Apples vs. Pears: Body Type Matters

Being overweight can raise your risk for a range of health problems, but evidence shows that it's not just how much fat you carry, but where it's located that counts most.

Abdominal fat—an apple-shaped figure—may pose a different health risk profile than fat spread all over the body, or from the hips down (the so-called pear shape). A 2016 study in the Annals of Internal Medicine determined that a “spare tire” (central or abdominal obesity) can be hazardous to your health even if you’re not overweight.

Researchers from the Mayo Clinic assessed the mortality risk among more than 15,000 adults, comparing those with a normal Body Mass Index (BMI), but with central obesity, to those who were overweight or obese overall. Over an average period of 14.3 years, those with fat stores concentrated in the middle, but who were not necessarily heavy for their size, had a death risk up to double that of those who were overweight or obese based on BMI. A separate 2016 study found that normal-weight older adults with central obesity had the worst long-term survival.

Gut Check

Central obesity is defined as having a waist-to-hip ratio of greater than 1.0 for men or greater than 0.9 for women. To calculate yours, measure your waist (just above the belly button) and your hips (around the widest part of your buttocks) and divide the first number by the second. If you fall at or above these numbers then dietary and exercise changes are recommended.

What’s the problem? Adipose tissue that accumulates in the midsection (visceral fat) is stored around several organs.When fat infiltrates organs such as the liver and pancreas it can lead to problems such as inflammation and insulin resistance that spiral into health woes like heart disease and diabetes.

A better shape. While it’s never a good idea to carry around high amounts of body fat, people who accumulate more in their hips and legs don’t appear to suffer from the same disease risk as those with too much belly fat. Further away from vital organs, below-the-waist fat is related to fewer disease-provoking concerns, such as inflammation. Unfortunately, we can’t control how fat is going to accumulate on our bodies. So even normal-weight or pear-shaped people need to pay attention if their belts are getting tighter.

While genetics and sex play a big role in what “fruit” your body looks like, lifestyle measures can make an impact. Like all weight loss, trimming belly fat requires a commitment to frequent full-body physical activity to burn calories and help create a calorie deficit, as well as resistance training, which builds metabolism-boosting muscle. To take a bite out of your apple shape, focus on consuming whole foods, such as fruits, vegetables, whole grains, legumes, and lean proteins at the expense of processed ones. Some data suggest that prioritizing protein over some dietary carbs can help; improved blood sugar control may encourage less central fat storage.

—Matthew Kadey, MS, RD

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