The Truth About
Special to the Journal By
Geoffrey Moore, MD
There has been a
lot of talk in the media lately about the serious health problems associated
with obesity, body mass index (BMI), and so-called “belly fat.” These are
important conversations to have; however, I rarely hear enough discussion about
the critical role of physical activity in reducing the health risks associated
with abdominal obesity.
There are robust
data demonstrating that exercise is the single most important factor in
effectively reducing abdominal fat. This is significant because abdominal fat
is a specific marker for increased risk of cardiovascular disease, which is the
number one cause of death in this country.
One of the seminal
studies to highlight the relationship between physical activity and increased risk
of heart attack was done in the 1950s by Jeremy Morris, a London doctor and
researcher. His famous work, known as the “double-decker bus study,” was a non-randomized
study of the drivers and conductors working on London’s double-decker buses. The
drivers and conductors shared the same work environment, but the drivers sat
all day long while the conductors walked through the bus and up and down stairs
all day. The data showed that the drivers were twice as likely to die of a heart
attack than the conductors. The investigators also examined the uniforms of the
drivers and conductors and determined that abdominal girth was an additional risk
factor for heart attack!
are looking more specifically at the relationship between waist circumference
and cardiovascular risk factors, and finding that abdominal fat, not body mass
index (BMI), indicates higher risk. In other words, it is the fat around your
middle--not the fat on your thighs or under your arms—that is most dangerous in
terms of heart disease and diabetes. Additionally, several studies now show
that the most effective way to reduce abdominal fat is through exercise.
Reducing your girth
and lowering your risk
It turns out that
you can reduce your risk for cardiovascular disease through exercise even if
the number on the scale doesn’t go down! If you can wear your belt on a smaller
notch, if your clothes are getting loose at the waist, if there is more room
between you and the steering wheel of the car, you are lowering your risks.
Given that belly
fat poses the greatest risks and that we know reducing belly fat is really only
possible through exercise, one logical conclusion is that exercise is medicine.
For many people, it’s their most important medicine. If you want to reduce the
amount of abdominal fat you are carrying, you’ve got to become more active:
physical activity will help you do this more than any medicine or supplement
and it is very cost effective.
Where to start
If walking does
not cause you pain, start out on a level path. Cass Park, Sapsucker Woods, the
South Hill Recreation Trail, and Cornell Plantations all have safe and
beautiful walking paths that are level and give you the added benefit of
getting in touch with nature. The key is to just get started. Don’t go hard,
just walk a few minutes every day and gradually work your way up to walking 30
to 40 minutes, five days a week. If walking is too painful for your joints,
then check out a water aerobics class at the Island Health Center or the YMCA. Your
main goal is to get moving.
will not get rid of abdominal fat; you must include exercise as part of
the program. One of the best prescriptions I can give to improve and extend your
life is to go for a walk every day to reduce the size of your waist.
expertise spans the spectrum from physical activity and lifestyle modification
in the care of chronic disease, to sports medicine for athletes. A specialist
in lifestyle medicine, he is the director of clinical services at the Cayuga
Center for Healthy Living (CCHL), a program of Cayuga Medical Center. For more
information about CCHL, call 607-252-3590.