Does it matter to health?

Bodies come in a variety of shapes and sizes, making us unique.

While there’s tremendous societal pressure to look a certain way, it’s important to prioritize your health over beauty ideals — and keep in mind that “health” looks different for everyone.

For some time, people have described body shapes by comparing them to fruit, especially pears and apples. People with “pear” bodies are often considered healthier than those with “apple” bodies.

But is this true?

This article dives into apple and pear body shapes, the research behind them, and whether they really mean anything to your health.

People have used fruit terms to describe body shapes for many years because it’s an easy way to describe body types without using more scientific, formal terms.

The “apple” body shape is known in the scientific community as an “android,” meaning that most of the fat is stored in the midsection and less fat is stored in the hips, buttocks, and thighs.

Android-bodied people tend to have a larger waist-to-hip ratio, meaning their waist is larger than or close to the equivalent circumference of their hips.

In contrast, a “pear” body shape is known as “gynoid,” meaning more fat is stored in the hips, buttocks, and thighs than in the midsection.

People with a gynoid body often have a smaller waist-to-hip ratio, meaning their hips are usually wider than their waist.

Although there are more formal terms to describe body shapes, the average person may better imagine an apple or pear than an android or gynoid body type.

First things first: The way a person’s body looks doesn’t automatically tell you if they’re healthy.

However, certain body shapes may be at increased risk of negative health outcomes, according to numerous studies.

one 2020 review of 72 studies found that people with a greater distribution of fat in the stomach area (apple shape) had a significantly higher risk of death from all causes than those with a pear-shaped body.

In one 2019 survey involving 2,683 postmenopausal women, those with an apple body type — more fat in the midsection and less fat in the legs — were three times more likely to have heart disease than those with a pear body type.

Interestingly, having a pear body type has a protective effect against heart disease, reducing the risk by up to 40%.

Another study found that apple-shaped bodies were significantly associated with an increased risk of heart disease and type 2 diabetes, independent of body mass index (BMI). (Remember: BMI has limitations as a predictor of health, especially for people of color.)

Also, small study including 49 men found that despite the same BMI, body weight, and body fat percentage, men with more android fat had lower endothelial function, leading to poorer blood flow in the body.

They also have higher insulin resistance, blood lipid levels and heart rate, suggesting poorer heart and metabolic health.

Finally, a 2021 views of 31 studies found that excess weight around the midsection was significantly associated with a greater risk of heart disease.

The review found that for every 10cm (3.9in) increase in waist circumference, there was a 3% and 4% increased risk of heart disease for women and men, respectively.

Other negative health effects – such as kidney disease, lung and colorectal cancer and even cognitive decline — are associated with central obesity (presence of excess fat in the midsection).

After all, most research shows that fat distribution—not necessarily body weight or BMI—can influence health outcomes.

While using fruit metaphors to describe body types may be convenient, it’s not ideal.

Using objects to describe a person’s body type creates an opportunity for others to make general assumptions about someone’s health and body.

For example, people with higher body weight and body fat tend to experience weight bias in healthcare facilities, meaning healthcare professionals can focus solely on their weight, regardless of the reason they seek medical attention.

This can cause people to lose confidence in health professionals and delay diagnosis, treatment and care.

Making assumptions about people’s health based on their body type can also be a disservice to those with pear-shaped bodies, as the health professionals they interact with may not screen for health conditions based on their body type.

Furthermore, the use of such terms can worsen a person’s body image by suggesting that they do not have the “ideal” body type. The binary nature of these terms also fails to recognize that there are body types other than pear and apple shaped.

Moreover, positioning one body type as superior to another can lead to judgment and stigma against people with other body types. No one should modify their body to look like someone else’s, and research shows that body shape is not a choice anyway.

Genetics can play a role in your body shape. Some people have a longer torso and shorter legs, while others may have a shorter torso and longer legs, or fall somewhere in between. Your height and limb length can play a huge role in how your body looks.

Hormones can also play a role. For example, hormonal differences between men and women may lead to differences in fat storage. Men often store more fat in their abdominal area, while women tend to store more fat in their thighs, legs and buttocks.

As women’s estrogen levels decline with age, their bodies tend to store more fat in the stomach area and less in the lower body.

Although research has linked apple or android body types to a greater risk of chronic disease, this is not always the case. Someone with more belly fat may be in great health, while someone with a different body type may not be.

Finally, the available research is mostly based on observational data, which means it cannot confirm cause-and-effect relationships. Thus, while apple body types are associated with increased health risks, it is not certain that apple body shape is the cause of these risks.

There is many ways that you can better understand your body composition and health risk, such as:

  • Waist measurement: A larger waist circumference (greater than 35 inches or 85 cm for women; more than 40 inches or 101.6 cm for men) indicates more abdominal body fat and a greater risk of chronic disease.
  • Waist to Hip Ratio: This ratio compares the difference in waist and hip circumferences, which can help indicate fat distribution. A ratio greater than 0.80 in women and greater than 0.95 in men suggests greater fat stores in the stomach area. Those with a higher waist-to-hip ratio are at greater risk of chronic disease.
  • Body Fat Percentage: This can tell you how much fat is stored in your body. Although this can generally be helpful, not all tests tell you where fat is stored.
  • Laboratory researches: A blood test can tell you and your healthcare professionals what your health is like, regardless of your body type.

Although these measurements and tests can be helpful, healthcare professionals should not rely on just one test to make a judgment about someone’s health. Instead, they should have follow-up tests if they have any concerns.

It’s also important to look at health from all angles, including diet, physical activity, sleep habits, stress, genetics and mental well-being.

People often use the terms “pear” and “apple” to describe how bodies look and how fat is distributed. Historically, these terms have been used as indicators of human health.

Numerous studies have found that a greater distribution of fat around the midsection—an “apple” or “android” body type—may be associated with a higher risk of chronic disease and poor health outcomes.

However, because many of these studies are observational, the results do not clearly show how much of a role body type really plays in health.

Also, using a person’s appearance to make generalizations about their health is problematic because bodies come in all shapes and sizes. Such generalizations also promote weight bias, which can lead to delayed care and treatment.

Instead, it’s important for you and any healthcare professionals you work with to look at your health holistically, taking into account all aspects of health, including lifestyle, genetics and age-related factors.

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