There is a single lifestyle related deficiency that is very common today that increases your risk for a heart attack or sudden cardiac death, decreases your cognitive function and brain speed, and promotes weight gain. What is this critical need?……………………..

 

The answer is SLEEP! Far too many people are not meeting their sleep requirements. They either don’t get enough, or it is poor quality sleep. Inadequate sleep worsens multiple aspects of hormonal health, lowers metabolic rates, increases appetites, and diminishes brain performance.

Having just returned  from a family trip to SE Asia with major jet lag, I was extra sensitive to this topic this week when several of my patients were suffering from obvious sleep deprivation.

Most people need 7-8 hours of sleep nightly, although 5-10% of people may do well with only six hours per night, and likely 5-10% of folks need 8-9 hours nightly. If you are getting enough quality sleep, you should be able to wake up and feel rested without an alarm in the morning, you don’t need extra caffeine to get and keep going, you don’t have afternoon or evening fatigue, and you feel mentally sharp all day long.

Here are seven tips to improve your quality of sleep.

1. Same sleep time: Aim to go to bed and go to sleep at a similar time each night and rise at a similar time each morning, ideally within one hour. Staying up late on the weekends and sleeping in and then getting up early all week decreases the quality of your sleep all week long. If you are exhausted, then take an extra hour in the morning on the weekends, but more important is to make sure you get to bed at a reasonable time.
2. Caffeine and alcohol: Don’t overdo caffeine during the day, or alcohol in the evening. It takes 6-7 hours to remove each cup of coffee from your system. Having more than two servings daily guarantees you go to bed with caffeine in your blood stream. You might fall asleep exhausted, but after 3-4 am the caffeine kicks in and you can’t stay asleep. Drinking alcohol before going to bed ensures your alcohol levels will drop during the night, potentially awakening you with a startle. If you have 1-2 glasses of wine with dinner at least two hours before going to bed, that is ok, but your body can only remove about one serving of alcohol per hour and if you go to sleep with excess alcohol in your system, likely you will feel a startle when the alcohol leaves your system, waking you up during the night. Typically this occurs around 2-3 am in the morning.
3. Exercise: Add daily exercise. Exercise improves sleep waves, burns off tension from the day, and helps your body to feel physically tired, improving sleep. One caveat is to avoid exercising 2-3 hours before bedtime as exercise initially revs up your mental alertness, a good thing during the day.
4. Keep your room cool, dark, and quiet. Most people sleep best in a room between 68-72 degrees F (about 20-22 degrees C). Here in Florida, many people try sleeping at 78 degrees F with high humidity and they wake up sweating during the night. Your room should be cool enough so you can enjoy covering with a comforter and if your feet are cold, wear socks. Ideally your bedroom should be dark, but if not you can easily wear eye blinders to keep out the light. City life can be very noisy at night, disrupting your sleep multiple times. Ear plugs can help, but better yet consider a bedroom window upgrade with sound proof (better insulation and safety too) to keep out the traffic and city sounds. Be sure to keep pets out of your bedroom as they can wake you up multiple times each night; the same applies to children, although obviously exceptions are made for children who are ill or nursing.
5. Limit your bedroom to sleep, relaxation, and romance. Don’t watch TV or work/play on the computer within 1-2 hours of going to sleep. TV and computer screens change brain waves and activate deep brain centers, making high quality sleep elusive. Ideally unwind before going to bed. Read, relax, use prayer or meditation, and spend time with loved ones. Additionally, keep  your office activities out of the bedroom. You don’t need a workstation to distract you from good sleep.
6. Certain foods help you sleep. The brain needs serotonin to relax and your body makes serotonin from tryptophan. It shouldn’t be a surprise that your grandmother suggested you have a snack before bedtime, in particular warm non-fat milk, turkey, bananas, and peanut butter are all high in tryptophan. But if you suffer from heartburn, eat these foods at least two hours before bedtime. Warm herbal brews, such as valarian can be helpful.
7. If you have problems falling asleep, then try meditation or listen to a relaxation recording to help calm your soul before falling asleep. If you can’t fall asleep, avoid watching the clock. Even better would be to get out of bed and read for a while, select something soothing, even boring, then return to bed.

If none of these optimize your quality of sleep, then talk to your medical provider about herbal agents for occasional use, such as valarian or ashwagandha and to clarify that medical issues are not disrupting your ability to sleep. For a short term crises, a minimal-habit forming sleeping medication can be used; however please keep in mind that if used long-term, all sleep medications disrupt normal sleep architecture and make it harder to sleep without the medication.

Wishing You Sweet Dreams!

Steven Masley, MD, FAAFP, CNS, FACN

Japan has fantastic food. Each dish is a display of visual art. The flavors are diverse and sumptuous.  Japan enjoys the longest lifespan and the longest  “health span” on the planet. I just spent part of our family holiday visiting Tokyo and the highlight for my wife Nicole and two sons was visiting the world’s largest seafood market with an incredible array of  fresh (still wiggling) seafood from around the world.

Let me share seven quick secrets to ensure you benefit from your next Japanese restaurant experience. A Japanese meal has multiple courses designed to stimulate most of our senses and add vitality to your life. Six to seven courses seem essential  for a complete meal, although we were served a sixteen course meal with fortunately many small portions.

Here are my  suggestions to a healthy, delicious meal. Keep in mind Japanese portions are typically modest and sometimes tiny.

1. Start with a soup.  Traditionally, a noodle or seafood soup would be the first course and Miso would actually be served towards the end of the meal. In an American Japanese restaurant, Miso is typically served first, so look at other options.  Miso is a soy based broth with a few slivers of tofu, seaweed, and green onion; it is very light and satisfying with delicate flavors after the main meal.
2. Next order edamame, fresh soy beans. Edamame with a tiny dash of rice vinegar and soy sauce is packed with protein, calcium, and many anti-aging compounds and has been a staple food in Japan for centuries.
3. A small salad comes next. My favorite is a mixed seaweed salad with wonderful flavor and texture, but if seaweed isn’t your thing, go for the green salad with the light Japanese dressing, often with ginger and rice vinegar.
4. Either sushi (rice rolled with seaweed and fish, cooked shrimp, and/or vegetables) or sashimi (raw fish) comes next. The quality must be fresh and excellent, or select the cooked shellfish option. Typically, sashimi is served as two small pieces, or one roll is split between two people. Although ahi tuna is one of my favorite foods, be cautious eating this type of big mouth fish often as it is very high in mercury.
5. A grilled or broiled entree is next, the most substantial part of the meal. Typically this is fish, shellfish, meat, or poultry served with white rice. From a health perspective, brown rice would be a much better choice, but white rice represents purity–fortunately it comes in a tiny bowel. My favorite entrees are unagi, (river eel) and unaga (sea eel) which are typically served over rice with a lovely sauce.
6. A mixture of pickled vegetables is next, adding  sour and bitter to complete a nearly full palate and aid in digestion. Various types of vinegar are used to pickle food. Cabbage is commonly included, and be sure to look beyond the pickled ginger that comes with  your sushi. Adding vinegar (acid) at the end of a meal is medically smart as acid improves digestion, nutrient absorption, and helps to prevent heart burn after a meal.
7. Last is fresh fruit and a cup of tea. During the dinner regular green tea is served, but the final cup will usually be something special, like Matcha (made from a special green leaf powder). If you enjoy alcohol with your dinner, then typically a lager beer or cold sake goes best with Japanese food. Although most Americans order warm sake, cold sake is usually much better quality and has a more delicate flavor suited for a Japanese meal. Fruit could be sliced mango, papaya, or strawberries.

This seems like a great deal of food, but the portions are small, and the flavors are complex and satisfying. The Japanese are not only one of the healthiest cultures on the planet, but they enjoy their food immensely, and despite their national wealth, they remain trim. We would all benefit from eating Japanese food more often.

Bon Appétit!

 

This weekend I had the pleasure of speaking to physicians at the Florida Academy of Family Physicians meeting on “Cutting Edge Nutrition”. I had a fantastic dinner while there, and the best part was that I had the chance to talk about food over dinner with long time friend and colleague, Michelle May, MD. Dr. May is a physician from Arizona and the author of several books including “Am I Hungry” plus her newest book, “Eat What You Love and Love What You Eat”. As I was enjoying each bite of my dinner, our conversation focused on “when” we eat, “why” we eat, and how the when and why often lead to what type of food and how much we consume.

Let me ask a few questions to clarify if our conversation would be  important to you:

• Do you sometimes over eat, to the point you feel uncomfortable?
• Do you eat out of control, when you know you shouldn’t?
• Do you eat when you are mad, stressed, or tired but not  hungry?
• Do you make a healthy eating plan, and then can’t resist junk foods that you carefully intended to avoid?
• Do you find yourself sneaking food so others won’t notice?

If you answer yes to these questions, then you are not eating mindfully.  If you don’t eat mindfully, then you risk overeating, eating foods you don’t want to eat, and feeling worse after you eat than you did before you took the first bite.

Over the holidays, we are surrounded by excessive amounts of food, often the nutrient quality of food is poor, and our  schedules are jammed-packed, making meal planning more chaotic.

Here are my four suggestions to eating mindfully over the holidays: 

Step 1: Ask yourself prior to eating, “Are you hungry?” Are you about to eat because you need fuel, because is it socially required, or because you are upset or stressed out? It doesn’t mean you can’t/shouldn’t eat, but be very clear “why” you are eating, or you risk uncontrolled eating, and subsequently regret. If you are not hungry, select a small portion.

Step 2: Declare your space for eating. Plan a place to sit (not in front of the television, not in the car, not in front of the computer, and not at your desk), and if you are lucky, sit with a loved one you want to spend time with. Before you take a bite, look at your food and your surroundings.

Step 3: To eat mindfully, be sure you visualize, smell, taste, and feel the food in your mouth, including each and every bite. Look at the presentation of your food. Is your plate colorful, and is it the right amount to match your appetite? As you slip your first bite across your lips, how does the food taste? Hopefully it tastes delicious, if not, before taking a second bite, ask yourself, do you really want more, or would you like something else? Can you smell the food as you eat it? What is the texture like in your mouth? Switch from one item on your plate to another, and appreciate the difference between each bite.

Step 4: If you are eating with another person, then talk about the food you are enjoying.

This style of eating reflects mindful eating. If you practice mindful eating, very likely you will eat less, enjoy your food more, and make better choices. In contrast with mindless eating, (such as eating in front of the television) you may not taste or smell your food clearly, you may over eat—perhaps to the point you will be uncomfortable, and you may eat foods you would not have normally chosen.

Practicing mindful eating over the holidays will allow you to enjoy your food at a new level, and help you to make excellent food choices.

I wish you a wonderful and meaningful holiday season, filled with love and happy memories, and of course, wonderful food.

Bon Appétit!

Steven Masley, MD, FAAFP, CNS, FACN

 

Nearly everyone knows that we need adequate calcium for good health, but magnesium is equally important, and taking calcium supplements blocks magnesium absorption. As the majority of Americans don’t meet their recommended magnesium intake, calcium supplements may make this problem worse.

Despite its obvious importance, most Americans don’t meet their calcium requirements. Adequate calcium intake helps promote bone health, prevent osteoporosis and osteopenia, improve blood pressure control, and even seems to help with weight loss and fat loss. For more details on how much calcium you need and what type of calcium to take, please see my Bone Nutrition article for details.

Similarly, most Americans do not meet their need for magnesium. Good sources of magnesium are nuts and seeds, green leafy vegetables, beans and whole grains. Sadly, these are foods that many Americans fail to eat and enjoy. See my magnesium food content table for details.

Magnesium has many important health benefits:

• It is good for bone health
• It improves bowel function and helps prevent constipation, especially since calcium supplements when given without magnesium can cause constipation
• It improves blood sugar control
• It improves blood pressure control
• It is involved in hundreds of anti-aging enzyme reactions
• It helps prevent sudden cardiac death. Low magnesium levels have been clearly shown to cause cardiac arrhythmias that can cause major health problems and even death.

So now you get it. Magnesium is important and we don’t get enough. But what does this have to do with calcium?

Calcium blocks the intestine from absorbing Magnesium

Calcium inhibits magnesium from being absorbed in the gastrointestinal track. (In contrast, magnesium does not block calcium absorption.) If you have adequate magnesium intake (400 mg daily, see table above), then you’d be fine taking calcium alone, but very few people get this much magnesium from their diet.

The Solution: If you take Calcium, be sure to take it with Magnesium.

Most experts recommend a 2:1 or 3:1 calcium to magnesium intake. So if you take 800 mg of a calcium supplement daily (usually taken as 400 mg  of calcium divided into twice daily dosages), take 260 to 400 mg of a magnesium  supplement daily too (usually taken as 130 to 200 mg of magnesium divided into twice daily dosages).

What type of Magnesium should you take?

The worst form of magnesium to take is magnesium oxide because it is a gastrointestinal irritant. Magnesium citrate is better and less irritating, but clearly the best form is protein bound (chelated forms of magnesium). Not only is protein bound magnesium easy on your stomach and tolerated nicely, but it has much better absorption than most other magnesium forms.

A good calcium-magnesium combined supplement is OsteoForce, which comes with 200 mg of calcium and 75 mg of magnesium per pill, plus it has extra vitamin D and vitamin K. If you are looking just to add a protein bound form of magnesium, then I’d recommend magnesium malate chelate.

Saturated fat in excess increases your risk of clogging your arteries. The table below helps you to identify common sources of saturated fat. Please calculate what you might eat in a typical day (not good and not bad days).

 

SATURATED FAT TABLE

Item     (serving size)               Cal   Sat Fat

Seafood

Catfish (6 oz)                            115      1.5

Clams/Scallops (6 oz)             300      0.4

Cod (6 oz)                                 218      0.3

Crab (can, 3 oz)                       220*    0.3*

Crab cakes (2)                         318      4.4

Grouper (6 oz)                         201      0.5

Lobster, spiny (6 oz)               285      0.6

Mahi Mahi (6 oz)                     218      0.5

Muscles (3 oz meat)                170*    0.8*

Oysters (3 oz meat)                 72*    0.6*

Salmon (farmed, Atl, 6 oz)     400      5.0

Salmon (wild, Atl, 6 oz)           360      2.4

Salmon (wild, Coho, 6 oz)       278      2.0

Salmon (wild, Pink, can 3 oz) 110*    1.0*

Sardines (can 3 oz)                  215*    1.5*

Shrimp (6 oz)                          200      0.5

Sole (6 oz)                                155      0.5

Trout (6 oz)                             300      2.1

Tuna, Albacore (3 oz)             128*    0.8*

Tuna, Bluefin (6 oz)                360      3.2

Tuna fish sandwich (1)           533      4.0

 

Poultry

Chicken, breast, fried (6 oz)    319      3.0

Chicken, breast, baked (6 oz)  230      2.0

Chicken, leg, fried (6 oz)          208      3.5

Turkey, breast, baked (6 oz)   200      2.0

Turkey, leg, baked (6 oz)         270      2.2

Meat

Bacon (4 strips)                       140      4.0

Bologna(2 slices, 1.5 oz)         180      5.0

Brockwurst (1)                         300      9.0

Hamburger (6 oz)                    490      14

Cheeseburger, large                580      12

Hamburger, lean (6 oz)          467      12.5

Hot dog                                    140      6.0

Pork Chop (6 oz)                     280      6.0

Salami, beef (3 oz)                  450      13

Sausage (6 oz)                        550      15

Steak, sirloin (6 oz)                 316      4.0

Steak, Prime rib (6 oz)           692      24.

Other Fast Food

Chick nuggets                          430      5.0

French fries (large)                 577      8.0 (trans)

Pizza, Sicilian  (2 slices)          590      13.2

Pizza Supreme (2 slices)         820      12.5

Sandwich, ham & cheese        790      13.

Sandwich, chicken (reg)         500      8.5

Sandwich, roast beef              473      9.0

Taco, beef (2)                          520      12.

Taco, chicken (2)                     410      8.0

Appetizers

Chicken wings (6 oz)              607      10.

Nachos   (7)                              570      13.

Onion rings                              450      8.0

 Dairy

Egg, regular                              75      1.6

Egg, omega-3 enriched           75      1.0

Egg white only                          17      0.0

Egg, scrambled                       101      2.2

Brie cheese                              100      6.0

Cheddar cheese (1 oz)            112      6.0

Gouda cheese (1oz)                105      5.0

Mozzarella part skim (1 oz)       80      2.7

Cottage cheese (1/2 cup WM)  120      3.0

Cottage cheese (1/2 cup LF)      90      1.0

Cottage cheese (1/2 cup NF)     80      0.2

Whole milk (1 cup)                 149      5.0

2% milk (1 cup)                       137      3.0

1% milk (1 cup)                       118      1.8

Non-fat milk (1 cup)                 86      0.3

Cream (2 Tbsp)                       100      6.0

Half and Half (2 Tbsp)             40      2.0

Soy Cream (2 Tbsp)                  40      0.1

Yogurt (whole, 1 cup)             160      4.5

Yogurt (low-fat, 2%,  1 cup)  145      3.0

Yogurt (non-fat, 1 cup)           120      0.1

Spreads

Almond butter (1 Tbsp)            95      1.0

Butter (1 Tbsp)                        100      7.0

Guacamole (1 Tbsp)                  21      0.5

I can’t believe its not butter (1Tbs)  90      4.0

Margarine (1 Tbsp)                  100      3.5

Mayonnaise (1 Tbsp)               100      2.0

Parkay spread (1 Tbsp)             60      1.5

Peanut butter (1 Tbsp)            100      1.5

Smart Balance (1 Tbsp)             45      1.5

 Oils

Almond oil (1 Tbsp)                120      1.0

Canola oil (1 Tbsp)                  116      1.0

Corn oil (1 Tbsp)                     120      2.0

Olive oil (1 Tbsp)                    120      2.0

 Nuts

Almonds (1 oz)                       170      1.1

Cashews (1 oz)                        163      2.6

Peanuts (1 oz)                         166      2.0

Pecans (1 oz)                           201      1.7

Walnuts (1 oz)                         185      1.7

Snacks

Corn chips (1.5 oz bag)           240      2.5

Potato chips (1.5 oz bag)        230      4.0

Popcorn, air-pop (1oz = 3 cups)    108      0.2

Popcorn, oil-popped (1 oz)     142      7.9

Tortilla chips (1.5 oz bag)       260      2.0

Tortilla chips (1.5 oz, baked)  180      1.5

 Breakfast

Cinnabon                                 670      14.

Croissant (1)                           350      11.

Danish, apple (1)                    197      6.0

Muffin, (1 small)                     200      3.0

Breakfast cereal (s)                           <1.0

Breads and Bagels                            <1.0

Scone, Cinnamon                    530      13.

 

Dressings (2 Tbsp)

Vinaigrette (oil and vinegar)125      2.0

Ranch                                      120      2.5

Blue Cheese                            120      3.0

Thousand Island                     116      2.0

Desserts (1 serving)

Carrot cake                             270      1.5

Cheese cake                            271      7.0

Chocolate cake                        270      5.0

Chocolate chip cookie (1)       250      8.0

Cream puff    (1)                     335      5.0

Donut  (glazed)                       491      7.0

Fudge brownies                      260      2.0

Ice cream (1 cup)                   520      18.

Ice cream, non fat (1 cup)     200      0.5

White cake                              270      4.0

Snickers (2 oz)                        280      14.

M&M’s (2 oz bag)                  270      8.0

Peanut Butter Cup (2 oz)     260      6.0

 

Sleep is essential to health, vitality, weight control, and well being. Not only do you need enough time to sleep, but the quality of your sleep is equally important.

While most people need 7-8 hours of sleep nightly, there are a few people who do well with 6 hours of sleep, while others may need up to 9 hours nightly. The key is meeting your needs. Keys to clarifying how much sleep you need are to see when you wake without an alarm, plus ensuring you do not have daytime fatigue without resorting to more than 1-2 servings of caffeine daily. If your alarm drags you out of bed, or you need an afternoon shot of caffeine to finish the day, you are getting enough quantity or good quality sleep.

Inadequate sleep is associated with weight gain, heart attack risk, depression, and poor work performance.

Once your clarify how much sleep you need, here is my list of tips to ensure you improve the quality of your sleep as well:

• Aim to go to bed and rise on a schedule that deviates by no more than 1 hour daily (2 hours max), even on weekends.
• Avoid more than 1-2 servings of caffeine in the morning, and no caffeine after noon.
• Avoid drinking more than 2 servings of alcohol at night, and preferably no alcohol within 2 hours of going to bed as this disrupts sleep. Alcohol might help you fall asleep, but decreases REM and deep restorative sleep.
• Exercise for 30-60 minutes daily, but not within 3 hours of going to bed.
• Use your bed for sleeping, rest, and/or romance, but not for office work, video games, or watching TV. Reading for 15-30 minutes before sleep while lying in bed is OK. If you have a computer or TV in the bedroom–move it to another room!
• Warm skim milk/almond milk or herbal teas before bed raise body temperature and help you to fall asleep.
• Specific tryptophan-rich foods will help to fall asleep if eaten 30 minutes before bedtime, such as bananas, turkey, peanut butter, or non fat milk. But if you suffer from heart burn, then keep the servings size to a minimum, and if heart burn is bothersome then avoid eating within 2 hours of bedtime.
• Don’t nap after 4 pm. If you take a nap daily (limit to not more than 30 minutes
• Avoid engaging in work or stressful activities within 2 hours of bedtime.
• Keep the bedroom dark and quiet while sleeping. The darker the better. Wear ear plugs and sleep masks if necessary.
• 30 minutes before turning out the light, dim the lighting to help ease into a sleep pattern. First thing in the morning you want bright full spectrum light for at least 5-30 minutes (such as sunlight, or use a full spectrum bedroom light that activates with your alarm) to stimulate your am wake cycle.
• Avoid sleeping in a warm room. Ideally you want your body and extremities warm but the air cool for optimum sleep. Some people do best with the bedroom between 68-72 degrees. If you use a fan, ensure it is ultra quiet.
• Try wearing socks to bed as warm extremities help you to fall asleep.
• Avoid pets or children in bed as they can be very disruptive to staying asleep. If you have cats or dogs in your bed, they also increase your risk for dander allergies greatly. It may be a long week, but your pets will quickly learn to sleep elsewhere. After six months of age, children benefit from learning to sleep most nights on their own.
• Ensure you have a high quality pillow and consider replacing every year. If you have neck problems, consider a orthopedic shaped pillow. If you use a down pillow, look for a fill power of 650-775 on the label.
• Try meditation before bedtime. Consider a 20-30 minute CD to help get you started.

 If you have trouble falling asleep:

1. Avoid watching the clock.
2. Get out of bed and read for a while, selecting soothing (even boring) not stimulating reading material for 10-20 minutes, then return to bed.
3. Consider a tryptophan-rich snack and warm beverage as noted above.

If nothing works, talk to your medical provider about the following:

• Sleeping supplements/meds can help but are best used on occasion rather than every night.
• An herbal agent for occasional use is Valarian 300-500 mg nightly. Other supplements are available but should be done as part of a comprehensive medical consultation.
• Prescription medications that are useful for occasional use include Ambien, Sonata, and Lunestra; if used long term they make it more difficult to sleep without them and should be considered habit forming.

 

Measure Your Waist and Hip Circumference

Your ten years younger weight loss goal shouldn’t be calculated on your bathroom scale! Most scales can’t tell the difference between fat and muscle. You want more muscle since it makes you look trim and fit. Rather than stepping on the scale, pull out that old fashioned tape measure. It’s going to help you determine how much fat you’re carrying around.

Slip the tape measure around your waist. Measure the smallest circumference between your lowest rib and the top of your hipbone along your side; that will be close to your belly button. Take a big breath, relax your tummy, and blow out. Measure while your lungs are empty and your tummy is relaxed.

Now measure your hips. Choose the largest horizontal hip circumference you can. Be careful not to let the tape dip and rise, as that will inappropriately increase your hip circumference.

Next, calculate your waist-to-hip ratio.  How to do that?  Simply divide your waist measurement by your hip measurement.  Here’s how 33-year-old Alicia did it.  Her waist was 26 inches and her hips were 35 inches. Twenty-six divided by 35 gave her the number of .74.  That would put Alicia at low to moderate risk for major health problems, such as diabetes and heart attacks for a woman her age.  In contrast, 200-pound John’s waist and hips were both 39 inches. At age 50, this 1.0 ratio puts him at high risk of major health problems.

The following chart will help you determine your risk level for your age and gender.

Waist to Hip Circumference Ratio
Adverse Health Risk for Men
Age	Low	Moderate	High	Very High
20-29	Less than 0.83	0.83-0.88	0.89-0.94	More than 0.94
30-39	Less than 0.84	0.84-0.91	0.92-0.96	More than 0.96
40-49	Less than 0.88	0.88-0.95	0.96-1.00	More than 1.00
50-59	Less than 0.90	0.90-0.96	0.97-1.02	More than 1.02
60 and up	Less than 0.91	0.91-0.98	0.99-1.03	More than 1.03

 

Waist to Hip Circumference Ratio
Adverse Health Risk for Women
Age	Low	Moderate	High	Very High
20-29	Less than 0.71	0.71-0.77	0.78-0.82	More than 0.82
30-39	Less than 0.72	0.72-0.78	0.79-0.84	More than 0.84
40-49	Less than 0.73	0.73-0.79	0.80-0.87	More than 0.87
50-59	Less than 0.74	0.74-0.81	0.82-0.88	More than 0.88
60 and up	Less than 0.76	0.76-0.83	0.84-0.90	More than 0.90