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Measure Abdominal Obesity, Not Just Weight

Researchers at the University of Michigan report that not all people who are fat are at high risk for heart attacks (Archives of Internal Medicine, August, 2008). They showed that 51 percent of overweight adults (36 million Americans) have normal blood pressure, cholesterol and blood sugar, while 25 percent of normal- weight Americans (16 million) have high levels of at least two of these tests. The media picked up this study with headlines such as "Better to Be Fat and Fit Than Skinny and Unfit" (New York Times, August 19, 2008).

However, the entire study is flawed. The authors measured overweight, not abdominal obesity. If you just compare weight to height to define obesity, more than 50 percent of professional football players would be obese, and they are not. I am sure that the study would show the far more harmful effects if the authors had measured abdominal obesity rather than just weight. Storing fat primarily in your belly can predict premature death. It means that a person's insulin levels are very high and high insulin levels mean that your body is not responding to insulin so you are at increased risk for a heart attack, stroke, kidney damage, arteriosclerosis and all the other harmful side effects of diabetes.

Other studies do show that it is better to be fat and fit than out-of-shape at any weight. Steven N. Blair of the University of South Carolina showed that adults over 60 who had higher levels of fitness lived longer than unfit adults, independent of how fat they were (JAMA, December 5, 2007). He showed that fat people who were able to run on a treadmill longer than unfit, fat people had better blood tests and fewer heart attacks and deaths.

How should these studies affect you? If you are overweight, you increase your risk for heart attacks, strokes, cancers and premature death. If you store large amounts of fat primarily in your belly, you are at such great risk for premature death that you should check with your doctor and probably get a thallium stress test to see if your coronary arteries are already blocked. If they are not blocked, start a supervised exercise program and diet to lose weight and become fit. If your coronary arteries are already blocked, you will need immediate counseling about future treatment.

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Dear Dr. Mirkin: If I exercise and eat salty foods, as you recommend, won't my blood pressure go up?

People who continue to exercise throughout their lifetimes are far less likely to develop high blood pressure and the more they exercise, the less likely they are to develop high blood pressure (Journal of Hypertension, June 2008). In various studies, up to 91 percent of the North American population suffers from high blood pressure which puts them at markedly increased risk for strokes, heart attacks, kidney damage and arteriosclerosis. Virtually all scientists agree that this frightening incidence of high blood pressure is caused by lifestyle, and the major lifestyle factors are lack of exercise, obesity, and eating too many calories, refined carbohydrates and saturated fats.

For some people, but not all, increased intake of salt also contributes to high blood pressure. However, if you exercise, you need to take in extra salt since salt is the only mineral that you lose in large amounts through sweating. Low salt levels can cause muscle damage, fatigue and depression. Salt deficiency can also raise high blood pressure because it causes your kidneys to produce large amounts of renin and your adrenal glands to make more aldosterone. These hormones constrict arteries to raise blood pressure.

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Dear Dr. Mirkin: What are the best sources of carbohydrates during exercise?

Athletes have known for more than 65 yeas that eating extra carbohydrates during exercise can markedly improve their endurance. A study from the University of California, Davis, shows that the form of carbohydrate doesn't make any difference (International Journal of Sport Nutrition and Exercise Metabolism, April 2008). Sugar in sports drinks, gels or sports jelly beans helped athletes exercise faster and longer and produced much higher blood sugar levels than athletes who drank flavored water that did not contain sugar. If you are going to exercise for more than an hour, you can drink any sugared liquid or eat any carbohydate-containing food that tastes good to you.

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Recipe of the Week

Here's a new way to cook whole grains, from reader Marti K.:

"I have a delightful, foolproof way of cooking whole grains. I preheat the over to 350 degrees Fahrenheit, and put the (raw) grains into an oven-proof casserole (usually I use pyrex or ceramic crockware) and pour over them boiling liquid in the proper amount for the quantity of grains I've started with. Cover this with the casserole's lid, and cook for about 50 minutes. As long as you've used the correct amount of liquid for the quantity of grains, the time is not crucial - it depends which grain and the consistency you desire, but it takes very little pot-watching, and when cooled, the casserole can go into the refrigerator, where one can scoop out servings as needed. I usually cook enough for a week at a time."

Quantities and more on cooking whole grains

Easy recipes featuring cooked whole grains:

Pink Beans and Brown Rice
Split Pea and Barley Stew
Wild Rice Fruit Salad

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE

June 25th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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