Good news: midlife health is about more than a waist measurement. Here’s why

• During the appointment they measure your waist.
• GPs and health professionals commonly measure waist circumference as a vital sign for health.
• Men are at greatly increased risk of health issues if their waist circumference is greater than 102 centimetres.
• More than two-thirds of Australian adults have waist measurements that put them at an increased risk of disease.

How much is too much?

• A ratio of 0.6 or more places a person at the highest risk of disease.
• This can kick off a discussion about their risk of chronic diseases and how they might address this.
• For women, hormone levels begin changing in mid-life and this also stimulates increased fat levels particularly around the abdomen.
• Finally, your family history and genetics can make you predisposed to gaining more abdominal fat.

Why the waist?

• Visceral fat surrounds and infiltrates major organs such as the liver, pancreas and intestines, releasing a variety of chemicals (hormones, inflammatory signals, and fatty acids).
• These affect inflammation, lipid metabolism, cholesterol levels and insulin resistance, contributing to the development of chronic illnesses.

• In addition to the direct effects of hormone changes, declining levels of oestrogen change brain function, mood and motivation.
• These psychological alterations can result in reduced physical activity and increased eating – often of comfort foods high in sugar and fat.
• And importantly, the waist circumference (and ratio to height) is just one measure of human health.

Muscle matters

• On current evidence, it is equally or more important for health and longevity to have higher muscle mass and better cardiorespiratory (aerobic) fitness than waist circumference within the healthy range.
• So, if a person does have an excessive waist circumference, but they are also sedentary and have less muscle mass and aerobic fitness, then the recommendation would be to focus on an appropriate exercise program.
• Conversely, a person with low visceral fat levels is not necessarily fit and healthy and may have quite poor aerobic fitness, muscle mass, and strength.

Getting moving is important advice

• Exercise can counter a lot of the negative behavioural and physiological changes that are occurring during midlife including for people going through menopause.
• And regular exercise reduces the tendency to use food and drink to help manage what can be a quite difficult time in life.
• Measuring your waist circumference and monitoring your weight remains important.

Rob Newton receives funding from National Health and Medical Research Council, the Medical Research Future Fund, Cancer Council Western Australia, Spinal Cord Injuries Australia and the World Cancer Research Fund. Rob Newton is a board member of The Healthy Male.