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UK Warning over Apple-Shaped Figures and Infertility

a blog by Claire, June 27, 2012

Remember Scarlett O'Hara's 18 inch waist? Marilyn Monroe's hourglass figure? Those days appear to be long past.

In Britain, a warning was recently issued to women about their growing waistlines and "apple-shaped" figures. The warning was issued by Nuffield Health, the United Kingdom's largest health care charity, after analyzing data from more than 54,000 women taking the Nuffield Health MOT, which is a series of tests to assess overall fitness and health. The researchers are very concerned about the health risks that extra fat around the waist imposes on women — including the havoc it can wreak on fertility.

Nuffield Health found that more than half — 57 percent — of the women had waist sizes that put them in the high health risk category for diseases such as infertility, cancer, heart disease and type 2 diabetes. A healthy waist size is 31.5 inches or less — the average British woman's waist measured 2 inches more.

America would fare much worse in a study such as this. According to the Centers for Disease Control and Prevention, the average waist circumference for women over 20 is 37 inches. "in the USA, the incidence of overweight adults is 74 percent, making the United States the ninth most overweight country in the world," says Beth Hartog, M.D., a fertility doctor with East Coast Infertility & IVF. "In the UK, only 64 percent of adults are overweight, ranking England 28th on the list of overweight countries."

In the Nuffield Health survey more than 52 percent of the British women had a body mass index (BMI) in excess of the healthy 18 to 25 range, with over 16 percent being moderately or morbidly obese, and the average waist-to-hip ratio measured was 0.83, which meant that most women were "apple-shaped" (storing extra weight above the waist) as opposed to "pear-shaped" (storing extra fat below the waist).

"Pear-shaped" is generally accepted as the healthier shape. Much research has found that carrying excess weight around the waist — "apple-shaped" — significantly increases the risk of breast cancer in women, as well as heart disease, liver disease and type 2 diabetes. In addition, too much weight stored around the middle can compromise ovarian function, causing irregular ovulation cycles and anovulation, which can cause infertility. Dr. Hartog says there has been a steady rise in obese fertility patients for many years. "We do believe obesity contributes to fertility and that weight loss can reverse the issues," she says. "Fat stores steroid hormones such as estrogen and testosterone. The more body fat, the more hormones. The more hormones in body fat, the more interference in reproductive hormones made in the hypothalamus, pituitary and ovaries — HPO axis."

According to Nuffield Health, 50 to 60 percent of women with polycystic ovarian syndrome (PCOS) are abdominally obese.

Dr. Hartog recommends losing weight before fertility treatment. "When obese patients want to try fertility treatment, it is best for them to attempt weight loss first for better outcomes," she says. "Although, in older women — older than 40 — the time it takes to lose the weight may 'age them out' of treatment."

If you are concerned about your waist size and want to reduce, here are some tips from Nuffield Health:

  • Check your waist size every few weeks to make sure you are lowering it. Don’t hold your stomach in when you measure.
  • There are foods and drinks that can cause blood sugar levels to change too often and can increase the fat store around the stomach. Try to avoid such things as white rice, white bread, white pasta, sugar and high levels of caffeine (more than 3 cups of tea or coffee per day). Whole grains, such as brown basmati rice and whole wheat pasta, lean proteins such as turkey, chicken, salmon, mackerel, raw nuts or seeds and decaffeinated drinks are good options.
  • Exercise for at least 2.5 hours per week and try to walk as much as possible in addition to the exercise.
  • Talk to your doctor about waist size concerns, as well as any other health problems.

For more information about weight and fertility, read: Lose Weight for Fertility or IVF.


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