Bellies and Ankles: What’s Your Story?

I’ve recently taken a little more interest in my ankles and belly.

First, the belly. Fifteen months ago, I was excited to join long lost friends for 35^th Year High School reunion. One of the votes taken at the post-reunion evaluation was “the man with the biggest belly award”. Opinion was divided. Everyone was over 50, and sadly, there was no six-pack abdomen at the reunion.

Here are a few tell-tale signs that you may be heading for an “award”:

1. You stand with your feet together under the shower and place a coin between your big toes. You look down but cannot see the coin.
2. You usually wash one foot with the other and not your hand
3. Your shoe laces are permanently knotted
4. Wearing your underwear or stockings requires careful balancing
5. A coin disappears effortlessly in your belly button
6. Picking things off the floor is a chore
7. You can grab a chunk of flesh from either side of your abdomen
8. You take a deep breath and keep your belly tucked in when taking photos.

Why have I developed a big tummy?

Someone else is to blame!

1. My parents gave me the wrong genes. “I was a ten-pound baby at birth. Though I was skinny throughout my childhood and young adult years, the fat cells which were laid down while I was in the womb have finally been let loose!”
2. The environment is not conducive for healthy living: “Government has allowed the food and beverage industry to drown us with fat, salt, sugar and alcohol. Public spaces are not friendly for walking, running or cycling. Work is stressful – headlines, deadlines and I’m just too ‘bushed to work out’. “

Maybe “I have grown older and now spend endless hours in front of my laptop. I work late; eat large portions of high calorie meals late in the night and go to sleep. Never thought the day would come when I would require that much energy just to snore!” Some people even have a home gym to support a varied exercise routine, yet they remain inactive.

I dare say that if you have a big belly (and no other health problem), it’s probably because you eat too much and exercise too little. Oops! Perhaps you enjoy your fizzy drinks, drive-through take-away, beer and other alcoholic beverages or have a home cinema and finger on the buzzer.

Take a look at your ankles and feet. Are they swollen? If you are a pregnant woman, as long as your urine has no protein when tested and your blood pressure is normal, this may just be a sign that the pregnancy is going well. Good luck. Some women who are not pregnant and take hormonal contraceptives may also have swollen ankles.

What about the rest of us?

You may have been on your feet for a long time. Some people spend far too many hours seated in their offices – “sitting disease”. Over time, this can lead to venous insufficiency. When we are sedentary, the pumping action of the contracting calf muscles is reduced and the valves within the deep veins in our legs may also become less effective and blood leaks backward. With time, the legs swell, with skin discolouration, possible breach of the skin leading to infection and (venous) ulcers.

Swollen ankles may be symptoms of diseases of organs such as the kidneys, heart or liver. Swelling on one leg could be a sign of a blood clot. Certain blood pressure medications called calcium channel blockers e.g. Amlodipine, Nifedipine, also hormones and steroids, some antidepressant and diabetes medication could cause ankle swelling. Damage to lymph channels that take a small percentage of fluid back to the heart from the legs, trauma to the legs and certain diseases within the pelvis and/or abdomen which obstruct the flow of blood to the heart can have a knock on effect and cause ankle or leg swelling.

So what’s your story? Have you gone from normal weight, to overweight and are now officially obese? Don’t despair. There are over 600 million obese adults in the world. We are obese primarily because we consume more calories than we burn. The result is that we accumulate fat (in our belly and elsewhere) and this has a negative impact on our health: High Cholesterol, Hypertension, Heart disease, Diabetes, Stroke, Liver disease, Cancers, abnormal menstrual periods, Infertility, Respiratory Disease, Depression and many more.

Why not get that measuring tape and check your abdominal circumference: Men >=94 cm  (Increased risk); >=102 cm (substantially increased risk);  Women >=80 cm  (Increased risk) >=88cm (substantially increased risk)
We cannot change our genes (for now). We cannot influence government overnight (big business has a tight noose around the neck of many politicians worldwide). The slower day will never come. Workaholics pay cheques out of their body bank accounts and never make any deposits. Their bodies run on overdrafts, permanently in the red. Is that you? The one thing we have control over is our lifestyle. We can make little changes over a long time. Agreed, there’s more to it than meets the eye. It’s not easy to change behaviour. Still, we can consume fewer calories (healthy eating) and expend more calories (physical activity) or join the queue for a wonder pill or bariatric surgery. Each one to his own.