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Thin is still in.

Although the desire to be thin is, and certainly has been, "in" as far as American women are concerned, public concern seems to have leaned toward assuaging the male heart over that of the female. And because taking and keeping off those excess pounds requires a discipline that most of us, male or female, find very difficult to cultivate, even the medical profession has been unduly tolerant of female patients who are just a tad overweight."

A study recently published in The New England Journal of Medicine, however, concludes that there is no such thing as a truly "safe" level of excess weight as determined by the 1983 Metropolitan Life Insurance Company actuarial tables of desirable weights for height, age and sex. After reviewing the records of more than 115,000 healthy women between ages 30 and 55 over an eight-year span, the researchers concluded that the thinner any woman is for her height and age, the less likely she is to have a heart attack or other heart disease.

The thinnest 20 percent of women in this study actually weighed 5 percent below the desirable weight for height and age, and they had the lowest incidence of heart attacks in the entire group. A 5'4" woman in this 20 percent group weighed less than 125 pounds. The next group, of average weight by the tables (130 pounds at 5'4"), had 30 percent more heart disease than the thinnest group. Those 15 to 29 percent above desirable weight had 80 percent more heart disease, and the heaviest group-30 percent or more in excess of desirable weight-were 300 percent more at risk than the lightest group.

Overweight women smokers were 500 percent more at risk than overweight nonsmokers, and women who had gained more than 20 pounds since age 18 were twice as likely to have heart attacks as those who did not add the extra poundage.

Most of us gain weight as we age. Although only 20 percent of women are thought to be overweight in their youth, the percentage increases to 33 percent or more in middle age. Excess weight increases blood pressure, raises cholesterol and increases the likelihood of becoming diabetic. Dr. JoAnn Manson evaluated the results of her study: "Obesity is a major cause of heart attacks in women," she said. "The risks of obesity have been underestimated and underappreciated."

What, then, are we to do? In the March issue of Medical Update, we discussed the futility of leaping on the bandwagon of every new diet fad. We also hinted we might show you some recently formulated weight tables in a later issue that were more tolerant of older persons being mildly overweight. With this recent study, however, we will now wait until the compilers of those new weight tables can show more evidence for their recommendations. Meanwhile, let us again remind you of some very simple dietary truths that have previously been set forth in this and many other publications:

When more calories are taken in than are burned up each day, the result is an increase in body weight. This is true whatever the calories' source or whether they are burned up by normal metabolism or by exercise.

Foods high in insoluble fiber (e.g., wheat bran) not only increase the speed that food passes through the intestinal tract, but also decrease the quantity of digested food absorbed. They also tend to be less "filling," thus limiting the amount of food taken in at mealtime. (Note: Although insoluble fiber also prevents increases in serum cholesterol levels, it does virtually nothing to decrease them.)

Fat, whether saturated or polyunsaturated, contains almost twice as many calories per gram as carbohydrate and protein. A healthful diet should therefore contain less than 25 percent fat, with as little saturated fat as possible.

Exercise is essential to a healthful diet, but it does not have to involve jogging or running. A brisk half-hour walk each day is excellent, and, in bad weather, a lot of exercise can be done inside, particularly if there are stairs in the home. Swimming is probably the most nearly perfect form of exercise because it protects joints from the stress of many other forms of strenuous physical activity and brings virtually every muscle into play.

The most effective exercise of all in reducing and maintaining weight is to place both hands firmly against the edge of the table as soon as the recommended caloric intake has been reached and push hard.
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No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1990 Gale, Cengage Learning. All rights reserved.

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Title Annotation:health risks of obesity in women
Publication:Medical Update
Date:Jul 1, 1990
Words:746
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