Truncal Obesity and Health


Now that America’s most passionate day of food consumption has passed, it is time to get smart about food choices and how it affects our body.   

“Apple shape” is a popular term used for truncal obesity – fat that has accumulated around one’s middle.  It is defined as a body-mass index (BMI) 30 and above, and a waist-to-hip ratio of greater than or equal to 0.88.  Normally, obese people put on weight relatively evenly through their entire body.  Sufferers of truncal obesity put on larger than normal amounts of fat around their midsection, often making them seem disproportionately overweight compared to others with the same BMI.

Having any excess body fat above a standard range is unhealthy.  The more overweight, the greater the risk for onset of chronic and serious illnesses.  Unfortunately, suffering from truncal obesity as opposed to ‘normal’ obesity only makes the problem worse.  This is because the fat is concentrated around the belly and digestive systems, as opposed to hanging off the legs, hips, and buttocks. 

Truncal obesity is associated with atherosclerotic heart disease and an increased risk of acute myocardial infarction, hypertension, hypercholesterolemia, diabetes, and increased blood pressure in the kidneys with an increased risk of kidney disease over time.  It also weakens the immune system, decreases sexual performance, can trigger bouts of depression and other mental disorders, and is universally acknowledged as reducing the quality of one’s life.

The obvious solution to treatment of truncal obesity is to lose weight, either by reducing your caloric intake of food or by increasing the expenditure of calories through exercise.  A combination of both is strongly preferred by health professionals and will provide quicker, longer lasting results.  Despite many infomercials and diet plan claims, you cannot ‘spot-target’ fat reduction.  Try adding an exercise regimen that involves gradually increasing amounts of cardiovascular exercise.  Using a diary to chart foods consumed and exercises performed is very helpful in charting your progress.  Bottom line, in order to lose weight, calories consumed must be less than calories burned!   

Start now and your weight loss goals for 2014 will be in full-swing by New years!

References:, Christian Romero

Sit or Stand? Strategies to Improve Workplace Health

Many people sit at work these days.  There has been a large amount of interest in designing the seated workstation with the application of ergonomic principles to reduce the likelihood of injuries.     

With the changes to a more sedentary lifestyle, we are encountering an increase in chronic diseases such as diabetes and heart disease.  Current research shows that sitting for long periods of time is a risk factor for a variety of these chronic diseases.  Prolonged sitting contributes to the risk of heart attack, stroke and metabolic syndromes.

A study by Dr. Hidde van der Ploeg found that sitting for 11 or more hours each day increased the risk of death by 40% compared to sitting less per day.  Added to this increase is the development of chronic diseases and the negative effects that accompany a relatively sedentary lifestyle.  The fact is that Americans are getting bigger.  The U.S. Centers for Disease Control and Prevention (CDC) states that nearly 36% of American adults are obese and another 33% of adults are overweight.  There is increasing evidence that the seated lifestyle contributes to this increase.

During the past few years, there has been an increasing interest in getting workers out of their chairs.  As part of this trend, many employers have started to use and promote the stand-up workstation as a way of enforcing movement on an otherwise sedentary work force.  A recent article in the Huffington Post provided the following suggestions for adding movement to the workplace:

  • Use a standing desk.  Working from an upright position burns more calories (20 percent) than sitting.  Additionally, prolonged sitting has been shown to increase plasma triglyceride levels, decrease levels of HDL cholesterol levels and decrease insulin sensitivity.
  • Take frequent office laps:  Regular walk breaks helps circulation, helps to refocus the brain and helps to burn fat.
  • Desk exercises:  Perform exercises such as stretching while seated.
  • Treadmill desk:  This allows the user to walk at a slow pace while working.  You can place a computer and a keyboard on a treadmill and type (work) while you walk.
  • Yoga ball chair:  Sitting on a yoga ball (aka Swiss ball, balance ball) helps to engage the core muscles and improved balance.
  • Standing station:  There are commercially available standing work stations, but improvisation is also acceptable.
  • Active meetings:   Instead of sitting in a meeting room, move meetings outdoors.  Meetings wouldn’t last quite so long if they were not held indoors in meeting rooms with attendees seated comfortably in chairs.

Of course, prolonged standing is not always the best position either.  Movement is the key to remaining healthy.  Workers should be encouraged to move from a sitting to standing position and back as frequently as possible.  Vary your activities in the workplace and see if this makes a positive difference for you!


  1.  Van der Ploeg HP, Chey T, Korda RJ, Banks E, Bauman A.  Sitting time and all-cause mortality risk in 222,497 Australian adults.  Arch Intern Med, 2012 Mar 26;172(6):494-500.
  2. Harper, Paul, Dynamic Chiropractic Sit or Stand?  Strategies to Improve Workplace Health and Reduce Disease, Oct 1, 2013 p8,10.

Use of Foam Rollers – Tips and Techniques

Benefits of using a foam roller is comparable to a deep tissue massage, myofascial release and myofascial trigger point therapy. Myofascial trigger points are taut bands or knots in the muscle tissue that can refer pain to other areas. For example, a trigger point in a gluteal muscle may refer pain down the leg. Trigger points can also limit range-of-motion, inhibit muscle strength and cause muscle fatigue. Regular work can increase flexibility and performance while decreasing muscle tension and pain.

Maximize the effectiveness of the foam roller by incorporating it into your daily stretching routine. Use the roller before and after activity, and always roll before you stretch. This will help to warm up cold muscles and prepare them for deeper stretching.
Make sure you roll on soft tissue and not over joints, ligaments or bony protrusions. Start by placing your body on a roller and slowly roll up and down the muscle. If you find a knot or tight band, hold that spot and try to feel the tissue release and soften underneath the pressure. Take deep breaths and try to keep your body as relaxed as possible.

Use of the foam roller can be painful. If an area is too painful to roll, place your body on the roller for 15 seconds before moving on to the next spot. As the tissue starts to loosen up you should be able to roll with less pain.

For low back lumbar extensor muscles:
Position the roller so that it’s in line with your spine. To focus on your right side, roll your body to the left, keeping your spine parallel to the roller and stop on the muscles that run along the length of your spine. Hold and allow your back to relax. Repeat on the left side.

For lateral low back obliques & quadratus lumborum muscles:
Position yourself as shown placing the foam roller between your ribs and hip. Slowly roll backwards until you feel a stretch and pressure in your lower back region. Hold on tight spots until you feel the tissue soften. Do not hold on any one spot for longer than a minute. Be careful not to over-treat. Repeat on the opposite side. 17

For gluteal muscles, piriformis:Start side-lying on the foam roller. Extend your right leg so that it’s in line with your torso and rotate back to position your right gluteal on the roller. Bend and place your left leg behind your right and place both hands on the floor for support. Proceed to roll the right gluteal region along the roller. Repeat for your left side.


Stop in the office and take home your roller today! 802-655-0354

Foam Roller Techniques, OPTP, 2008, Michael Fredericson, MD, Terri Lyn S. Yamamoto, PhD, Mark Fadil, CMT, p. 15, 17, 23.