I'm not in the clear yet. We talk about my body mass index, the relationship of weight to height. (To calculate yours, go to familycircle.com/bmi.) A healthy BMI is between 18 and 24.9. A BMI between 25 and 29.9 means you're overweight. Obesity's defined as a BMI equal to or greater than 30 and is strongly associated with a sharp increase in heart disease. Dr. Goldberg informs me my BMI is 31. In other words, I am obese. Not merely overweight, as I'd hoped. My face grows hot. It's not like I hadn't noticed I've grown from a size 8 to a size 14 over five years and two children. But obese?
Dr. Goldberg quickly points out I'm making a smart move with the aerobic exercise, crucial to burn off the excess abdominal fat that's correlated with heart disease. "But you have to organize your diet a little better," she says. She suggests I decrease my simple-carbohydrate intake (white bread and pasta) and eat more whole grains, fish, and grilled chicken. I might not be personally satisfied until I'm in a single-digit dress size again, but even a modest weight loss would help: Dropping just 10% of body weight if you're overweight or obese significantly reduces the risk of heart disease.
As we wrap up our appointment I'm instructed to come back for blood work—and to take small steps to improve my diet, such as reducing my salt intake and planning a week's worth of meals ahead of time.
After I get my blood drawn and while I wait for my next appointment, I read more research on my own. I learn I ought to cut out the fat—but not too much. Low-fat diets are typically recommended to improve heart health, but a moderate-fat diet may be even better. In a 2004 study from the University of Buffalo, overweight or obese participants who followed a moderate-fat (33% of calories from fat) diet had healthier cholesterol numbers and lowered their cardiovascular risk by 14%, compared with people who followed a low-fat (18% of calories from fat) diet, who reduced their risk by only 9%. Of course, not all fats are created equal: Saturated fat, which raises bad cholesterol, should make up no more than 7% of anyone's diet. And trans fat should be avoided whenever possible, since it not only raises bad cholesterol but also may lower good cholesterol.