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The Corporate UPDATE

Volume 3, Issue 7 February 2011

Studies have shown that an elevated BMI resulting in

Fit, Fat & central is much more sensitive in predicting future

heart attacks than body weight alone. The larger the

Lisa Sheehan RN, MSN, CFNP, COHNs-CM percentage of a person’s waist measurement compared

Palomar Pomerado Corporate Health Services to their hip measurement, the greater the risk for cardiac

disease. The risk of heart attack increases because

visceral fat differs significantly from subcutaneous fat

Many of us are looking forward to the upcoming spring (which is found underneath the skin), and intramuscular and summer months. We relish the longer daylight hours, fat (found interspersed in ). Increased warmer weather and outdoor activities. Unfortunately, the abdominal fat may produce substances that cause long winter months may have taken a toll on our bodies, . Inflammation in blood vessels and as a combination of rich foods and decreased activity throughout the body may raise heart disease risk. may have caused us to gain weight. As our body weight creeps upward and our activity slows down, an increase In addition to cardiovascular problems such as a heart in our Body Mass Index (BMI) is the inevitable attack, an elevated BMI can increase blood pressure. consequence. Body Mass Index is the measure of High blood pressure is also known as . someone’s weight in relation to their height. You can use Blood pressure (BP) is the force of blood pushing against an on-line BMI calculator such as can be found on blood vessel walls. The systolic or top number measures pph.org under “Health Resources”, to easily check your the force of the pressure against the arteries when the

BMI. heart contracts. The diastolic, or bottom number,

measures the pressure inside the arteries when the heart

Why does BMI matter? An elevated BMI reflects general is at rest. Blood pressure is directly affected by obesity. obesity and possibly increased waist-hip ratio, which For every 10 pound weight gain, blood pressure may increases the risk for the development of high blood increase by 20 mm in the systolic (top number) and 11 pressure and other cardiovascular diseases, elevated mm in the bottom (diastolic number). Hypertension is cholesterol levels, , , certain dangerous because it makes the heart work harder to and contributes to the development of pump blood to the body. Chronically elevated blood

Alzheimer’s disease. Persons who are shaped more like pressure damages the main blood vessels known as an apple typically have a higher waist/hip (W/H) ratio arteries, as well as the arterioles which are very small than those who are shaped like a pear. arteries that connect larger arteries to tiny capillaries.

Vessel damage leads to an increased risk of heart attack,

An excess of visceral fat, also known as central obesity, stroke, kidney and eye disease. A normal blood pressure results in the "pot belly" or "beer belly" appearance, in is less than 120/80. Be sure to see your medical provider which the abdomen protrudes excessively. A waist if your blood pressure reading is higher. circumference of 35 inches or greater in women, and 40 inches or greater in men suggests that the waist/hip ratio Other potential problems arising from increased BMI and will be abnormal. Increased W/H ratio is an overt sign of W/H ratio include diabetes and Metabolic Syndrome. The increased abdominal or visceral “white fat” deposits risk of developing diabetes increases with increased interspersed throughout the abdominal organs. W/H ratio abdominal (visceral) fat. Abdominal fat is especially is the measurement of waist circumference divided by hip active hormonally, secreting a group of hormones that circumference. A healthy W/H ratio for women is 0.8 or may possibly interfere with the body’s ability to use less; a healthy waist/hip ratio for men is less than 1.0. insulin. In other words, being along with a

Visit pph.org and look under Health Resources for an high W/H ratio may cause cells to change, making them easy online calculator to determine your Waist/Hip resistant to the hormone insulin. measurement. (Continued on page 2)

The Corporate Health UPDATE Palomar Pomerado Health The Corporate Health UPDATE

Volume 3, Issue 7 February 2011

Insulin carries sugar from blood to the cells, where it is used for energy. When a person is insulin resistant, blood

sugar cannot be taken up by the cells, resulting in high blood sugar. In addition, the cells that produce insulin have to

work extra hard to try to keep blood sugar normal. The overworked insulin cells may cause the cells to completely

fail over time.

The risk of developing Metabolic Syndrome also increases with an elevated BMI and Waist/Hip ratio. Metabolic

Syndrome, which affects 27% of adult Americans, is a cluster of obesity-related risk factors that increase the risk for

heart disease and diabetes. A person with Metabolic Syndrome has almost twice the risk for coronary heart disease

and five times the risk for developing . Three or more risk factors, including triglyceride levels of

150mg/dl or higher, a waist line of 40 inches or more for men, and 35 inches or more for women, low levels of HDL,

the “good” cholesterol below 40mg/dl for men and below 50mg/dl for women, high blood pressure of 135/85 or

higher, and/or high fasting blood sugar of 100mg/dl or higher must be present for a diagnosis of Metabolic

Syndrome.

Certain types of cancers have also been linked to elevated BMI and W/H ratios. occurs when cells grow out

of control. Cancer risks increase with weight gain and abdominal fat because the “white fat” cells embedded in and

around the abdominal organs release hormones that increase cell growth, which may result in cancer of one or more

of the abdominal organs.

Alzheimer’s disease has also been linked to elevated BMI and W/H ratios. Studies have shown that excess body

weight is associated with brain structural and functional changes. In older adults, higher BMI was associated with

smaller global brain volumes. In other words, the brains of older, overweight persons were smaller than those who

were of a normal weight and W/H ratio. Studies also show that an elevated W/H ratio and increased BMI cause

areas of the brain associated with memory and learning to shrink. In addition a brain positron emission tomography

(PET scan) study found that higher BMIs are associated with lower glucose metabolism in the brain, resulting in

poorer memory and poorer “executive” functions such as planning and decision-making. Obese persons (BMI of 30

or greater) at midlife had dementia risk that was twice as high as controls in older adulthood.

So, what to do? If your calculated BMI falls in the overweight or obese zone, and your waist/hip ratio shows that you

fall in the medium to high risk zone, even a small change can make a big difference. Losing 10% of your body weight

may result in your BMI dropping from Overweight to the Normal zone; and your waist/hip ratio may drop below 1.0

(for men) or 0.8 (for women). The best way to achieve these results is to monitor your portion sizes, increase intake

of fresh fruits, vegetables and whole grains, and decrease high fat, high calorie foods and drinks. It is also very

important to get enough —30 minutes of exercise daily, combined with dietary modifications can painlessly

reduce your BMI and W/H ratio, resulting in a slimmer, healthier you! Start now, and by the time summer rolls

around, you will be just a fraction (90%) of your previous self!

For information on our services, contact our business development representative: Duane Johnson 760.637.7665.

The Corporate Health UPDATE Palomar Pomerado Health