By Dr. Mercola
Most people are aware that carrying excess weight increases your risk of heart disease and type 2 diabetes, but few realize that it may also harm your bones. And, it turns out, where you carry the fat matters, with excess belly fat being among the worst types of fat for bone health.
New research presented at the 2012 annual meeting of the Radiological Society of North America revealed that obese men who carry more of their fat deep in their belly are at a greater risk of weak bones and fractures than obese men who have more fat located just below the skin around their thigh and buttocks areas.
It was predicted that the men with belly fat would be 25 percent more likely to break a bone than the other men.
Since it's well known that weight-bearing exercises are great for building up your bones, this news may come as a surprise. It has been long believed that carrying extra weight provides a benefit for bone strength by increasing the dynamic forces on your bone.
However, it’s now known that this is not necessarily the case. Newer research shows that the excess fat deep in your belly and around your organs, known as visceral fat, has been linked to lower bone mineral density, a measure of bone strength.1 This is true even among children and adolescents, for whom higher levels of visceral fat are associated with lower bone mineral density.2
Another study published in the American Journal of Clinical Nutrition found adolescent girls with high body fat had bones that were 8 percent to 9 percent weaker than those with normal body fat.3
It's thought that these fat cells produce substances not yet identified that may lead to bone disease, along with other hallmarks of overweight and obesity, like heart disease and diabetes. Furthermore, people with more visceral fat are also more likely to have more fat within their bone marrow, which may further weaken your bones.
Your body is designed to operate best when it's at an ideal weight, which varies slightly from person to person. Carrying around extra pounds will inevitably increase your risk of developing just about every chronic degenerative disease, while taking a toll on your bone health as well.
Whether you’re overweight, obese or at a healthy weight, keeping tabs on your waist size is important -- likely far more so than monitoring your BMI (body mass index). The visceral fat that tends to build up in your belly is related to the release of proteins and hormones that cause inflammation, which can in turn damage not only your bones but also your arteries and affect how you metabolize sugars and fats.
An expanded waistline is associated with insulin resistance, high blood pressure, blood lipid imbalances, cardiovascular disease, thickening of the walls of your heart, and even increased risk for developing Alzheimer's disease decades later.
This is why waist size provides a far more accurate benchmark for predicting your risk of death from a heart attack and other causes than simply monitoring your weight. Waist circumference is also far better than BMI for evaluating whether or not you may have a weight problem, as BMI fails to factor in both how muscular you are, and your intra-abdominal fat mass.
Determining your waist size is easy. With a tape measure, measure the distance around the smallest area of your abdomen, below your rib cage and above your belly button. The following is a general guide for healthy waist circumference:
You can also use your waist-to-hip measurement. This is done by measuring the circumference of your hips at the widest part, across your buttocks. Then measure your waist at the smallest circumference of your natural waist, just above your belly button. Divide your waist measurement by your hip measurement to get the ratio. (The University of Maryland offers an online waist-to-hip ratio calculator4 you can use.) The Mayo Clinic uses the following waist-to-hip ratio designations:5
These measurements are useful to take even if your weight is in the normal range. In a presentation at the European Society of Cardiology Congress, senior author Francisco Lopez-Jimenez said that people who are of normal weight, but who have a high waist-to-hip ratio (i.e. belly fat), have an even higher risk of death than people who are considered obese, based on BMI alone.6 The risk of cardiovascular death was 2.75 times higher, and the risk of death from all causes was 2.08 times higher in people of normal weight with central obesity, compared with those with a normal body mass index and normal waist-to-hip ratio.
To address a greater-than-ideal waist size, the first step you need to take is remove all grains and sugars, particularly fructose, from your diet until your weight has normalized. Following my comprehensive nutrition plan can help you take control of your diet in an incremental manner.
The average American now consumes about 70 grams of fructose every day. Worse yet, about 25 percent of all Americans consume over 134 grams of fructose a day, according to research by Dr. Richard Johnson, chief of the division of kidney disease and hypertension at the University of Colorado.
To learn more about how fructose impacts your weight and health, I highly recommend reading Dr. Richard Johnson's new book The Fat Switch. In it, he reviews groundbreaking new research showing that eating too much and exercising too little are NOT solely responsible for why you keep gaining weight or have trouble shedding those excess pounds.
His research shows that metabolic syndrome (characterized by central obesity or increased waist circumference, high blood pressure and insulin resistance) is actually a normal condition that animals undergo to store fat. Animals' ability to gain "hibernation fat" appears to be regulated by a switch in the mitochondria that is turned on and off by a common food that no longer provides survival advantage to humans living in contemporary society, namely fructose.
Fructose-containing sugars cause weight gain not by the calories they contain, but by triggering this "fat switch," which tells your body it's time to store fat, just as if you were an animal preparing for hibernation. Furthermore, uric acid is increased by fructose, and also causally contributes to obesity and insulin resistance. Effective treatment of obesity therefore requires turning off your fat switch — by avoiding fructose, which is the trigger — and improving the function of your cells' mitochondria.
As a standard recommendation, I strongly advise keeping your TOTAL fructose consumption below 25 grams per day. However, for most people – especially if you struggle with high blood pressure and insulin resistance – it would be wise to limit your fructose to 15 grams or less, as it is virtually guaranteed that you will consume "hidden" sources of fructose from most beverages and just about any processed food you might eat.
One of the best ways to achieve healthy bones is a diet rich in fresh, raw whole foods that maximizes natural minerals so that your body has the raw materials it needs to do what it was designed to do. In addition, you need healthy sun exposure along with regular, weight-bearing exercise. To sum it up:
Optimize your vitamin D either from natural sunlight exposure, a safe tanning bed or an oral vitamin D3 supplement. Check your blood levels regularly to make sure you're within the optimal range. If you take oral vitamin D, be sure you are also aware that you need to optimize your vitamin K2 accordingly (you should take 100 mcg of vitamin K2 per 1,000 IU's of vitamin D). Optimize your vitamin K2 through a combination of dietary sources (fermented foods like natto, raw milk cheeses, etc.) and a K2 supplement, if needed. Although the exact dosing (for oral supplementation) is yet to be determined, and you must use caution on the higher doses if you take anticoagulants, if you are generally healthy and not on these types of medications, I suggest 150-300 mcg daily. Vitamin K2 is the “miracle” calcium glue that actually removes the calcium from your artery’s lining and puts it back into your bones. Make sure you do weight-bearing exercise, which has profound benefits to your skeletal systems. My favorite is Peak Fitness, a short intense training protocol that improves muscle energy utilization and expenditure due to its positive effects on increasing muscle mass and improving muscle fiber quality. It is also very important to do strength-training exercises to produce the dynamic piezoelectric forces in your bones that will stimulate the osteoblasts to produce new bone. Power Plate is also particularly useful for building bone, so much so it was used by the Soviet space program to preserve astronaut bone density. Consume a wide variety of fresh, local, organic whole foods, including vegetables, nuts, seeds, organic meats and eggs, and raw organic unpasteurized dairy for calcium and other nutrients. The more of your diet you consume RAW, the better nourished you will be. Minimize sugar and refined grains.
