Nobody is questioning those numbers. We realize as a nation we are getting too fat. Portion sizes are up, calories are up, and physical activity is down.



We also know that obesity does increase the risk for an assortment of diseases and conditions such as high blood pressure, heart disease, diabetes, and stroke. Some estimates have obesity running neck and neck with smoking as a leading cause of early death in the U.S.

However, science has known for some time that obesity by itself does not tell the entire story. It is the location of where fat gets deposited that serves as a better predictor for related diseases than total percentage of fat on the body. The more fat deposited around the waist, the greater the risk.

Here is the test. Using just a tape measure, divide the circumference of your waist measured around the narrowest location near the naval by the number you get measuring your hips around the buttocks. The bigger the belly, the higher your number will be and the greater your risk. The waist-to-hip ratio for women should be no higher than 0.8, and men should be 0.95 or under.

In order to get rid of that extra belly fat, new research indicates that dieting alone may not be as effective as exercise. A study published in the August 2006 International Journal of Obesity split 45 middle aged women into 3 groups; one that reduced calories, one that did only exercise, and one that did a combination of diet plus exercise. The total caloric deficit for each group was 2,800 calories per week.

After 20 weeks it was discovered that fat cell size in the abdominal area shrunk dramatically in the 2 groups who included exercise, but did not change in the diet group, even though all 3 groups of women lost weight and overall body fat.

This is a very small study, but significant because it supports the belief that a combination of exercise with diet modification is more effective at reducing your risk of obesity related disease than just dieting alone.

How much exercise is enough? For effective weight loss, the American College of Sports Medicine recommends a minimum of 150 minutes per week of moderate intensity exercise, eventually increasing to between 200-300 minutes per week. That would be 30 minutes on 5 days per week progressing to at least 30 minutes every day of the week.

The good news is that it does not appear that all of this activity need not be done all at once. Those with no time for long workouts must find ways to accumulate more body movement throughout the day.

More good news is the fact that intensity of exercise does not make much of a difference. However, remember that a slower pace requires more time to burn the same amount of calories.