Call it a beer belly, love handles, middle-aged spread. Whichever the euphemism, what we are in fact talking about is excess blubber. And, while providing a useful "central heating" system for seals and whales, it can pose a real danger to scuba divers for whom water is not our natural environment. Amanda Ursell reports

Fitness
Some of the problems associated with carrying excess weight as a diver are fairly obvious. However much you may resist admitting it, being overweight often goes hand in hand with it being more tiring to get around, and being out of peak fitness.
     At its simplest, this can mean faster air consumption and potentially shorter dives for you and your buddy.
     Other, more serious, issues of poor physical fitness include its ability to hamper rescue skills. It's hard enough to rescue yourself, let alone your buddy or another diver in distress, when physically in top form; it is even harder when unfit.
     Making long swims and hauling yourself and others onto boats or the shore is made umpteen times more difficult, and very much more exhausting, which in turn can lead to stress and panic, putting yourself and others into even greater jeopardy.
     Increased buoyancy
     Being overweight also brings with it possible problems with buoyancy. The more body fat you carry, the more naturally buoyant you are in water.
     Uncontrolled ascents can happen to anyone, but the risk of them occurring could be higher in overweight divers, especially if your weight has changed significantly between dives and you have not taken this into account with your weight system. Rapid ascents increase the risk of decompression illness (DCI).

Decompression illness
While rapid ascents in themselves, as well as deep, long dives, cold water and hard exercise at depth, are all known to increase the risk of DCI, there is some evidence that obesity could be another risk factor.
     Here's the theory. Nitrogen is very soluble in fatty tissue, and extensive bubble formation can build up in your fat stores while diving. The more fat you carry, the more your nitrogen loads can rise. While highly soluble in fat, fatty tissue releases this nitrogen slowly.
     And here is the potential problem. Dive computers and tables are conservative and have been set to take into account a range of human sizes. But they are based on normal-weight people, Mr and Mrs Average, not Mr and Mrs Big. If the diver is overweight, they may lose their accuracy.
     So it's possible that, with extra nitrogen being released from fat stores as you ascend, fatter divers need slower ascent times than computers or tables actually account for.
     The result could be an increased chance of a classic bend, as well as the extra nitrogen bubbles released travelling up to the lungs, blocking tiny blood vessels and causing blood pressure to rise in its main pulmonary artery, not to mention bubbles passing through the lung vessels and embolising in the brain. Both scenarios increase the risk of stroke and neurological decompression sickness.
     Multiple dives naturally compound this potential problem. While your computer may say it is safe to dive, this may be the case for lean divers, but possibly not be the case when you are overweight, and still retaining significant quantities of nitrogen in your slow-releasing fat cells.

Heart disease
The diving medical profession is much clearer over its concerns relating to heart health in overweight divers. Fitness of our heart and blood vessels is crucial when diving.
     The problem, according to the British Heart Foundation, is that millions of us are living with blocked arteries (making it difficult to get adequate blood and oxygen through our hearts even in normal everyday life), without even knowing it. If you dive with this undiagnosed condition, the results are not hard to imagine.
     The extra strain on our circulatory systems through lugging scuba gear, swimming and actually diving, means that the supply of blood and oxygen is even less likely to be able to keep up with the heart's demand.
     Shortage of breath may be noticeable and lung congestion can occur, with a heart attack or sudden death under water both possible results. That this happens in reality only too often is reflected in the most recent DAN report on decompression and diving fatality statistics, which show a high incidence of deaths caused by heart problems.
     Arteries blocked by cholesterol affect other major organs as well as the heart, reducing blood flow for instance to the brain, kidneys and skeletal muscles, all of which can be at increased risk of abnormal functioning through diving with poor circulatory health.
     And it's worth bearing in mind that clogged-up arteries are no longer simply a problem of older age. Research is showing that lousy diets and weight problems are responsible for arterial disease showing up even in teenagers these days. The extraordinary fact is that the UK is behind only Samoa in the world's fastest-growing rates of obesity.

The bottom line
Overweight and obesity can lead to arterial damage and is a danger to divers. If you are overweight, shed the excess pounds. This will reduce raised levels of cholesterol and lower the risk of atherosclerosis and raised blood pressure, itself a danger to divers.
     Meanwhile, ask your doctor to arrange for you to have an exercise stress test. It will give you an insight into the health of your circulatory system, and show early signs of problems.
     Remember that you may be symptomless in ordinary everyday life, but that the stress, anxiety and physical exercise involved in diving can provoke symptoms or sudden death.
     Remember, youth is no protection. Exercise stress tests used to be mostly recommended for divers over the age of 40. However, worrying trends in rising overweight and obesity in younger people no longer make furred and blocked arteries the preserve of the "older" diver. A cholesterol, blood pressure and fitness test could be a lifesaver for younger overweight divers too and, if nothing else, make you face the reality of needing to shift blubber.
     If heart disease runs in your family, even if you are a normal body weight, get a regular check-up to keep an eye on your blood cholesterol levels. If they are raised, seek specialist medical help and advice on your own particular safety issues with diving.
     Heart surgery and angioplasty patients who have had successful bypasses or balloon angioplasty have been known to return to sport diving. Careful individual one-to-one advice is necessary to ensure safety after such procedures.

Diabetes
An estimated 750,000 people in the UK are unaware that they have type 2 or Ônon-insulin dependent' diabetes, in which blood sugar levels are almost permanently raised. The vast majority of these people have it because they are overweight, which means that the pancreas simply cannot produce enough of the hormone insulin to keep up with the large quantities of food consumed.
     The result is raised levels of sugarin the blood and an increased risk of developing furred and damaged arteries.
     Are You overweight?
     If we are being honest with ourselves, few of us really need weight and height charts or complicated calculations to tell us if we are overweight. It is there to see when we look in the mirror, when waistbands begin to strain and you realise that you are just not getting around as easily as you used to.

Body Mass Index
That said, if you love facts and figures, there are ways of measuring your level of overweight. One of the most useful is the Body Mass Index (BMI) calculation. It gives a number that measures the relationship between weight and height.
     Cut-off levels tell us in no uncertain terms whether we are a "normal" weight or are "overweight" or "obese".
     To calculate your BMI you need to do the following calculation:

• Divide your weight in pounds by your height in inches squared.
• Multiply the result of step 1 by 705

BMI = 140 divided by 63 x 63, multiplied by 705 = 24.9

If your BMI is:

• Under 25, you are lower than average and can breathe a sigh of relief.
• 26 - 30, you are over classified as "overweight" and need to shift some.
• 31-plus, you are obese and definitely need to shift some.

     There is an exception to this rule, however. Some men, particularly, can be lean but carrying a lot of heavy muscle. If you are one of these, do the calculation and come out as having a high BMI, use your common sense. Go back to the mirror. If your belly is not hanging over your trousers, then don't panic.
     At the moment it is left to the discretion of the diving physician to certify people fit to dive when a BMI is showing you to be overweight or obese.
     While you may get the official OK, it is clearly going to reduce your risk of injury while diving if you are within the normal ranges.
     Percentage body fat
     If you have a flashy set of bathroom scales that tell you not only your weight, but also your percentage body fat, you can also use this measurement to give a sense of perspective to weight issues.
     Remember that women naturally have a higher percentage of body fat than men. A sedentary woman usually has around 25% body fat, while trained women can dip to 15%.
     It is desirable for women to have less than 28% body fat for diving.
     Trained men can go as low as 7-10% body fat, but less than 22% is the desirable level.

How to lose it
My bookshelves strain under the weight of the books declaring their ability to shift weight and shift it fast. You can do it with cabbage soup, by eating no carbohydrates after a self-imposed 5pm curfew or by separating out carbo-hydrates from proteins. Take a spin around supermarkets and healthfood stores, and there you will find milkshake meal replacement diets, detox potions and weight-loss supplements promising to soup up your metabolism.
     There is only one thing you can be sure of when it comes to diet books and products. If they make promises that sound too good to be true, that make weight-loss seem a doddle and give the impression that the pounds will melt away without the slightest effort from you, then they are fibbing.
     Burning off fat is about fairly basic physics. You eat fewer calories than your body needs and it burns fat to make up the deficit. Yes, it is harder for some people to lose than others, because there are genetic factors that affect the speed with which we lay down and burn off fat and no, this is not fair.
     But these are the facts, and until you deal with them weight loss will not happen, or at least if it does, you will simply pile it back on again, and more.
     So what is the most healthy and effective way to burn the blubber? Well, it's not rocket science. It is about going back to basics.
     There is no doubt that high protein diets work. You do lose weight quickly, because you cut out carbohydrates and feel full quickly on protein-rich foods. But as anyone who has taken this drastic action will tell you, it is not possible to keep up banishing the carbs forever.
     What you can do, however, is to choose the "right" carbohydrates. Ones like porridge, pitta bread and pasta, that take our bodies ages to digest, keep us feeling full for yonks, and stop big highs and lows in blood sugar levels that in turn stop us craving the "wrong" carbo-hydrates, such as fat and calorie-laden cakes, sweets, biscuits and general junk.
     The filling, slowly digested carbohydrates are known as "low glycaemic" or simply "low GI" carbo-hydrates. Eating a "low GI diet" has been proven around the world not only to help people lose weight enjoyably and painlessly, but also to reduce the risk of heart disease and type 2 diabetes, both vital bonuses to divers.

What are low GI carbs?
The GI of a carbohydrate is mostly determined by its level of processing.
     The less processing they have undergone, the lower their GI.
     Porridge and sugar-free muesli full of whole oat and barley flakes have a lower GI than cornflakes that mixes corn with sugar then bakes it, for example.
     The actual structure of the starch grain also counts. Big, fluffy, open starch grains in baked potatoes are much easier to digest than the more compact ones in pasta or tortilla wraps.
     The way to build your meals is to start with low GI carbohydrates and then add to it some good old-fashioned plain protein foods. Rather than have them coated in breadcrumbs, wrapped in pastry or dipped in batter, keep meat, fish and chicken lean and cook simply by grilling, baking or stir-frying. Tofu, soy beans and Quorn make excellent vegetarian alternatives or additions.
     With your meals serve plenty of vegetables, the more the merrier from the low GI list, and ditto fruit as between-meal snacks.
     Eating in this way will keep you energised and help to wean you off the junk. You do need to eat normal serving sizes but you don't need to count every calorie or gram of fat.
     And to shed weight most efficiently, you do need to exercise. If you can't stand the gym, then at the very least buy a pedometer and make sure you stride out 10,000 steps a day.
     An average of 1-2lb a week will begin to fall in a way that is sustainable and tasty, and which can be achieved while
     eating out, eating at home and when away on holidays.
     Staying in B&Bs, taking packed lunches and relying on local cafes or even garage forecourts is no excuse for succumbing to junk and stuffing down excess calories. It may take a bit of careful pursuing and manipulation of menus, as well as a bit of forward planning, but when you consider that your life could be at stake, the effort has to be worth it.

B & Bs
When making your booking, ask what a B&B serves for breakfast to get a feel for what you will be offered.

Breakfast cereals
If all else fails, take your own slow-releasing, low GI breakfast cereal, such as sugar-free Alpen, Sultana Bran or All Bran. The least they can do is to supply a bowl and milk!

The half monty
It is possible to negotiate your way around the traditional cooked breakfast menu and come up with something tasty and healthy without your waistband going berserk.

• Go for poached eggs on toast with grilled tomatoes and mushrooms
• Ask for baked beans on toast with lean grilled bacon.
• Unless you have the nerve to ask for scrambled eggs made without butter or cream, avoid them. You're better off with fried eggs.
• Swap fried bread for toast, multigrain if it's on offer. If not, ask for wholemeal. Only as a last resort have white.
• Skip the sausages and black pudding. They are loaded with fat and calories.
• Have a glass of fruit juice; you don't need half a litre.

The local café
You can use the same rules for cooked breakfasts in local cafés as at a B&B.
     You may, however, get some added options.

• If bacon butties are on the menu, take off the visible fat and rind before eating. OK, it is a bit messy but it's worth doing.
• Omelettes are fine for breakfast - go for ham, mushroom or tomatoes. Avoid cheese versions. You don't need the extra fat.

Garage forecourts
It's not so easy to choose something healthy, low GI and filling from petrol station forecourts. The best you can do is to check out the yoghurts - go for Mullerlite or natural, and fruit. Also look for packets of sliced ham or chicken and some rolls, multigrain if possible.
     Avoid muffins, pastries sweet and savoury, cakes and biscuits and sugary drinks.
     If you are thirsty, stick to water, not least because no one needs extra gas in their digestive systems just before diving, and if it is after the dive, no one needs the extra eight teaspoons of sugar in a typical can of fizzy drink.

Holidays abroad
There is not much excuse for eating badly in hotels when you're on a trip abroad. With cooked breakfasts, stick to the guidelines for B&Bs and cafés in the UK.
     If only continental breakfasts are on offer, have fruit, plain yoghurts and toast with ham. Avoid the croissants and pastries.
     Lunches and dinners should not be too difficult either. Just remember to keep it simple. Go back to basics such as grilled fish or meats with vegetables or salad and some kind of carbohydrate such as pasta, potatoes or bread.
     Traditional Italian and French sourdough loaves are ideal they are medium-to-low GI.
     Avoiding chips and fries and fried dishes like fried calamari goes without saying. For puddings you can't go wrong with fruit. Ice cream and crème caramels make surprisingly low GI choices, but don't go overboard with serving size.

LOW GI FOODS TO OPT FOR

Cereals Oats Oatmeal Sugar-free muesli Sultana branflakes All-Bran Rye bread Pitta bread Plain boiled noodles Rice noodles Tortilla wraps Multigrain bread Sourdough bread Buckwheat Bulgur wheat Oatcakes Vegetables Sweet corn Sweet potatoes Peas Green vegetables Mushrooms Tomatoes Onions Pulse vegetables

Fruits Medium ripe bananas Apples Pears Oranges Grapefruit Nectarines Peaches Berries Kiwi fruit Cherries Mango Orange and grapefruit juice Fruit salad in juice The following foods have a high GI and need to be replaced by low GI foods: French bread White rice Baked potatoes Corn Flakes / Rice Krispies/ CoCo Pops and other refined cereals Puffed wheat Rice Cakes Waffles Bagel French fries White bread Sweets Biscuits Cakes Cream crackers

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