Why Being Skinny Doesn't Mean You're Fit

Remember when a total cholesterol reading of under 200 was the standard for judging cardiovascular health? Today, of course, we know that it's the components of cholesterol (LDL, HDL, the size of those cholesterol particles, and triglycerides) that are much more predictive of heart health. Well, our understanding of total weight and its effects upon your heart has evolved in similar fashion. It's not your total weight but the characteristics of that weight—how much is fat and where it's deposited—that matter most.

Surprised? Thank the scientists at the Mayo Clinic, who are behind this recent discovery. After comparing various health markers with the weights and body mass index numbers of thousands of adults, they found that more than half of those with normal weights and BMIs actually had "high body-fat percentages as well as heart and metabolic disturbances." In other words, they had the same risks of coronary disease, diabetes, and other chronic illness as people who weighed much more.

This research, and its sobering implications for millions of Americans, led to the establishment of a new condition called normal weight obesity (NWO). This is more than just the latest fat phobia. It's worth paying attention to because the accumulation of fat in the body, especially in the belly and around internal organs, causes low-level inflammation that gradually damages tissue and blood vessels. (Think of it as metabolic rust.) So even though your weight or BMI may be within acceptable limits for your height and age, don't be lulled into a false sense of security. Do your own analysis, starting with these steps:

1. Stop being preoccupied with pounds.
As with total cholesterol, total weight is just one general assessment of your health. Yes, people who are trying to lose weight are more likely to succeed if they weigh themselves often. But seeing numbers that are within a healthy BMI range may actually disguise your heart disease risk. Keep them in perspective.

2. Measure your body fat. For a quick estimate of this key factor, wrap a cloth measuring tape around your naked waist just above your belly button. If your weight is fairly normal but the number you see above your navel is 35 inches or more (40+ inches for men), you may have NWO. For a more exact reading, ask your doctor (or health club) to measure your body fat. This can be done using a variety of noninvasive methods. If it's higher than 30 percent (20 percent for men), you likely have NWO.

3. Get a blood test. Ask your doctor to order a thorough blood analysis at your next physical. Warning signs of NWO include low HDL (total cholesterol and LDL may be normal), along with elevated triglycerides, blood sugar, and blood pressure.

4. Target belly fat.
If you're diagnosed with NWO, take aim at visceral fat. Despite how entrenched it may seem, you can lose it. The keys are: Avoid the white stuff (white bread, rice, pasta, and other refined carbohydrates). Add monounsaturated fats, which target belly fat, to your diet. And do interval exercises to burn more fat and strength-training to build lean body mass.

5. Keep tracking fat. Just as you hop on the scale to keep tabs on your weight, do the same with your body fat. Have it measured periodically at your doctor's office or health club. Or just observe the notches where your belt buckles.

Conversely, if you're considered overweight by current standards, there may be some good news here. If your body-fat percentage is lower than 30 percent (20 percent for men) and your blood chemistry is normal, then you are among the "fat and fit." (Many athletes are in this category.) Continue to eat smart and exercise, but accept your body for what it is and know you're not unhealthy because of it. Feeling fat and feeling healthy are no longer mutually exclusive.

More Heart-Healthy Advice

Staying hydrated is one simple way to keep blood pressure in the safe zone. See 12 more tips to lower hypertension naturally at prevention.com/bloodpressure.

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