Going to Waist Part I by Dr. Mauro DiPasquale

I’ve had a lot of women and men complain that they’re putting weight on and it’s all going to their waistline. Besides being unattractive and limiting your ability to touch, and sometimes even seeing your toes, fat around your middle is more of a health hazard than body fat any where else.

Several new studies show that increasing waist size increases the risk for developing metabolic syndrome, diabetes, heart disease, and other illnesses. In fact the size of your waist appears to be a better predictor of disease than either your weight, your BMI (your weight in relation to your height) or your waist-to-hip ratio.

Waist size is easy to measure using a tape, but most people are aware that their waist is expanding before then even think of measuring it. That’s because you can tell by how your clothes fit and how you look in the mirror without clothes on. But for a more objective view, and as a way to measure your risk, it’s a good idea to use a tape measure.

If you’re of average height and your waist size is more than 36 inches, then it’s time to do something about it. If it’s more than 40 inches then you’re already at risk. That’s because abdominal fat measured by waist circumference can indicate a strong risk for obesity, diabetes and other diseases whether or not the person is considered overweight or obese according to his BMI.

Several studies have shown a correlation between waist size and cholesterol, blood pressure, diabetes and other health risks. The most recent study looked only at men’s waist sizes relative to diabetes risk.1 The authors of the study found that risk started to creep up when the belt size went higher than 35 inches, and that 80 percent of type 2 diabetes cases occurred in men with waists larger than 37 inches.

In a study based on data collected from 27,270 men tracked over 13 years through the Harvard Health Professionals Follow-Up Study2, men who had a waist size of 40 inches or more were 12 times more likely to develop the type of diabetes in which the pancreas either doesn’t make enough insulin or doesn’t respond properly to insulin than men with waist sizes of 34 or less. With a waist size of 34 to 36, the diabetes risk doubled; at 36 to 38 inches, the risk tripled; and at 38 to 40 inches, the risk for the disease was five times greater.

The bottom line is that an expanding waist line, while something to avoid for aesthetic reasons, is also a significant health risk.

Spider Bite Tale – Recently, a woman in her mid fifties complained to me that after being bitten by a spider she was put on a cortisone pill for the swelling. While she was on the cortisone, and especially after stopping it she complained of gaining weight, mostly around the belly, and that no matter how hard she dieted and exercised, she just couldn’t budge that belly fat.

And I’ve heard this story before from many others. Not about being bitten by a spider or taking cortisone-type drugs, but about a spreading waistline. The problem, as I see it, is two fold. First of all, increasing cortisol levels by taking cortisone drugs, as in the woman who was bitten by the spider, or simply secondary to inflammation, can be an instigator for obesity in general and especially abdominal obesity.

Once you gain that fat, it only takes normal levels of corticosteroids to maintain it. But you would think that at least theoretically you should be able to lose this weight and fat gain by careful dieting and exercise.

Unfortunately this is not the case with a lot of men and women because there are factors at play that may be responsible for their inability to lose weight. A lot of this is due to insulin resistance secondary to the increase in pro-inflammatory cytokines and increase in cortisol, leading to a tendency for weight gain rather than weight loss.

There is definitely a link between the pro-inflammatory cytokines and both insulin resistance and excess local glucocorticoid activity. For example, it’s been shown that an increase in pro-inflammatory cytokines results in an increase in insulin resistance, which in turn increases the formation of local cortisol production from cortisone by the enzyme 11beta-hydroxysteroid dehydrogenase.

In any case, the solution to weight gain and a spreading waistline is decrease the levels and thus effects of the pro-inflammatory cytokines, increase her insulin sensitivity, and decrease the formation of cortisol in the fat cells.  :: LipoFlush III :: targets all of the above, plus much more.

For more information on Inflammation and Obesity see articles II and III in this series.


1 Wang Y, Rimm EB, Stampfer MJ, Willett WC, Hu FB. Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. Am J Clin Nutr. 2005 Mar;81(3):555-63.
2 Koh-Banerjee P, Wang Y, Hu FB, Spiegelman D, Willett WC, Rimm EB. Changes in body weight and body fat distribution as risk factors for clinical diabetes in US men. Am J Epidemiol. 2004 Jun 15;159(12):1150-9.

:: Part I ::  Part II ::  Part III ::

:: Dr. Mauro Di Pasquale :: is one of the most influential voices on diet, performance and athletic training in the world. His innovative work in finding safe nutritional alternatives to anabolic steroids and other performance-enhancing drugs has won him praise from athletes, trainers and fitness experts around the globe. Dr. Di Pasquale was a world-class athlete for over 15 years, winning the World Championships in powerlifting in 1976 and world games in 1981.

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