the international team of investigators that conducted the ten-year INTERHEART research finished a new analysis of their data, gathered from more than 27,000 participants among several major ethnic groups in 52 countries. More than 12,400 of these subjects had suffered acute heart attacks. The other subjects - included as controls - were in good health. Incidence of heart attack was assessed in relation to subjects' body mass index (BMI - an estimate of total body fat based on weight and height) and waist-to-hip ratio (WHR - a comparison of the circumference of the waist to the circumference of the hips). Results showed a slight association between high BMI and heart attack risk. But for waist-to-hip ratio the results were much more dramatic. When subjects were grouped from lowest WHR to highest, the risk of heart attack steadily rose as well. Subjects with the greatest WHR were found to be at two and a half times greater risk compared to subjects with the smallest WHR. Needless to say, a slender hip circumference isn't the problem here; it's all about the abdominal fat. And heart attack risk is only one part of the problem. In the e-Alert "Extra Baggage" (5/18/05), I told you about a 23-year study that showed how excessive abdominal fat raises the risk of factors associated with metabolic syndrome, such as type 2 diabetes, high blood pressure, and heart disease. Protein helper When the INTERHEART researchers first reported their study, they noted that the relative risk for heart attack can be lowered by about 80 percent by doing three things: getting regular exercise, eating plenty of fruits and vegetables, and avoiding smoking. No surprises there, especially with that first item. When it comes to reducing abdominal fat, regular exercise is a must. To get rid of that extra baggage around the middle, you're going to have to get up and get moving. But once you do get moving, there are other ways to help the cause. In the e-Alert "Pretzel Logic" (3/3/05), I looked at a study that showed how a high-glycemic diet (that is; a diet with plenty of simple, refined carbohydrates) is strongly associated with obesity and a tendency to be overweight. And in the e-Alert "Beef 'n' Butter" (4/20/04), I told you how an intake of a fatty acid called conjugated linoleic acid (CLA) may provide some help when it comes to getting rid of excess body fat, especially in the abdominal area. CLA is available in supplement form and from protein-rich dietary sources such as meat and dairy products. This association between protein intake and a trimmer waist was confirmed in a study published in the Journal of Nutrition. Researchers from Canada's Population Health Research Institute recruited more than 600 male and female subjects with a variety of ethnic backgrounds. After subjects completed food frequency questionnaires they were measured to determine WHR. Energy intake from protein averaged less than 16 percent in subjects with the highest WHR. Those with the lowest WHR averaged 17.4 percent energy intake from protein.
In their conclusion the authors wrote: "Substituting a modest amount of protein for carbohydrate may reduce abdominal obesity."
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