Apples, pears and fat cells

Q: Why is the waist/hip ratio so important? I read all about apples and pears, but why is it such a big deal?

A: Apples and pears have been used to describe the location of fat around the middle. "Pears" tend to have more of their fat located around the hip region, and "apples" have significantly more fat in the mid-section. Their waist-to-hip ratio is generally greater than .8 for women or 1 for men.

The fat tissue in the abdominal area seems to be more metabolically active. Researchers have discovered a significant relationship between fat in this area and an increased risk of heart disease, diabetes and insulin resistance, or syndrome X. This would be the apple-type of fat distribution.

The fat cells in this area might be a major source of inflammatory cells called cytokines. As the fat piles up, cytokines multiply and become more active. Cytokines might activate the body's inflammatory cells, which can damage blood vessels, loosen fatty plaque and cause obstruction in blood vessels.

Cytokines might also cause the liver to release stored fat and sugar into the blood stream, causing higher triglyceride and blood sugar levels. They might also encourage more fat to be deposited in the abdomen area. It seems like once they get started, they really hang around.


Abdominal fat appears to be a key site for the general processes of inflammation, coagulation and fibrinolysis. These are the primary mechanisms linked to heart disease, diabetes and insulin resistance.

So if fat is piling up around your midsection, work to reduce your weight. This is one case where an apple won't keep the doctor away.

Sue Kosharek, of Rochester, is a registered dietitian in private practice. Questions for Nutrition Briefs should be sent to the Food section, Post-Bulletin, 18 First Ave. S.E., Rochester, MN 55904. Questions can be left on the Nutrition Hotline on City Line, 252-1111, category 5100, and questions will be forwarded to columnists. You also may e-mail questions to

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