Body shapes: the health implications

Different as we may be, many of us fit into particular categories of body shape, including apple, pear or athletic. Find out how this has effects on our health.

We all know that being overweight or obese increases our risk of developing certain illnesses, but did you know that where you store your excess fat is also important?

Although you may hate having the big hips that come from being a pear shape, this is actually better for your health than being apple shaped. As an apple shape you store fat round your middle; if you are overweight as well, you are twice as likely to develop coronary heart disease - especially if this runs in your family. The reason is not fully understood, but is thought to be related to the inherited, metabolic ways in which you handle dietary fats and carbohydrates in different ways.

To work out if you are apple shaped, measure your waist and hips in centimetres using a non-stretchable tape measure. Divide your waist measurement by your hip measurement to get your waist/hip ratio.

For example, if your waist is 88cm (34½"), and your hips are 100cm (39"), then your waist/hip ratio is 88/100 = 0.88. A waist/hip ratio greater than 0.85 is apple shaped for women, while a ratio greater than 0.95 is apple shaped for males.

In fact, waist size alone is also a good indicator of health. Men with a waist size of more than 94cm (37"), or 80cm (31½") for women, are most at risk of developing weight-related health problems such as shortness of breath, high blood pressure, high cholesterol levels and diabetes than those with slimmer waistlines. If your waist size is greater than 102cm (40") for men or 88cm (34½") for women, the likelihood of having metabolic syndrome - also known as pre-diabetes – is very high.

Metabolic syndrome is a condition in which the body becomes resistant to the effects of the hormone insulin. As many as one in five people are believed to suffer from metabolic syndrome in the UK, either as a result of inherited genes, or of diet and lifestyle factors such as eating excessive amounts of sugar and refined carbohydrates, together with little or no exercise.

When too many foods that raise blood sugar levels are eaten, more insulin is secreted to help push the excess glucose into fat cells for storage as body fat. This leads to central obesity, producing the classic apple shape. Body cells become increasingly insensitive to the effects of insulin if levels are persistently raised, so the pancreas is forced to produce more and more insulin to help maintain normal blood-sugar levels. People with metabolic syndrome are basically overdosing on glucose and insulin and develop a number of symptoms including difficulty losing weight, tiredness and sugar cravings.

People with metabolic syndrome also tend to develop high blood pressure, abnormal blood-fat levels (eg low HDL-cholesterol, raised LDL-cholesterol, high triglyceride levels) and a poor ability to handle glucose. One of the criteria for diagnosing whether or not someone has metabolic syndrome is having a waist measurement of more than 102cm (40") in men or 88cm (34½") in women. Asian people are more susceptible to being apple-shaped, and for Asian males, the risk is greatest in those with a waist circumference greater than 90cm (35½"), while for Asian women risks increase significantly above a waist size of 80cm (31½").

The best way to lose weight permanently is to change your eating habits, so you eat more healthily without feeling you're actually on a diet. Look on it as a healthy eating plan for the rest of your life, rather than a temporary slimming phase. For people with metabolic syndrome, following a low-carbohydrate, higher-protein diet such as the Atkins nutritional approach seems to be one of the best ways of getting their metabolism back onto an even keel while they slim down.

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