Sagittal Abdominal Diameter

Here is another reason to get rid of that pot belly. It turns out that belly fat, the “apple” body shape, increases the risk of dementia. Dr. Rachel Whitmer, an epidemiologist working for Kaiser Permanente, has found strong association between obesity in middle age and future risk of Alzheimer disease, dementia, and cognitive impairment. Obese people with a Body Mass Index (BMI) of 30 or higher had a 74% increased risk of dementia.[1]

Although BMI has been used as a measure of corpulence, BMI reflects only the ratio of body weight to the square of the height, so it does not take into consideration the distribution of the weight. It is well known that bodybuilders with massive chest muscles and small waists have BMIs over 30 which is the range for obesity. Similarly, persons with skinny legs and a fat abdomens have BMIs in the normal range. Increasingly, BMI is being displaced or supplemented by other measures that more accurately reflect the degree of abdominal adiposity, such as the Waist-to-Height ratio and the Sagittal Abdominal Diameter.

The Sagittal Abdominal Diameter, normally measured with a caliper, is the distance from the back to the upper abdomen midway between the top of the pelvis and the bottom of the ribs. This is basically the distance between the belly button and the back, as illustrated above. The Sagittal Abdominal Diameter closely correlates with the amount of belly fat and has become a good predictor of risk of sudden death from cardiovascular disease[2] and of insulin resistance[3].

[1] Whitmer RA, et al., Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study, BMJ (British Medical Journal) 2005 Jun 11;330(7504):1360. Epub 2005 Apr 29. PMID: 15863436

[2] J.P. Empana, et al., Sagittal Abdominal Diameter and Risk of Sudden Death in Asymptomatic Middle-Aged Men. The Paris Prospective Study I, Circulation, 2004;110:2781-2785.

[3] Ulf Risérus, et al., Sagittal Abdominal Diameter Is a Strong Anthropometric Marker of Insulin Resistance and Hyperproinsulinemia in Obese Men, Diabetes Care, 27:2041-2046, 2004.

Forsythia in Bloom

March is the month when the Northern Hemisphere starts to come out of hibernation. The trees are starting to show some buds, crocuses and daffodils are in full bloom, and forsythias are showing their yellow splendor. March is also the time when the basketball season ends with a frenzy of championship games. Sports fans go crazy as the indoor game season ends and baseball and other outdoor sports start a new season.

Easter is celebrated with eggs to symbolize new life and resurrection. The date for Easter is based the cycle of the moon. Easter is the first Sunday after the first Full Moon which occurs after the vernal equinox; it falls between late March and late April each year. This year, Easter falls on the 23rd of March. Since spring usually starts around the 21st of March, this is about as early as Easter can happen. The U.S. Naval observatory has an explanation of how the date of Easter may be different in some parts of the world as a consequence of the International Date Line conventions.

On the topic of Spring Training, one of my neighbors is training for a marathon. Not too long ago, his cholesterol was 204. He improved his diet and started to use grape seed oil, an oil high in polyunsaturated fatty acids, in his salad dressings. His cholesterol level is now 140. It is good to see that dietary interventions can make a big difference in the biomarkers for health. Every time that I see one of those TV commercials where an actor says “I exercise and watch my diet, but it is not enough.” and concludes that he still needs some statin to lower his cholesterol, I keep thinking: “NO! NO! NO! You cannot just WATCH your diet, you have to eat foods with the right fatty acid balance, you have to eat less, and you have to exercise.” It is actually very simple. Diet is a major factor.

Last year, I had to get a new laptop computer because my old IBM Thinkpad with Windows 95 was basically obsolete. The computer had only one USB port and it needed an Ethernet card to connect with my desktop computer through my local area network hub. With Windows 95, the system would sometimes pause as I was typing a document, and it would stay in a state of limbo for about 30 to 40 seconds before resuming. This would interrupt the flow of ideas that I was trying to type, and during this time I could think of nothing but the top row of keyboard: #$%%*!, %$&^%$!, and @$%*!

I started using the old Thinkpad as a perch for my new laptop because I hated the idea of using it as doorstop, as a mean-spirited geek had suggested. At the time that I bought my new laptop, I also bought a copy of Linspire, a Linux-based operating system, with the idea that one day I would convert the IBM Thinkpad to Linux. Several months later, when I finally installed the new operating system, I found out that the old Thinkpad had regained some of its spark. Linux had fixed the intermittent pausing problem.

You can buy Linux systems very inexpensively, but you can also download them free from the Internet if you have a broadband connection and you can create a 700 megabyte CD. The three most common Linux versions are Ubuntu, OpenSUSE, and Freespire, a free version of Linspire. Ubuntu has gained wide popularity because it provides online support through a large community of users. All three operating systems come with free web browsers (Mozilla Firefox), e-mail, and a free office suite (OpenOffice) compatible with Microsoft Office to handle spreadsheets, documents, and slide presentations. A wide array of Linux applications can be downloaded from the Internet.

I downloaded GCC, the GNU Compiler Collection, and now, I use my old IBM Thinkpad as a platform for testing the Linux 32-bit versions of my linguistic programs. This has become important now that many of the systems that I previously used for development have been replaced with machines that use 64-bit architecture.

The moral of this story is that you can recycle your old computer and make it useful again with a minimal investment.

It has been a little over five years since I adopted a Calorie Restriction (CR) diet.  I am always aiming to make it a CRON diet, i.e., CR plus Optimum Nutrition, but it is difficult to know what is Optimum Nutrition because scientists continue to argue about the ideal level of nutrients.  Vitamin D, for example, has been in the news as a significant suppressor of cancer, but like any complex problem, it is not easy to establish the cause and effect, and it is much more difficult to quantify it.  Just in case, I take 1000 IU of Vitamin D as a dietary supplement.

Many members of the Calorie Restriction Society argue that the optimum Body Mass Index (BMI) for a CR practitioner is between 18.5 and 21.  Although I could cut down my calories to go down to a BMI of 21, I have decided that as long as I have good musculature, the best BMI for me is just below 23.  At this BMI, my percent of body fat is 13 percent which keeps me in the “athlete” category, according to the American Council on Exercise.  I weigh myself almost daily.  If my average weight goes up by half a pound, I decrease what I eat.  If my weight drops by one pound, I increase my food.

What I eat now is very different from what I ate before the CR way of life.  Before, I would always have a sweet dessert, I baked pastries such as “Napoleon” (flaky puff pastry with butter cream), I did not read labels, and in ignorance, I ate hydrogenated fats.  Today, I read labels, I eat large salads, and my dessert consists of fruits, nuts, or dark chocolate.  I am not a vegetarian; I eat everything, but in moderation.

I recently watched a TV show which showed a researcher who studied more than 500 people over 90 years old.  The researcher said that there was not a single vegetarian among them.  He also pointed out that most of these old people were slightly overweight, but active.  He concluded that genetics was the most important contributing factor to a long life.  Like most research, this finding is likely to be contradicted by some future research project.  I believe that a balanced diet, exercise, and weight management all contribute to longevity.

A recent article by Dr. Mark Liponis[1] listed several things that can increase your life expectancy. Three items of advice were related to food:

Eat a heart-healthy diet. A Mediterranean diet rich in colorful fruits and vegetables, olive oil, fish and whole grains reduces the risk of cardiovascular disease. The average lifespan in France, Italy, Greece, Spain, and Israel rank in the top 25, whereas the U.S. is in 45th place.

Drink up. Moderate wine consumption (up to 5 ounces a day) have been found to reduce the risk of cardiovascular disease. Other beverages like green or black tea, as well as coffee, also contain substances that lower death rates from cardiovascular disease.

Watch your waist. There are virtually no obese centenarians. Excess body weight contributes to heart disease, high blood pressure, and diabetes. (Learn how to stay trim.)

Other suggestions for living longer were related to life-style:

Read the Newspaper. Centenarians keep abreast of current events and remain engaged in society. Isolation can lead to deterioration and loss of function. Mental activity will help to keep your brain in good working order. (Try some Puzzles)

Buy a farm. Studies show that living in the country extends life compared to living in urban areas. Is it just the clean air that makes farmers live longer? Not necessarily. Farmers are always physically active. Staying physically fit is important for longevity.

Get Married. According to a 2006 study in the Journal of Epidemiology and Community Health, people that never married were 58 percent more likely to die earlier than an age-matched group of married people. Divorced or separated people were 27 percent more likely to die earlier than married people.

Have Children. Women who have children after age 40 are four times more likely to live to 100. Men who father children and start raising a family at a younger age also live longer.

Have Faith. Dr. Liponis points out that most centenarians have some kind of regular religious practice or belief, and that researchers have found that clergymen and nuns tend to be long-lived.

The article by Dr. Liponis is based on statistical correlations which sometimes can lead to strange conclusions. I know a married couple, both in bad health, who keep alive hoping to outlive each other because they do not agree on the disposition of their assets after they die. That is an incentive for longevity. I just hope that it is not too late for me to become a clergyman.

[1] Parade Magazine, March 9, 2008, p. 10.

Free Food Samples

The word “cheating” is frequently associated with the word “diet”. Just like we feel guilty when we do something that is immoral or unethical, we also feel guilt when we break our promise to stick to a diet. Guilt is good. It can lead us back to the true path. The real problem is when our guilt becomes indifference or apathy because then there are no mental or moral boundaries to give us strength to achieve our goal.

Temptation is everywhere, specially when you go to a Whole Foods supermarket at lunch time. In the fruit section there are pieces of papaya and pineapple that you can try. Walk over to the deli section and there you will find samples of hummus, tuna salad, and other dips that you can put on corn chips or crispy breads. A little bit further in the cheese section, there are cubes of different cheeses that you can try. Finally, as you go by the bakery section, you will find samples of cakes or other sweet goodies. If you have not passed all these displays with your mouth closed, you will have consumed at least 200 calories before you leave the store.

What can you do to stay on track with your diet? You can walk for 30 minutes to burn off the 200 calories, or you can cut 200 calories from your next meal. What if you don’t? One day of straying from your diet won’t do you great harm, but if you continually snack on 200 calories per day, you will gain one pound in less than one month. Guaranteed.