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Orange or roseapple?

April 8th, 2015


Orange or roseapple?

Apples? Pears? I’m not asking you to pick your favourite fruit. I’m talking about the human shape. Some people are shaped like an apple, accumulating fat around the waist. Some people are shaped like a pear with fat accumulation falling mostly around the hips.

This is a Western comparison, so I would like to compare using Thai fruits instead – orange and roseapple. Some Thais might not be familiar with pears, so comparing this body shape with a roseapple might make it easier for them to visualise. I don’t think there are many Thais who have never eaten a roseapple (and if there are, these people should, at least, be familiar with noses shaped like a roseapple).

Being overweight is certainly not healthy, at least for the knees and joints. It is also important where in the body the extra fat is accumulated. Lately, it has been found that obese people, who are shaped like an orange, meaning they have more fat around the waist than other areas in the body, run a higher risk of having a heart disease, becoming paralysed or developing diabetes, hypertension and certain types of cancer. Roseapple-shaped people, those with extra fat hanging mostly around the hips and thighs, have a lower chance of getting those diseases. Other health risks are also minimised, especially in women.

Weight and shape is not only a health concern; it plays an important role in appearance. The definition of beauty changes with time and trends. If you visit museums abroad, you may see women in old paintings with plumper (or, from a contemporary perspective, fatter) bodies. Sculptures of Venus, the Roman goddess, make her look quite plump and well-built compared to models today. Luckily for Venus, fat seems to have accumulated mostly in her hips and thighs.

People nowadays live a lot longer. Many people in the past died from infections, but modern medicine is so effective in treating and preventing infections that we are able to live longer and it takes a lot more to kill us. Being overweight wears the body down more quickly and this is especially the case the older one grows.

Obesity is a health hazard, but thinness isn’t healthy either. Also, one needs to taken into account where the fat is stored; around the waist is more risky than around the hips. By keeping your stomach firm and flat, you will also be healthier.

Doing sit-ups is a good workout, as it can tone up the stomach muscles as well as treat back pain. In order to lose tummy fat and body fat – and not just tone up one’s muscles – one needs to do aerobic exercises (dancing, running, swimming or cycling).

Tools and equipment that claim to help you shed fat from certain areas effortlessly are just a waste of money and time. They don’t help your physical health, just your mental health’ they trick you into thinking you’re very close to having a beautiful body (or, even worse than that, they can make you become obsessed with having a beautiful body).

Why does fat gather around the hips for some, and the waist for others? And no, it’s not because you use your waist muscles so much that fat migrates to the hips and thighs. The reasons have mostly to do with gender (men have a higher chance of developing belly fat, while women after menopause can develop thicker waists), genetics and exercise.

Orange-shaped people may have high LDL cholesterol and triglyceride levels, high blood pressure and blood-sugar levels. They might also be resistant to insulin, and have lower levels of HDL cholesterol (the “good” one). These factors may give rise to diseases affecting the heart, blood flow and brain.

Fat in the hips and thighs is stored in cells under the skin (subcutaneous fat) while belly fat accumulates around the liver and other organs in the torso (visceral fat). Inner fat also produces oestrogen, which is partly why fat people run a greater risk of developing breast cancer after menopause.

Apart from cardiovascular disease, brain disease and cancer in people with more belly fat, research by Columbia University shows that orange-shaped (or apple-shaped, in Western terms) people also have more chance of developing amnesia (forgetfulness). It is also reported that thick-waisted people, 40 to 45 years old, have a threefold chance of developing amnesia when they reach their 70s. Pear-shaped people don’t have an increased risk.

So, how much is too much for belly fat? There is a measurement method used by doctors by comparing the waist to the hips. Measure the waist, slightly above the belly button, and then measure the widest part of the hips. No cheating, no sucking in! Measure the waist from the midpoint between the lowest ribs (the ticklish area). This might be difficult for those with a belly so big it pushes the belly button down with the bulk (seriously, it’s been known to happen). If your belly button travels down south, there is no need to measure. You are at risk for sure.

The risks can be measured. If your waist-to-hips ratio is more than 1.0 (for men) or 0.9 (women), then you’re at risk. Men with waistlines in excess of 40 inches (35 for women) run a higher risk of deteriorating health. But these figures are far from exact. A man with a 39.5-inch waist shouldn’t consider himself safe. Moderation is the key. Try to keep your weight proportional to your height; that’s the surest protection from ill health.

Prof Nithi Mahanonda is consultant cardiologist and interventionist, Perfect Heart Institute.


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