How Does Your Belly Measure Up?

Tape Measure

Use this to assess your risk for disease.

It seems that many Americans are in denial about their health. With two-thirds of our country classified as over-weight or obese and people looking to lay blame on everything or everyone but themselves, I find it alarming when people are surprised, no SHOCKED, when I tell them they are in the over-weight or obese.To classify people as over-weight or obese, we often measure their height and weight and plug it into an equation to find their Body Mass Index or BMI. It is a ratio of height to weight without taking into account gender or body fat percentage. Because of this, many health professionals look at risk factors for disease in other measures.

Measuring someone’s body fat percentage is the better way to assess their health status, but they are not always available in the privacy of your own home. For more on this, see more about measuring body composition/body fat in my earlier blog post “What Determines a Healthy Weight?”

Another way of measuring disease risk/health status is waist circumference. Gone is the measure of waist-to-hip ratio from the 90’s; measuring the waist circumference is the standard now.

Why measure waist circumference?

Excess abdominal/belly fat increases the risk of high blood pressure, type 2 diabetes, high cholesterol and triglycerides, and heart disease – all preventable diseases. When taking into account a BMI between 25 and 35 the waist circumference can help find the risk for these diseases. For example someone with a BMI of 29 but a waist circumference below the cutoff is at less risk than someone with a BMI of 27 and a waist circumference above the cutoff. Someone with a BMI over 35 will very likely be above the cutoff points for waist circumference.

How to measure waist circumference?

Get a tape measure and wrap it around your waist making sure it is parallel to the floor and that the tape measure is not twisted. Do not measure over your clothing, no matter how thin the material. The “right” place to measure is at the top of the hip bone known as the iliac crest. Some people have trouble finding this spot. If you can’t locate the top of your hip bone, then measure the waist at the smallest part making sure you are measuring the waist on not the hips. If there isn’t a smallest part of the waist, you can use the “landmark” of your belly button. You want to make sure the tape measure is on the same parallel to the floor all the way around the body/waist; not lower in the front and higher in the back. Also don’t hold your breath.

One of the biggest mistakes made when measuring waist circumference is measuring underneath the belly. For example, men with larger belly tend to measure where their waistband sits. This isn’t the right place. Men often disagree with my measurement results when I tell them they have a waist circumference of say 42”, when they wear size 36” pants. Not the same…

Now what does that number mean?  

What is the result – without pulling too tight on the tape measure? For women >35” (88 cm) and for men >40” (102 cm) is “at risk.” This measure it the same no matter how tall you are. If you are close to or right at these measures, you need to make sure you don’t gain more weight/fat. If you are at risk, you need to work on losing weight now to help you lose body fat.

It is not possible to cut body fat in one specific part of the body without surgical intervention. However, adding strength/resistance training, cardiovascular exercise, and right calories can help reduce overall body fat, and decreasing belly fat in the process.

After working on your eating and exercise habits measure again in six to eight weeks. Make sure you are heading in the right direction.


Do you hear what you want to hear?


Are you always being honest with yourself?

A friend told me the story of her mother’s recent visit to the doctor: In reviewing the result of the patient’s blood work, the patient’s blood sugar control was not a good as it should be (referring to the hemoglobin A1C results). The patient promised to be better and the doctor conceded to let her continue with her lifestyle changes and no medication as a result of this visit. The doctor’s instructions/orders: no desserts except for birthdays; the patient agreed. No problem, just birthdays.

What the doctor didn’t know: this patient has six children, all married, 17
grandchildren, many of whom are also married, and 23 great-grand children! With that much family, she averages a birthday a week, sometimes more. This doesn’t include the birthday’s she celebrates with her friends – she can’t leave out her friends. Giggling about this, she also said she could perhaps stand outside Wal-Mart and ask everyone when his or her birthday is, so when she had her dessert every day, she could say “This is for Tracy’s birthday, the woman I met at Wal-Mart.”And she honestly was not going against her doctor’s wishes.

Many of you have heard the story of my grandmother, of when diagnosed with lung cancer at the age of 79, asked her oncologist, at the same appointment he was giving her treatment options, if she needed to quit smoking. He told her, “I’d like you to.” (Personally, I think he was just stunned by the question.) She said, “He didn’t say ‘yes’.” She did quit a short time later but it was only because you can’t smoke in the ICU.

The point I am making here is for both the practitioners AND the patients/clients:

Practitioners: We must be literal with our patients. And, be careful with what you say, and how you say it. If we aren’t careful with what we say the patients, knowing full well what we mean, will take our words literally. We need to be specific. For example, don’t tell someone  they can have a hamburger “once in a while” or “on occasion.” Your “once in a while” or “on occasion” may mean one a month while their “once in a while” may mean every 48 hours.

Don’t speak in jargon. We must admit that we do speak in jargon, and may not realize it. Ask our patients and clients if they understand what we are saying.

Patients/clients: A lot of times our patients/clients know what their health professionals are telling them, but they choose to believe otherwise. If you truly don’t know what your practitioner is telling you, ASK. Do you really think that a hamburger every other day is fine? If you don’t know what your practitioner means by “once in a while” then ASK him or her. Really.

Also, when you don’t give your health care practitioner the truth, aren’t forthcoming, or have led yourself to believe something that isn’t entirely correct, you aren’t helping yourself. And we can’t help you be healthier. By this I mean don’t say, “I exercise all the time,” when you really mean, “I was an athlete in high school” or “I sit in a chair on the side-line of my kid’s soccer game and watch them exercise.” Driving you kids around to their activities makes you active but that isn’t exercise. (I am a parent, I know.)

Both sides need to get better with communicating, getting more clear with what they mean, and being more honest with themselves and their healthcare providers.

An Ounce of Prevention…

Visit now for fewer visits later.


An ounce of is worth a pound of cure. Benjamin Franklin

I am one of the first to admit that wellness, prevention and taking care of your health does take some time. You must invest in your health to help stay healthy. Taking the TIME to go through your preventive medical appointments today, saves you time in the long-run. Waiting until you are sick to do something takes much more time and money (appointments, treatments, medications, lost work time, etc.) than taking the time to take care of yourself before you are sick.

Early last month was the start of what will end up being over two months of preventive maintenance for my body. The product of age and being a woman I have to take the time for several appointments to get through all of my “preventive care.”

This year is unusually busy since my six month appointments, annual appointments, and bi-annual appointments all came together at around the
same time. I have no unusual health issues for a woman in her early 40’s, so
everything I have appointments for are all a matter of routine. Here is what I
am going through right now:

  1. Dentist appointment, for routine cleaning  – every six months
  2. Routine physical – annually
  3. Dexa scan (bone density test) – every two years referral from the routine physical. This is unusual for someone my age, but I’ve had them every two years since 30 years old because I need them.
  4. Blood work – annually, referral from the routine physical. The blood cholesterol, glucose, liver function, etc.
  5. Annual gynecological exam – annually
  6. Mammogram – every two years

That is six separate appointments on six separate days to make sure I am still healthy. Or, what I have estimated, 11 hours of time for actual appointment and “travel” time. Not counting time being on hold making the appointments.

I need to schedule two more appointments outside this flurry of medical merriment: my annual eye exam and dermatology exam. Despite having LASIK several years ago, I still need to get checked for eye diseases that run in my family. I also need to get checked for skin cancer since I am a fair-skinned, red-head living in New Mexico.

I feel that I must stay on track with my preventive appointments because of the family history of high cholesterol, high blood pressure, cancers, and other health issues. I would rather know early and be able to take care of the issues than when it is potentially too late or the visits to the doctor will take a LOT more than 11 hours…

Take the time now to make your preventive appointments, and keep them. They may not be convenient and they do take time, but it is worth it in the long run.


Go Red for Women® – Increasing Awareness of the #1 Killer of Women


Friday, February 4, 2011 is National Wear Red Day

February is American Heart Month, and the first Friday in February is National Wear Red Day® to increase awareness of heart disease in women. While deaths from heart disease have declined in recent years, it is the leading cause of death in men and women in the United States.

The risk factors for heart disease between men and women are the same: smoking, unhealthy cholesterol levels, high blood pressure, sedentary lifestyle, being obese or overweight, and diabetes. What is different between men and women when it comes to heart disease? Women are at higher risk when they are 55 years, while men are at risk at 45 years.

According to the American Heart Association:

  • Since 1984 heart disease has claimed the lives of more women than men.
  • In 2006, women represented over 50% of deaths from heart disease.
  • The surprise to most people: heart disease of all types kills more women each year then all forms of cancer combined! In 2006, 432,709 women died of heart disease, while lung cancer killed 69,385 women and breast cancer killed 40,821 women creating a combined 110,206 from the top two cancers, or about 25% of the deaths from heart disease.

Go Red for Women® is more than just wearing a red shirt or red dress this Friday, February 4, but encouraging women to take steps to learn their risk for heart disease, take steps to cut their risk, and learning the symptoms of heart disease.


As mentioned, risk factors are the same for both women and men. Women should know their numbers for blood pressure, cholesterol, and glucose and find out the results.
Not smoke, which increases risk for heart disease, breast cancer and lung cancer.

Exercise regularly, at least 30 minutes, five days a week and eat a heart healthy diet. If necessary, lose weight. Obesity increase risk of heart disease, as well as breast cancer. Even if you are not overweight or obese, women and men can still have heart disease.


  • Chest pain or discomfort – usually in the form of pressure.
  • Pain or discomfort in other areas, such as the arm, neck, back and/or jaw. Women tend to experience pain in the jaw and back more often.
  • Shortness of breath – which occurs more often in women.
  • Nausea/vomiting, sweating or feeling light-headed – women often feel the nausea/vomiting more.

So, wear red today, but mostly know your risks, work to reduce your risks, and stay informed on the signs and symptoms of heart disease and how it could present in you.

Don’t be afraid to seek treatment, and worry that it isn’t a heart attack. In 2004, at the age of 60, model and actress Lauren Hutton thought she was suffering from a heart attack. She was airlifted to the Heart Hospital of New Mexico from the hospital she went to in Taos, NM. It turns out she was suffering from indigestion, but she used herself as an example of a woman at risk, who took the necessary steps to seek treatment. To her, it didn’t matter that it wasn’t a heart attack (actually it probably did matter), but she sought treatment immediately. Lucky for her, it wasn’t a heart attack, but if it had been, her chances of surviving greatly increased.


Are you doing enough for your heart?


There are many things we can do to lower our risk!

As American Heart Month kicks off, the Centers for Disease Control and Prevention (CDC) states we are not doing enough to control risks for it.

WE include both the people who have the risks for heart disease and the “front line” practitioners who see and treat the patients.

In case you haven’t heard, heart disease is the number one killer of men AND women in the U.S. According to the CDC, half of the U.S. adult population has high blood pressure or unhealthy cholesterol levels.

Even if you don’t have health insurance, there are many things that WE can do to cut our collective risk for heart disease that doesn’t cost anything: LIFESTYLE.

  • Don’t smoke and avoid second-hand smoke. This not only costs nothing, but saves money. (1-800-QUIT-NOW can help).
  • Eat a healthy, plant-based diet. Include lean protein too, and less salt. Need help? Find a Registered Dietitian.
  • Move more. You don’t need a gym membership or equipment other than shoes. Walk, walk, walk.
  • Aim for a healthy body mass index (BMI).
  • Consume alcohol in moderation. Any type of alcohol, red wine or otherwise, is only healthy in moderation.

Genetics? It has a role, but it isn’t your destiny. My grandfather died of a heart attack at 49. My father, who has the genes and some risk factors, just turned 62 and is a healthy cancer survivor.

Gender? Men are at higher risk once they turn 45 and women at age 55. But again, lifestyle can help.

Disease? If you have high blood pressure, unhealthy cholesterol and/or type 2 diabetes you are at higher risk.

Don’t know your numbers? Get them checked and ask for the results. When the nurse takes your blood pressure, ask her what it was. Ask your practitioner for a blood test asking to check your cholesterol and fasting glucose. When the medical assistant or nurse calls you with results, ask for a copy or the real numbers, and don’t just accept the statement: “the doctor says you are good, keep doing what you are doing!” Find out how “good” they are. I have found people with borderline good, and a year or so later are not good anymore.

Do you know your risks? Do you know your numbers?


U.S. Diabetes Rates Rising


Lifestyle can reduce your chances of having to do this.

This week the Centers for Disease Control and Prevention (CDC) released its diabetes fact sheet. Unfortunately the numbers are not good: they are rising.

“Nearly 26 million Americans have diabetes and an estimated 79 million adults have prediabetes. The new estimates show how important it is to make healthy lifestyle choices to prevent type 2 diabetes.”

Of the 79 million adults who have type 2 diabetes (T2DM) or prediabetes, about 7 million of them don’t know it. Even though they don’t know they have it, they are still getting the complications from diabetes. Do you know your risk for T2DM? Take this 10 question quiz.

If someone you know has diabetes, which most people do, it is probably type 2 since it is the most common form affecting about 90-95% of those who have diabetes. Only about 5% of the people with diabetes have type 1, formerly called juvenile diabetes.

Based on current trends, the CDC predicts that one in three adults in the United States will have diabetes by 2050.


  • Be active by exercising regularly. Studies show that exercising for 150 minutes each week (equal to 30 minutes five days a week) reduces risk of diabetes, or helps with better control in those with diabetes. Exercising for 300 minutes per week (60 minutes five days a week) is even better.
  • Lose 5 to 7 percent of your body weight if you are overweight. Even if losing that weight doesn’t move you from being overweight, you still reduce your risk of diabetes.

The benefit of doing these things? Losing weight and getting regular exercise won’t hurt you and has many added benefits, including reducing risk of heart disease and certain cancers.


Have your fasting blood glucose checked regularly. If you have never had it done, check with your physician to order a test. If your blood glucose is normal, the American Diabetes Association recommends having it retested every three years.

However, I have personally seen people move from “normal” to “diabetes” in less than two years. If you can afford it, or have health insurance, I suggest you have your fasting blood glucose tested every 1 to 2 years. Because the complications from diabetes are extensive, from blindness to amputations, it would be a tragedy to go a couple of years with diabetes without knowing.


American Diabetes Association

Diabetes Prevention Program Fact Sheet