Recently, a study in the British medical journal, The Lancet, suggested that using the BMI as a marker for disease may not be accurate as using the waist measurement. Why? The BMI does not differentiate between adipose tissue (fat) and lean body mass (muscle). In other words, a body heavy with fat and a body heavy with muscle could have the same BMI, yet one would have little risk of developing disease and the other a far greater risk.

Why The Waist?

Abdominal fat is a greater predictor of health risk than fat on other parts of the body, such as the hip and thigh area in women. (This applies even if your BMI falls within the normal range.) People with mid-section fat are more likely to suffer from coronary heart disease and related diseases such as high blood pressure, stroke and Type 2 diabetes. It also increases the risk for certain cancers including those of the breast and colon. Your risk of developing these life-threatening diseases is further increased if you smoke.

Measuring Up

To measure your waistline, place a tape measure around your bare midriff, just above your hipbone. Make sure it sits firmly in place, but don’t pull so tight that it makes an indentation. Don’t suck your stomach in, but stay relaxed.

Men with a waist measurement greater than 102 centimeters (40 inches) and women with a waist measurement in excess of 88 centimeters (35 inches) are considered obese and at greater risk of developing the diseases mentioned above.

Why Our Waistlines are Bigger

Recent studies into the cause of obesity in Canada have revealed that most obese people believe that a “portion size” is almost twice that recommended by nutritionists, and also fail to get as much physical activity as they should. We are eating up to four times the amount that we were 40 years ago, when Canadians generally adhered to the principal of three square meals a day and no snacks. With the advent of email and the Internet, activity has dramatically declined, meaning fewer calories are burned off during normal daily activities.

Marketing also plays a significant role in our increasing waistlines. Larger portion sizes are perceived as better value - something that restaurants and many fast food outlets are well aware of.

Add to this the fact that baby boomers eat out more frequently than previous generations, and you have a recipe for an expanded waistline and increased health risk.

What You Can Do

If your waistline measurement confirms that you need to wage battle on extra pounds of fat, you may want to check out your portion sizes and activity level. Many people swear that they are “only” having a specific number of calories a day, and take great pains to add their calories up. Since many calorie charts base their values on portion sizes, it is easy to take in double or triple the number of calories that you believe you are consuming in a day.

Here are some portion sizes for reference:

• 1 serving pancakes = 1 pancake, the size of a CD
• 1 serving cheese = the size of 4 dice
• 1 serving bread = 1 average slice
• 1 serving pasta/rice = 1/2 cup, the size of a hockey puck
• 1 serving meat = 50-100g, the size of a deck of cards, or your palm
• 1 serving nuts = 3/4 cup, the amount held in your cupped palm
• 1 serving juice = 1/2 cup
• 1 serving fruit or vegetables = 1 medium sized whole fruit such as an apple or banana, 1/2 cup diced fruit or vegetables.

The Canada Food Guide recommends that the average adult consume the following on a daily basis:

• Grain products: 5 - 12 servings
• Fruit/vegetables: 5 - 10 servings
• Milk products: 2 - 4 servings
• Meat & alternatives (eggs, peanut butter, tofu): 2 - 3 servings

Eating in restaurants or fast-food takeouts can be particularly challenging since the portion sizes are usually considerably larger than recommended. The typical serving of pasta, for example, is three cups - six times the serving size of one-half cup. A six-inch sub will give you three grain servings, and a quarter-pound burger almost two meat servings.

If you find it challenging not to eat everything on your plate, you may wish to ask the server to place half your order in a take-home box before you are served your food. Most restaurants are used to this request and are more than happy to oblige. When you are going to eat fast food, plan to divide the serving yourself, place it in a handy container, and enjoy what you have left. Remember that this was likely the full serving size in your grandparents’ day!

Eating slowly will help curb any cravings for additional and unnecessary food. (It takes approximately 20 minutes after the first mouthful of food for your brain to receive the message that you are no longer hungry.)

Reducing your portion size and eating slowly can painlessly trim your daily calorie intake by 100 - 800 calories (a loss of approximately ten to 80 pounds/4.5 to 36 kilograms in a year).

To further trim calories, and your waistline, try increasing your activity level by 100 calories a day. This will result in the loss of a further nine pounds (four kilograms) a year. The following activities burn off approximately 100 calories:

• 15 minutes brisk walking. (Park your car 15 minutes away from the mall or your workplace and double the calorie expenditure.) 
• 15 - 20 minutes stair climbing (this can be accumulative. Walking up one or two flights, several times a day will quickly add up to 15 minutes).
• 20 minutes housework. Make your daily household chores count by power cleaning. Hold in your abdominal muscles (particularly when vacuuming) and move quickly from chore to chore to raise your heart rate and tone your muscles.
• 25 to 30 minutes gardening will not only tone your muscles and elevate your heart rate but also help reduce stress. Most people find gardening - even pulling weeds - relaxing. Remember to tighten your abdominal muscles and bend your knees when lifting or pushing heavy objects.

Addressing portion size and increasing your activity level even slightly will help you pare down the pounds where they count: around your waistline. You will look trimmer, feel better, and reduce your risk of life-threatening diseases. What do you have to lose?

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