5 Really Simple New Rules for Weight Loss

The news is bloated with information on weight loss—but as it turns out, there are some simple key rules to keep in mind. Researchers at Tufts University looked at more than 16 years of data from 120,000 men and women who were included in three long-term studies. According to their results published in the American Journal of Clinical Nutrition, these are the things that might help you drop pounds for good, and keep them off:

Load up on low-glycemic foods

Diets with a high glycemic load (GL)—think refined grains, starches, and sugars—were linked to more weight gain. The reason: Foods that rank high on the glycemic index can cause rapid spikes in blood sugar and a resulting surge in insulin, the hormone that helps the body use or store blood sugar. While that’s not a new finding, past research hasn’t shown how an inflated GL relates to weight gain over time.

RELATED: 10 Easy Ways to Slash Sugar from Your Diet

Eat more of these protein-rich foods, specifically

Boosting consumption of yogurt, seafood, skinless chicken, and nuts best helped stave off pudge, researchers observed. The more people downed, the fewer pounds they gained.

Don’t worry so much about full-fat dairy 

An increase in eating full-fat cheese and whole milk did not relate to weight gain or weight loss. “In fact, when people consumed more low-fat dairy productions, they increased their consumption of carbs, which may promote weight gain,” said primary study author Jessica Smith, PhD, in a statement. “This suggests that people compensate, over years, for the lower calories in low-fat dairy by increasing their carb intake.”

RELATED: 30 Healthy Foods That Could Wreck Your Diet

Do balance out your meals

Researchers also examined the relationship between protein-rich foods and GL of the diet. They discovered that decreasing GL by eating red meat (commonly linked to weight gain) with veggies (instead of with, say, refined white bread) helped offset gain. And when people ate more eggs and cheese in combination with lower glycemic foods, participants lost weight (while combining them with high glycemic foods was linked to weight gain).

Quit obsessing about calories

All of the above tactics matter more. “Most interestingly, the combination of foods seems to make a big difference,” said senior author Dariush Mozaffarian, MD, DrPH, in a statement. “Our study adds to growing new research that counting calories is not the most effective strategy for long-term weight management and prevention.”

 RELATED: 10 Diet and Exercise Tricks to Control Diabetes



This Is How Much Longer You Should Stand Each Day to Get Health Benefits

By Steven ReinbergHealthDay Reporter

THURSDAY, July 30, 2015 (HealthDay News) — Sitting too long may be hazardous to your health, even if you exercise regularly, Australian researchers report.

A new study found that sitting appears to be linked to increased blood sugar and cholesterol levels, which can lead to added weight, diabetes and heart ills. But standing more helps improve all these measures and can give you a trimmer waist to boot, the researchers said.

“Switching some of your sitting time to standing could have benefits for your heart and metabolism,” said lead author Genevieve Healy, a senior research fellow at the University of Queensland in Herston.

“More time spent standing rather than sitting could improve your blood sugar, fats in the blood and cholesterol levels, while replacing time spent sitting with time walking could have additional benefits for your waistline and body mass index,” she said.

However, the study did not prove a cause-and-effect link between standing and walking more and better health.

The report was published July 31 in the European Heart Journal.

For the study, Healy and colleagues gave activity monitors to 782 men and women, aged 36 to 80, who took part in the Australian Diabetes, Obesity and Lifestyle Study.

The monitors kept track of how long each participant spent sitting/lying down, standing, walking and running.

In addition, participants provided blood samples, measurements of their blood pressure, waist circumference, and height and weight (body mass index). The monitors were worn 24 hours a day for seven days.

The researchers found that an extra two hours per day spent standing rather than sitting was associated with approximately 2 percent lower blood sugar levels and 11 percent lower average triglycerides (a type of fat in the blood).

More standing time was also associated with an increase in HDL (“good”) cholesterol and a drop in LDL (“bad”) cholesterol, the investigators found.

Moreover, replacing two hours a day of sitting time with walking or running was associated with about 11 percent lower average body mass and an almost 3-inch smaller waist.

The researchers also found that average blood sugar levels dropped by about 11 percent and average triglycerides by 14 percent for every two hours spent walking rather than sitting, while HDL cholesterol levels were higher.

“Get up for your heart health and move for your waistline,” Healy said.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said, “Many studies have found that the amount of sedentary time is associated with an increased risk of diabetes, heart disease and premature death.”

People who sit for prolonged periods have a higher risk of early death, even those who regularly exercise, but the risk is most pronounced in men and women who do little or no exercise, he said.

It’s clear that sitting down for too long is bad for people’s health, said Dr. Francisco Lopez-Jimenez, a cardiologist at the Mayo Clinic in Rochester, Minn., and author of an accompanying journal editorial.

“As a society, we have been focused too much on exercise and have paid less attention to the importance of just moving,” he said.

Lopez-Jimenez said that even if you exercise, sitting for long periods is a marker of a sedentary lifestyle.

Society, he said, values sitting and using labor-saving devices over standing, walking and moving.

“People need to recognize the importance of not sitting too long during the day,” Lopez-Jimenez said. “Avoid the mindset that says, ‘Do the least amount of effort.'”

More information

Visit the U.S. Department of Health and Human Services for more on decreasing sedentary behavior.

No Sleep? How It Can Hurt Your Health in the Long Run

By Steven ReinbergHealthDay Reporter

THURSDAY, Jan. 28, 2016 (HealthDay News) — Women who have chronic sleep problems may have an increased risk of developing type 2 diabetes, Harvard researchers report.

Problems such as trouble falling or staying asleep, getting less than six hours of sleep, frequent snoring, sleep apnea, or rotating shift work appear to increase the risk of type 2 diabetes, the researchers said. They found that women who reported trouble falling or staying asleep all or most of the time had 45 percent greater odds of developing type 2 diabetes.

Women who had four sleep problems had more than four times the odds of developing type 2 diabetes, the researchers said.

“Women with sleeping difficulty, especially when also having other conditions, should be aware of potential higher risk of diabetes,” said lead researcher Dr. Yanping Li, a research scientist at Harvard T.H. Chan School of Public Health in Boston.

“Doctors should pay more attention to the potential diabetes risk of women who have difficulty falling asleep or staying asleep,” she said.

Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, emphasized that the new findings only show an association between sleep problems and type 2 diabetes, not a cause-and-effect relationship.

However, he said it’s plausible that disrupted sleep could increase the risk of type 2 diabetes because sleep problems play havoc with the body’s hormones.

“Not sleeping well affects the circadian rhythm regulated by hormones that are so important for metabolism and involved in control of blood sugar. Thus, it is not surprising that sleep disorders are associated with obesity and diabetes,” said Zonszein, who was not part of the study.

The report was published Jan. 28 in the journal Diabetologia.

For the study, Li and her colleagues collected data on more than 133,000 U.S. women who took part in the Nurses’ Health Study between 2000 and 2014. At the start of the study, none of the women had diabetes, heart disease or cancer.

Over 10 years of follow-up, more than 6,400 women developed type 2 diabetes. Women with one sleep problem had a 45 percent increased risk of developing type 2 diabetes, the researchers found.

For each additional problem, the risk increased again—twice for two sleep problems, three times for three problems, and four times for four problems, Li said.

When the researchers took into account other factors, the risk for diabetes dropped. For example, looking at women with sleep problems who weren’t obese or didn’t have high blood pressure or depression, the risk was 44 percent. The risk decreased to 33 percent after reviewing revised data on weight, the study said.

“People who sleep well are healthier,” Zonszein said. People who are depressed, stressed by work or who are obese will likely develop more diabetes, he said.

“In our industrialized society this is common,” Zonszein said. “Many people don’t get a good sleep as they are watching TV, or are in front of a computer, or a smartphone screen all day and all night,” he said. “We have lost our natural good sleep that consists of work during the day, evening relaxation and a good night’s sleep.”

Losing this pattern disturbs a normal physiological process in which certain hormones normally raise blood sugar levels before we are ready to work, he said.

“These hormones include glucagon, epinephrine, growth hormone, and cortisol, which all work in tandem with insulin and play an important role in regulation of sugar, and this normal hormonal ‘rhythm-icity’ is lost in our society, and certainly may be a cause of diabetes and obesity,” Zonszein said.

More information

To learn more about type 2 diabetes, visit the American Diabetes Association.

Autism Risk Higher When Mom Is Obese and Has Diabetes During Pregnancy

By Alan MozesHealthDay Reporter

FRIDAY, Jan. 29, 2016 (HealthDay News) — Mothers-to-be who are both obese and diabetic have a higher risk of giving birth to a child with autism than healthy women, a new study suggests.

The two conditions in combination nearly quadrupled the risk that a child would receive an autism diagnosis, said researchers who looked at more than 2,700 mother-child pairs.

Individually, maternal obesity or diabetes was linked to twice the odds of giving birth to a child with autism compared to mothers of normal weight without diabetes, the study found.

“The finding is not a total surprise,” said study author Dr. Xiaobin Wang, director of the Center on Early Life Origins of Disease at Johns Hopkins University in Baltimore. “Many studies have shown that maternal obesity and diabetes have an adverse impact on developing fetuses and their long-term metabolic health.”

“Now we have further evidence that maternal obesity and diabetes also impact the long-term neural development of their children,” added Wang.

The study doesn’t prove that obesity and diabetes in tandem actually cause the autism, however. It only found an association.

The study, which tracked more than 2,700 births, adds to evidence that autism risk may start before birth, the researchers said.

In the United States, more than one-third of women of reproductive age are obese, while almost 10 percent struggle with diabetes, the study authors said in background notes.

Prevalence of autism—now affecting 1 in 68 U.S. kids—has skyrocketed since the 1960s, alongside the incidence of obesity and diabetes in women of reproductive age, the authors point out.

Their study, published online Jan. 29 in the journal Pediatrics, involved children born at Boston Medical Center between 1998 and 2014.

All the babies’ mothers were interviewed one to three days following delivery, with their obesity and diabetes status noted. In turn, their babies were tracked for an average of six years.

Almost 4 percent of the babies were diagnosed on the autism spectrum. About 5 percent had some form of intellectual disability, and nearly one-third were diagnosed with another developmental disability. Some were diagnosed with more than one condition.

Besides quadrupling autism risk, the combination of maternal obesity and diabetes was also linked to a similarly higher risk for giving birth to a child with an intellectual disability, the investigators said. However, most of the increased risk for intellectual disability was seen among babies who were simultaneously diagnosed with autism.

Along with pre-pregnancy diabetes, gestational diabetes—a form that develops during pregnancy—was also linked to a higher risk of an autism diagnosis.

Wang said more study will be needed before saying definitively that the combination of maternal obesity and diabetes actually causes autism.

But Andrea Roberts, a research associate at Harvard School of Public Health in Boston, suggested otherwise.

“I think in this case it probably is causal,” she said. “And therefore if women are able to change their weight status and avoid diabetes they might actually prevent the increase in autism risk in their children.”

Roberts isn’t blaming individual mothers, however. “In terms of casting blame, I would say that when you see a massive increase of obesity over the past 30 years it’s hard to say it’s an individual’s fault or problem. This is a societal issue.”

She likened the ready access to junk food to the availability of cigarettes years ago. “When I was a kid there used to be vending machines with cigarettes in them that were in the lobbies of restaurants. And vending machines with junk food is pretty comparable,” she said.

“So even though the problem arises from an individual’s behavior, it does not necessarily mean that the solution to the problem is at an individual level,” Roberts said.

Wang doesn’t want to cast blame on mothers either. “Rather, we hope that our research findings can translate into positive public health messages that will increase the awareness of the importance of healthy weight among future parents, pregnant women and health care providers,” he said.

More information

There’s more on maternal health and infant health at the U.S. Centers for Disease Control and Prevention.

Does Fiber Help You Lose Weight, and Other Burning Diet Questions

From Health magazineQ: I’ve heard that fiber cancels out calories. So can I eat more without gaining weight if the foods are high in fiber?

A: Fiber doesn’t cancel out calories; however, it can still be a dieter’s best friend, because it makes you feel full on fewer calories. You can usually eat much more of fiber-filled foods like fruit, veggies, and whole grains than you can of low-fiber foods. (For instance, you can eat three cups of raw veggies for the calories in a slice of white bread.) And when you eat fiber along with carbs or sweets, it helps slow down digestion, making you feel more satisfied with what you’ve eaten. In fact, in a Tufts University review of several studies, researchers found that women who maintained a 2,000 calorie diet but doubled their fiber intake from 14 grams to 28 grams a day lost an average of four pounds in four months. Take advantage of fiber’s feel-full benefits by choosing snacks like strawberries or almonds between meals. Also try eating a salad before dinner—research shows it makes you naturally consume fewer calories during the meal.

Q: To lose weight, do I need to track the glycemic index of the foods I eat?

A: No. The only things you need to track are the calories you’re eating and the ones you’re burning off through exercise. The glycemic index (GI) helps people with diabetes monitor how carb-heavy foods affect their blood sugar level—white bread, for example, is high on the GI because it breaks down quickly during digestion and causes a spike in blood sugar. Most fruits and vegetables, on the other hand, break down more slowly, so they’re lower on the GI. Although most low-GI foods are what I’d consider healthy “high-quality” carbs (like whole grains, beans, and vegetables), there’s no research showing that a low-GI diet helps you drop weight. Bottom line: Unless you have type 2 diabetes, don’t worry about the GI.

ASK US! Do you have a question about losing weight or staying fit? Send an email to askhealth@timeinc.com, and put “Shape Smarts Question” in the subject line.

Julie Upton, MS, RD, is a media resource for the American Dietetic Association.

FDA Adds Cancer Risk to Diabetic Foot Ulcer

Regranex Gel 0.01% (becaplermin), a cream used to treat diabetic foot ulcers, will now carry a “boxed warning” on its label after a study found a greater number of cancer-related deaths in frequent users of the drug, the U.S. Food and Drug Administration announced Friday.

Patients using three or more tubes of Regranex had a five-fold higher risk of cancer mortality than non-users.

“However, the risk of getting new cancers among Regranex users was not increased compared to non-users,” according to an FDA statement. “The duration of follow-up of patients in this study was not long enough to detect new cancers.”

Ortho-McNeil and Ethicon, Inc. issued a letter to doctors to clarify how the drug should be used.

“In announcing this label change, FDA still cautions health care professionals to carefully weigh the risks and benefits of treating patients with Regranex,” said Susan Walker, MD, director of the Division of Dermatological and Dental Products, in a prepared statement. “Regranex is not recommended for patients with known malignancies.”

The drug was approved by the FDA in 1997 and is a genetically engineered version of human platelet-derived growth factor, a normally occurring molecule that spurs cell growth in the body.

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Aggressive Therapy Doesn't Cut Heart Risk in Diabetes

SAN FRANCISCO — Tightly controlling blood sugar to lower-than-recommended standards using insulin and other drugs does not reduce the risk of stroke and heart attacks in people with type 2 diabetes—and may even be harmful, according to two major studies presented Friday at the American Diabetes Association’s annual meeting in San Francisco.

One of the studies, known as ACCORD, was halted earlier this year when patients treated aggressively with blood-sugar-lowering medication were found to have a greater mortality risk than those treated less aggressively.

The New England Journal of Medicine published both studies, called the ACCORD and ADVANCE trials, early to coincide with the meeting.

Experts emphasized that the findings do not mean that lowering blood sugar is harmful for most patients. Lowering blood sugar can reduce the risk of other diabetes complications, such as vision loss, kidney failure, and nerve damage. And it’s still not clear if more aggressive treatment may offer some heart benefits to certain patients (e.g., those without existing heart disease) or may work with some drugs but not others.

“You can safely reduce glucose to around 6.5% by using the sort of graduated, rather gentle approach to glucose control,” said Stephen MacMahon, DSc, PhD, a principal investigator in the ADVANCE study and a professor at the University of Sydney in Australia. “That won’t necessarily prevent cardiovascular events, but it will improve outcomes in terms of kidney disease.”

Neither trial emphasized diet and exercise as a way to lower blood sugar, and the trials used different types of drugs to lower blood sugar, with varying results.

In ACCORD, half of the 10,251 type 2 diabetes patients with a hemoglobin A1C of 8.1% tried to achieve an A1C of below 6.0% (similar to a nondiabetic) using more aggressive treatment with medication. The other half aimed for a level of 7.0% to 7.9% using standard therapy. (Currently, the American Diabetes Association recommends an A1C of less than 7%.)

About 90% of patients in the intensive-therapy group took thiazolidinediones such as rosiglitazone (Avandia), as did 58% of the standard therapy group (which also took sulfonylureas, metformin, and insulin as needed). After three and a half years—when the study was halted—those in the intensive treatment group had gained more weight, had more episodes of hypoglycemia, and had a 22% higher mortality rate than those in the standard therapy group. (Find out why drug combinations are used to treat diabetes.)

The ADVANCE study was similar in design, but less than 20% of patients took rosiglitazone or similar drugs (most took gliclazide, a type of sulfonylurea).

In that trial of 11,140 people, intensive therapy reduced the risk of kidney disease, but not the risk of death due to cardiovascular disease or any cause.

An accompanying editorial in The New England Journal of Medicine called the trials important if disappointing.

“There should be no misunderstanding that the ADVANCE trial had clearly negative results,” writes William Cefalu, MD, of the Louisiana State University System in Baton Rouge. “However, by virtue of the significant reduction in nephropathy, the ADVANCE trial extended our understanding of intensive glycemic control on microvascular events in patients with type 2 diabetes.”

Type 2 diabetes is the most common form of the disease, making up 90% of people with diabetes. Tight blood-sugar control has been shown to reduce the risk of heart attacks and strokes in those with type 1 diabetes, a less common autoimmune disease that most often occurs in children and young adults.

By Sean Kelley


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New Method Makes Diabetes Blood Sugar Tests Easier to Understand

SAN FRANCISCO — Although it sounds complicated, a new math formula could make it much easier for people with diabetes to keep track of their blood sugar.

Researchers in the U.S. and the Netherlands have developed a formula to convert the results of a test done in the doctor’s office—the hemoglobin A1C blood test—into a number that more closely matches the results people get from pricking their finger and testing their blood at home.

If all goes as planned, patients should be getting a lab-test result called the estimated average glucose (eAG), which lets them know how well they’ve been controlling blood sugar in recent months.

“Patients can translate what they’re doing at home to what we’re doing in the clinical chemistry lab,” said Robert J. Heine, MD, professor of diabetology at VU University Medical Center in Amsterdam and co-chair of the International A1C-Derived Average Glucose (ADAG) study. The results of the study were presented at the American Diabetes Association’s annual meeting in San Francisco.

For nearly 25 years physicians have been giving patients results from the hemoglobin A1C test, which measures the amount of sugar stuck to red blood cells. The results come back as a percentage, and the American Diabetes Association recommends that people aim for a level of 7% or less.

It’s a good measure of blood glucose control over a two- to three-month period, but it’s not a good match for blood-sugar monitoring that patients do at home.

Those at-home methods report results in milligrams per deciliter (mg/dL). Normal blood sugar ranges from 90 to 130 mg/dL.

With the new estimated average glucose, hemoglobin A1C results will be expressed in milligrams per deciliter for patients (doctors will still get A1C lab results in addition to eAG results).

Dr. Heine and colleagues tested the formula in a study in which they compared data from 507 patients who used continuous glucose monitors, and blood glucose monitors in 10 centers around the world. Patients had either type 1 or type 2 diabetes or no diabetes at all.

Now that there’s a way to translate A1C results into familiar units, more study is needed to see if it helps people control their blood sugar, said study investigator Edward S. Horton, MD, professor of medicine at Harvard Medical School.

“We’re just promoting this change now,” Dr. Horton said. “We’re hoping that it’s going to improve things, but we don’t have the data yet.”

The study will be published in the August issue of Diabetes Care.

By Sean Kelley

Related Links:Why You Should Monitor Your Blood Sugar at HomeWhy You Need Hemoglobin A1C TestsExpert Advice About Home Blood Glucose Monitoring5 Ways to Make Blood Sugar Testing Less Painful

Watching Blood Pressure, Cholesterol May Benefit Diabetics’ Hearts

June 11, 2008 (San Francisco) — People with type 2 diabetes who tightly control their blood sugar to lower-than-recommended levels have no greater heart benefits than those who use standard therapy, according to a study of U.S. veterans. It was the third major study of heart disease prevention presented this week at the American Diabetes Association meeting in San Francisco, and all had similar findings.

Unlike the others, the veteran study did suggest that controlling blood pressure and cholesterol could result in fewer strokes and heart attacks in older, sicker patients (see “Why Diabetes Boosts the Risk of Strokes and Heart Attacks”).

“We predicted ahead of time the number of incidents (of heart attack and stroke) we would have, and with our excellent blood pressure and lipid control…we did not come anywhere near the number we had predicted,” says William C. Duckworth, MD, director of diabetes research at the Carl T. Hayden VA Medical Center in Phoenix and co-chair of the study. “This trial reduced all kinds of incidents rather largely. We did good overall.”

In the VA Diabetes Trial, researchers are following more than 1,700 veterans. At the start of the study, the patients had an average hemoglobin A1C score of 9.5%. (The American Diabetes Association recommends an A1C of less than 7%.) All the patients had multiple health problems: 40% had prior cardiovascular events, 80% had hypertension, and more than 50% had cholesterol problems.

The researchers split patients into standard and intensive glucose control groups, and aimed to lower blood pressure and cholesterol in both. Within six months the standard group achieved an average of 8.4% hemoglobin A1C, while the more intensive group reached 6.9%.

There was no difference between the two groups in terms of heart attacks and strokes. However, both groups had a fewer-than-expected number of cardiovascular events, presumably due to their better diets, more exercise, aspirin use, and efforts to lower cholesterol compared with their peers in the general population. The researchers expected 650 and 700 events in the standard and intensive therapy groups, respectively, but there were only 263 and 231 heart attacks and strokes.

Carlos Abraira, MD, professor of medicine at the Miami VA Medical Center and a principal investigator of the study, said doctors will continue to follow patients for another nine years to see if there are any long-term benefits of tight blood sugar control. “We want to see if there are no fatal events and other favorable effects of glycemic control that might be expressed later on,” Dr. Abraira says.

The study had another important finding. The researchers found a link between severe low blood sugar events and cardiovascular events, Dr. Duckworth said. Severe hypoglycemia (altered consciousness or loss of consciousness) was a major predictor of stroke, heart attack, and death in the study.

“A severe hypoglycemic episode within three months prior was predictive of a cardiovascular event,” Dr. Duckworth said.

The two earlier studies released at the meeting, ACCORD and ADVANCE, also failed to show that intensive blood glucose control could help cut cardiovascular risk. In ACCORD, researchers actually had to halt aggressive therapy after patients were shown to have a higher risk of death than those with standard treatment.

The authors of all three studies say, however, that reducing blood sugar to recommended levels has been shown to lower the risk of diabetes complications such as vision loss, kidney failure, and nerve damage. And it’s still not clear if more aggressive treatment may offer some heart benefits to certain patients (e.g., those without existing heart disease) or may work with some drugs but not others.

By Sean Kelley

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Can You Be Fat and Healthy? Depends Where You Are Fat

MONDAY, August 11, 2008 (Health.com) — Is it possible to be fat and healthy? Two major new studies published this week in Archives of Internal Medicine suggest the answer is “maybe,” depending on where the fat lurks in your body. In normal and overweight people, those with belly fat are at greater risk of heart disease and diabetes than those with extra padding in the buttocks or thighs.

But for the obese, the ultra-high-risk spot may be fat accumulation in the liver.

Not all excess fat is created equalIn one study, researchers at the University of Tübingen, Germany, divided 314 patients into four groups: normal weight, overweight, obese but still sensitive to insulin, and obese with insulin resistance. They found that not all the obese patients had the same health profiles. Some had clogged arteries, which is a heart attack risk factor, and were insulin-resistant, a precursor to diabetes in which the body loses its sensitivity to the blood-sugar-regulating hormone.

But about 25% of the obese people had clear arteries and no insulin resistance—indeed, these people looked no different than normal-weight participant in those terms.

“No one would say overweight is healthy,” says Lewis Landsberg, MD, of the Northwestern University Comprehensive Center on Obesity in Chicago. “The message is that being overweight is much more unhealthy for some people than others.”

How humans are like force-fed geeseThe big difference between obese patients and their healthier peers seemed to be the percentage of fat in the liver. Obese people who were insulin-resistant more than roughly double the amount of fat in their liver as obese people who were not (8.8% vs. 3.5%, respectively).

In comparison, normal weight and overweight people had a liver-fat level of about 1.9% and 3.8%, respectively.

Next page: Excess calories may lead to fat infiltration of the liver

The infiltration of the liver by fat is increasingly being recognized as one of the potential dangers of too much weight, says Judith Wylie-Rosett, who holds a doctorate in education and is professor and head of behavioral and nutritional research at the Albert Einstein College of Medicine in New York.

Just like force-fed geese develop fatty livers that are used to make foie gras, excess calories may lead to fat infiltration of the human liver, says Wylie-Rosett, who is a coauthor of the second study in the journal.

“We don’t yet know what the longer term risks are [of excess fat in the liver], but we assume that it may then lead to scarring, and what we are now talking about is nonalcoholic liver disease,” says Wylie-Rosett. “It’s an area of tremendous concern particularly as younger people are becoming heavier and heavier and appear to be getting some of these fatty infiltrations in the liver.”

In the second study, Rachel Wildman, PhD; Wylie-Rosett; and other colleagues analyzed U.S. survey data from 5,440 people. They found a cluster of high-risk symptoms—elevated blood pressure, triglycerides, and blood glucose, among other problems—in 24% of normal-weight people, 49% of the overweight, and 68% of the obese.

“Just because you are lean it doesn’t mean you don’t have cardiometabolic risk,” she says. “We’ve tended to think that weight is a proxy for health but it may be more complicated than that. If you are obese there are still things you can do to be healthy and we need to think about where you stand on the cardiometabolic risk continuum.“

How can you tell if you’re at risk?• Do you have an apple- or pear-shaped body? Many studies have suggested that excess weight around your gut is more dangerous than weight around the hips and thighs. Belly fat pads organs, and can increase your risk of diabetes compared to other types of fat.

• What is your age and ethnicity? In studies, the odds of being in a high-risk category increased with age, regardless of body size. And in obese people, African Americans were at a lower risk of having metabolic risk factors than white people of the same age and body size.

• Check your lifestyle. People who don’t smoke and who exercise, even if they are obese, are less likely to be in the high-risk category. Smoking seems to encourage fat to cluster in the gut area, says Wylie-Rosett, and exercise protects you, regardless of body size.

• Visit your doctor. Dr. Landsberg says most doctors will check your body mass index, a measure of weight and height, but abdominal circumference is an important indicator of risk too. You won’t be getting a liver scan for fat content anytime soon (too pricey and of uncertain value), but doctors sometimes check for elevated liver enzymes, a sign of liver function. Standard tests for high blood pressure, lipid levels, and increasingly, blood glucose, will help determine if you’re at risk for heart disease and diabetes, regardless of weight.

Next page: What you should do about it

If tests suggest you are at high risk for heart disease or diabetes, the main thing to do is lose weight, says Dr. Landsberg.

“All physicians would recommend for a number of reasons that overweight patients should lose weight; there’s cardiovascular disease risk, there’s cancer risk, which wasn’t addressed in these studies,” he says. “So weight loss is important.”

However, if you’re overweight and can’t seem to shed the pounds, you should also keep trying, because exercise can help, says Wylie-Rosett.

“The physical activity story is—don’t just look at the scale, look at your whole lifestyle,” she says. “If you’re physically active, you still are potentially a lot healthier even if your weight doesn’t change much.”

By Theresa Tamkins


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