Photo by Hush Naidoo Jade Photography on Unsplash

• Share

PRINT

Q: I had a body fat measurement done by a company trying to sell me a handheld device. It showed my body fat percentage is 18%.  

I am a man in my mid-60s. Is that a good number? Aren’t there other ways to estimate body fat without spending money? 

A: There is no ideal percent of body fat, just as there is no ideal body weight. According to the World Health Organization, men ages 40 to 59 should aim for 11% to 21% body fat, while for men ages 60 to 79, the range is 13% to 24%. For women, the American Council on Exercise (ACE) suggests 25% to 31%. 

However, the “right” weight and fat percent for an individual depend upon multiple factors, such as the following: 

General health. A very low percentage of body fat and low body weight in someone who does not exercise regularly can indicate a medical problem. 

Distribution of body fat. Even if your weight is close to the normal range, a large waist size may mean you have an unhealthy amount of belly fat (visceral fat). Higher amounts of belly fat increase the risk of diabetes and heart disease. 

Metabolism. How an individual’s body handles excess calories significantly affects whether those calories are deposited in fat or turned into energy for physical activity and body heat. 

Amount, type and intensity of physical activity. You not only burn calories during exercise, but also continue to burn calories afterward as muscles replenish their energy stores. Also, doing regular strength training can add a bit of muscle weight that is healthy. 

Better measures to use 

Rather than spending money on a device to measure fat percentage, you can use one or both of these measurements: 

Waist size. There is no consensus on normal for this measurement either. Generally, men should have a waist size of no more than 40 inches and women no more than 35 inches.  

But those are not necessarily healthy waist sizes. For adults of average height, I like to use a goal ratio of waist size to height: waist size should be less than one-half of your height. 

Ratio of waist size to hip size. This is another way to evaluate waist size. Use a measuring tape to find your waist size just above your belly button. Then measure the size of your hips around the widest part of your buttocks. Divide the waist size by the hip size.  

A good waist-to-hip ratio for men is no more than 0.95 and no more than 0.85 for women. 

Both numerical waist size and waist-to-hip ratio offer a window into whether you are carrying too much dangerous visceral fat. 

Q: What are the current treatment options for varicose veins? 

A: Treatment for varicose veins has advanced steadily. And it’s poised to take another step forward. 

Varicose veins stem from problems with the “superficial” veins in the legs — that is, those near the surface, located about half an inch below the skin.  

Like all leg veins, superficial veins have one-way valves that open as blood is pumped up toward the heart, and close to keep blood from flowing back down into the legs. 

Over the years, the valves in a vein can become worn and stop closing properly. This can cause superficial veins to swell, and puts pressure on branches of the veins, which become engorged and twisted. 

To get rid of varicose veins, you must first shut down the malfunctioning superficial vein. That redirects blood flow through other (healthy) veins. 

For years, the only treatment was a surgical procedure (called vein stripping and ligation) that required patients to go to sleep under an anesthetic so the surgeon could make an incision, tie off the problem veins, and pull them out. That caused significant bruising, discomfort and swelling. 

Starting in the 1990s, doctors began using a much less invasive procedure called thermal ablation. It involves closing the affected vein (without removing it) by threading a small catheter through the vein and using heat to make the vein collapse. 

Newer techniques that often make small varicose veins disappear include: 

• chemical ablation, in which the doctor injects a foam solution that causes the vein’s interior walls to scar and close
• adhesive closure, in which the doctor uses a catheter to deliver a natural glue that pulls vein walls together
• mechanochemical ablation (MOCA), in which the doctor uses a catheter with a rotating wire to damage the vein, along with a vein-scarring medication.

If the varicose veins are large (and likely connected to other veins), doctors now have tools to remove them with a tiny incision, or inject a medication that causes the varicose veins to scar and close. 

The best treatment for varicose veins depends on your needs. They all require you to take it easy after treatment, and you’ll need to wear a compression stocking for a little while. 

Another technology is high-intensity focused ultrasound (HIFU), which the FDA has not yet approved. HIFU converts sound waves into a focused beam of heat that seals the vein.  

The treatment is done from the outside of the leg, almost like “zapping” the varicose veins away. 

Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, see health.harvard.edu. 

© 2024 Harvard University. Distributed by Tribune Content Agency, LLC.