Body Type: Are You an Apple or a Pear?

Are you apple-shaped or pear-shaped?

Most women (and men for that matter) understand intuitively whether their bodies tend to store fat around their waists (forming an apple shape) or lower down around their hips, thighs and buttocks (forming a pear shape in women). But few of us understand the dramatic impact body shape has on our current health and risk of future disease.

A number of recent studies have shown that it is your waist size and body shape rather than how much you weigh or tip the scale that best predicts your risk for a number of chronic diseases. For example, a study published in this week's Archives of Internal Medicine found that while only half of the obese patients studied had metabolic abnormalities that placed them at much greater risk of heart disease, a full quarter of the normal weight adults had these same worrisome metabolic risks as well.

Why the risk in normal weight adults? Experts concluded that waist size may be much more important in determining heart risk than body weight. A normal weight individual can have a greater waist size -- and therefore a greater health risk -- than an overweight but smaller-waisted friend.

The metabolic abnormalities that were studied included high blood pressure, high triglycerides and low HDL cholesterol (the good cholesterol) levels. If you have these metabolic factors, chances are you are apple-shaped. In fact, I call the metabolic syndrome the "apple-syndrome" because having an apple shape is a necessary part of the mix.

One of the largest worldwide studies on heart risk factors ever, referred to as The Interheart Study, found that a person's waist-to-hip ratio (WHR) was three times more powerful a predictor of heart disease risk than body mass index (BMI). An editorial in the Journal of the American Medical Association warned physicians that even their normal weight patients who have apple shapes should be screened for heart disease.

Figuring Out Your Figure

So do you know your WHR? How about your waist size and body shape?

Determining your body shape is easy: First, measure around your waist to get your waist circumference. If you have a visible waist, measure around the smallest part. If you don't have an obvious waist, measure around the largest part of your middle, or about one inch above your navel.

Next, measure around the widest part of your lower bottom to get your hip circumference. Divide the first number by the second to get your waist-to-hip ratio (WHR).

For women, if your WHR is 0.80 or less, you are a "pear." If your WHR is greater than 0.80, you are an "apple." For men, a WHR of greater than 0.90 means you are an apple and at increased heart risk too. If your WHR is 0.90 or less I would call you a "healthy apple." I have found that men don't like to be referred to as pear-shaped.

Many doctors rely on waist size only to predict health risk. For women, a waist size of more than 35 inches means generally way too much visceral fat. For men, a waist size of more than 40 inches is considered risky.

Why Is Body Shape So Important?

Although we've known for decades that these different body shapes existed, only now are their causes and related health risks becoming clear. The startling discovery is that the areas of our bodies where we are genetically and hormonally predisposed to store our fat make all the difference.

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