This week's newsletter, Metabolic Syndrome (MetS)

[Aaron Montgomery]

Hey Jordan, I just read this week's BB Medicine Newsletter and had a question for you about MetS (insulin resistance).

As of recently, my gut is just over 40", blood pressure is 138/86 (in the dr's office), fasting HDL is 36, and fasting glucose is 101. Fasting triglycerides are under 150 (131), but were lower last year. I've gone from 172 to just over 210 so far this year, am 30, 6'1", and am holding ~210lb eating 4700 cals/day. I tend to put on about 1.25" of gut growth for every 10lb of weight gain, and I think my HDL is lower because I quit taking fish oil/omega 3's for a few months before getting my blood work (HDL was 44 last year when taking fish oil).

So here's my question, should I be concerned about my vitals given that I'm trying to get my weight up to 230lb within the next 6 months? My plan is to gain 2-4lb/month, and then reach and hold 230lb till I hit 3/4/5 on the main lifts. After that I'm thinking about doing a major cut to get my bf% down. Given the above info, do I need to rethink my caloric intake and weight gain goals? I'd like to get big without jeopardizing my overall health in the process.

Thanks Jordan!

PS - I've read 'The Bridge' a couple times, and it looks interesting. I'll probably give it a whirl in a month or two. Thanks for releasing useful free info for the masses!

[Jordan Feigenbaum]

You have a 40" waist at 210lbs? I'd be worried about that, if true.

[Alchemist]

You have a 40" waist at 210lbs? I'd be worried about that, if true.

We talked offline and mine's 42" at 205 (5'10") but you seemed ok with it since my hips were 44" for a waist to hip ratio <1.

Is your concern due to his height or some other different factor?

[Aaron Montgomery]

You have a 40" waist at 210lbs? I'd be worried about that, if true.

I keep meticulous measurements at various body weights. I measure with a Mytotape, after emptying my system, first thing in the morning. I take my waist measurement around my belly button, relaxed. If I suck in as hard as I can, my waist measurement is 35.5", instead of 40".

Looking over my log book for this year:
- 1/6/2017 35/30.5" ( waist: relaxed/sucked-in) @174lb
- 2/7/2017 36/31.75 @181lb
- 4/1/2017 37/33 @189.4lb
- 5/2/2017 37.5/33.25 @194lb
- 6/5/2017 38/34.5 @199lb
- 7/28/2017 39.5/35 @206.6lb

So, given that I'm not liking my gut size, and you aren't liking my gut size, what is a good solution? I'm a bit torn because I want to weigh more (like 230lb), but the gut is getting a bit big. I've posted my macros in another thread, and you said they were ok given how many calories I have to eat a day to gain weight. I'm holding a steady 210-212lb at 4700 cals/day.

[Jordan Feigenbaum]

We talked offline and mine's 42" at 205 (5'10") but you seemed ok with it since my hips were 44" for a waist to hip ratio <1.

Is your concern due to his height or some other different factor?

You're right, I had more information on you and I should've asked for the OP's hip measurements.

I keep meticulous measurements at various body weights. I measure with a Mytotape, after emptying my system, first thing in the morning. I take my waist measurement around my belly button, relaxed. If I suck in as hard as I can, my waist measurement is 35.5", instead of 40".

Looking over my log book for this year:
- 1/6/2017 35/30.5" ( waist: relaxed/sucked-in) @174lb
- 2/7/2017 36/31.75 @181lb
- 4/1/2017 37/33 @189.4lb
- 5/2/2017 37.5/33.25 @194lb
- 6/5/2017 38/34.5 @199lb
- 7/28/2017 39.5/35 @206.6lb

So, given that I'm not liking my gut size, and you aren't liking my gut size, what is a good solution? I'm a bit torn because I want to weigh more (like 230lb), but the gut is getting a bit big. I've posted my macros in another thread, and you said they were ok given how many calories I have to eat a day to gain weight. I'm holding a steady 210-212lb at 4700 cals/day.

What is your hip measurement and what is your waist standing up straight?

[Aaron Montgomery]

Hips are 43", waist is 40", standing, completely relaxed (210lb, 6'1", 30). Thighs are 26.5", and lean enough to still see quads.

[Alchemist]

You're right, I had more information on you and I should've asked for the OP's hip measurements.

Fair. I always twitch when I hear 'big boned' as a rationale for being overweight so am not trying to imply that. To that have you seen some bone structures (I'm thinking hip width) that just make a larger than average waists and hips when carrying a not unreasonable amount of fat (20% more or less)? I suspect you will say yes and why the importance of the hip to waist ratio to normalize or put the waist measurement in context.??

[Kiril]

By your blood test I would think you're 55+. Do you have a heart disease in family, before 55-60? Hdl 44 is still pretty low(and a beginning of hbp).You need to change your diet, for improving the blood work.

[Jordan Feigenbaum]

By your blood test I would think you're 55+. Do you have a heart disease in family, before 55-60? Hdl 44 is still pretty low(and a beginning of hbp).You need to change your diet, for improving the blood work.

How many blood tests have you reviewed? Your thought process is not supported by evidence either, which is why we don't manage stuff based off an HDL of 44....

[Jordan Feigenbaum]

Hips are 43", waist is 40", standing, completely relaxed (210lb, 6'1", 30). Thighs are 26.5", and lean enough to still see quads.

You probably don't have MetS, but I think we need to get some blood pressure info and I'd need more info on your lipid panel to make a recommendation based on that.

Fair. I always twitch when I hear 'big boned' as a rationale for being overweight so am not trying to imply that. To that have you seen some bone structures (I'm thinking hip width) that just make a larger than average waists and hips when carrying a not unreasonable amount of fat (20% more or less)? I suspect you will say yes and why the importance of the hip to waist ratio to normalize or put the waist measurement in context.??

I have seen some folks who have much larger waists and hips than I'd think but no gut, which is interesting.