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Published December 05, 2012, 11:40 PM

Who’s healthier? Body not best indicator of good health

FARGO - Personal trainer Mariah Prussia recently took on a new client who was diagnosed with type 2 diabetes. The woman’s glucose level measures three times the normal range.

By: Tracy Frank, INFORUM

FARGO - Personal trainer Mariah Prussia recently took on a new client who was diagnosed with type 2 diabetes. The woman’s glucose level measures three times the normal range.

And she’s only a size 2.

“Let’s be real,” said Prussia, who owns Xtreme Measures fitness center in Fargo. “People don’t eat what they should be eating. Just because their appearance might look healthy on the outside doesn’t mean it’s healthy on the inside.”

People often assume if you’re thin, you’re healthy, and if you’re overweight, you’re unhealthy. But that’s not always the case.

Even if someone looks thin, she might have the same body fat percentage as someone who’s overweight, Prussia said.

No matter your size, you can possess a range of problems typical of people who are overweight. If you don’t eat right and exercise, fat can build up around your organs.

A study published in August in the Journal of the American Medical Association shows that almost one in four skinny people have pre-diabetes and are considered metabolically obese, according to Dr. Mark Hyman, an author and founder of The UltraWellness Center Massachusetts.

“New research points to just how dangerous being skinny can be – if you are a ‘skinny fat’ person, that is,” Hyman wrote on his website.

Dr. Anne Kidder, a family practice physician at Essentia Health’s West Fargo clinic, said she deals with people who look thin but are really unhealthy on a regular basis.

“Part of it is family history, genetics,” Kidder said. “Part of it is the sedentary activities that we have, lack of physical activity.”

Another huge part of the problem is that people are eating too much, and they’re eating the wrong things, she said. Our diets need more protein, fruits and vegetables, and fewer processed foods and grains, she said.

Pat Hesby, a personal trainer and instructor at Elements Fitness health club in Fargo, said she has worked with women who are thin, but they are inactive, have weak upper bodies, low energy levels, and eat a poor diet high in carbs and sugar.

While they look thin, they typically have a higher percentage of body fat and to maintain their weight, they skip meals and cut back on calories, she said.

“Not getting the proper nutrition eats at the good lean muscle mass,” Hesby said. “They send their bodies into a cycle of starvation to fat storage mode. This stored body fat usually settles right around the mid-section resulting in the ‘tummy’ or ‘muffin top.’ ”

It’s also possible to look overweight but be fairly healthy on the inside.

Prussia has another client who is 6’2” and weighs more than 200 pounds but is the most active person Prussia knows.

“You can’t judge a person by the cover,” Prussia said. “It’s really what lies within the text or your body that really tells the true story.”

Because our society focuses on body image and promotes thin as healthy, people assume that if you’re thin, you must work out and eat a healthy diet, but if you’re overweight, you’re inactive and eat a lot of junk food, Hesby said.

“Maintaining a healthy weight is important, but this does not show what your body fat count is,” Hesby said. “The bigger picture is to look at the body composition to see what is going on in the inside of our bodies.”

Hesby said she also encourages her clients to change the way they think and aim for being fit instead of being thin.

Dr. James Mitchell, Sanford psychiatrist and co-director of the Sanford Eating Disorder and Weight Management Clinic, said in general, weight correlates to health to a very large extent, but there are outliers.

“Some people survive being overweight or obese and do just fine, probably to some extent owing to genetic factors,” he said. “Other people develop complications like diabetes at a perfectly normal weight. Probably that’s inherited to some extent as well.”

Regardless of what a person weighs, diet and exercise can influence those risks substantially, Mitchell said.

“People who exercise, particularly if they engage in exercise that builds muscle mass, they can be at a higher body weight or BMI (body mass index) but actually be in good shape,” he said.

A lot of people who are thin are healthy, but people who are too thin have increased health risks as well, Mitchell said.

For the elderly especially, underweight is as dangerous as overweight, he said. People’s appetites tend to decrease as they age, and they may have to eat when it’s time to eat regardless of whether they’re hungry, he said.

The best thing to do is visit a physician for tests to make sure your glucose tolerance is normal, your serum lipids are normal and your organ systems check out as being normal, Mitchell said.

Dr. Hyman recommends the following tests to make sure you’re healthy on the inside no matter how you appear on the outside:

  • Fasting blood sugar or glucose (normal is less than 90 mg/dl).

  • Triglycerides (normal is less than 100 mg/dl).

  • HDL or good cholesterol (normal is greater than 60 mg/dl).

  • Blood pressure (normal is less than 120/80, ideal is less than 115/75).

  • Insulin response test (Glucose should be less than 90 mg/dl fasting and never go above 120 mg/dl at one and two hours. Over 140 mg/dl is pre-diabetes, and over 200 mg/dl is Type 2 diabetes. Insulin should be less than 10 fasting and never go above 25 or 30 after the sugar drink.)

  • NMR Lipid Particle Test to measures the size and number of cholesterol particles. (You should have fewer than 1,000 total LDL particles and fewer than 500 small LDL particles.)