August 2019 - Advanced Laparoscopic Associates
Body Shape: Why it Matters

Body Shape: Why it Matters

A July 2019 study has put a spin on the finding that body shape matters—despite one’s overall body size. We know that a pear-shaped body is better than an apple-shaped body in terms of health risks. That’s because the fat in the abdominal area (the apple shape) is mostly visceral fat, the most dangerous kind. And while it’s customarily been the case that this is true of only overweight people, the study contends that it doesn’t matter if you’re overweight or normal weight: Carrying fat around the middle is a significant mortality risk.

The study, detailed in the July 24, 2019 issue of the JAMA Network Open, included 156,624 postmenopausal U.S. women who are enrolled in the famed Women’s Health Initiative study. The authors state that while current public health guidelines for obesity focus on body mass index (BMI, which is determined by weight-to-height ratio), those guidelines do not sufficiently stress what is termed as central obesity, which is measured by waist circumference and reflected in the apple-shaped body.

Central (waist) obesity was highlighted in a 2010 JAMA Internal Medicine study of almost 105,000 people, which found that both men and women with bigger waistlines (apple-shaped) were twice as likely to die as those with smaller waistlines (pear-shaped). Those with bigger waists also had a greater risk for type 2 diabetes, cholesterol problems and coronary heart disease.  The study pointed out that it is the body shape, i.e. where a person carries body fat, is what matters most when it comes to health.

The body size in the 2010 study included apple-shaped participants who had waistlines of more than 47 inches for men and 43 inches for women. Yet the new study findings show that even women of normal weight can carry the same health risks if they have central obesity. In fact, it found that those normal weight (as defined by BMI) post-menopausal women studied who had central obesity had a 30 percent increased risk of mortality over normal weight subjects without central obesity.

Types of Fat

Colors of fat

Although the term “body fat” is widely used, not all body fat is alike. There are several types, and each serves a physiological purpose. Fat is divided into various types and by its color shades. To simplify, there are three basic colors of body fat:

  • Brown: Brown fat is considered healthy, but is only present in small amounts in adults. It is mostly a feature of newborn babies. Brown fat helps keep us warm, so it is known as “fat-burning” fat.
  • White: White fat, on the other hand, comprises a majority of the body and increases with age. In excess amounts, white fat can be harmful for our bodies.
  • Beige: Beige fat is a combination: it is similar to brown fat in that it is energy-burning, but it has its own unique cell type and is embedded (mixed in) in white fat.

Essential fat

Essential fat is necessary for life and health. It is found in the heart, lungs, liver, brain, nerves, intestines, bone marrow, muscles and tissues of the central nervous system. It helps to regulate body temperature, hormones (fertility hormones in women) and cell structure. This is the type of fat you should not lose, as its loss compromises health.

Subcutaneous fat

Subcutaneous fat is fat stored under the skin and is a combination of brown, white and beige fat cells. This fat is partially energy-storing, it helps regulate body temperature, is padding to protect muscles and bones and is part of helping nerves and blood vessels to travel between skin and muscles.

However, too much subcutaneous fat can be accumulated due to genetics or lifestyle, such as overeating and being sedentary. Too much of this fat can lead to heart disease and stroke as well as high blood pressure, type 2 diabetes, kidney and liver disease and some cancers.

Visceral fat

Visceral fat, also known as “belly fat”, is sometimes also called “active fat” as it can actively increase the risk of various serious health conditions. Visceral fat is white fat, and it is located within the abdominal cavity and surrounds organs such as the heart, liver, pancreas and intestines.

Some belly fat is not necessarily visceral fat; it can be subcutaneous fat, the type of fat found in the arms and legs. But visceral fat increases the risk of heart disease and heart attacks, stroke, type 2 diabetes, and breast and colorectal cancer. It is also associated with an increased risk of Alzheimer’s disease. 


It is well-established that obesity is connected to a number of health risks. It is also well-established by significant research and the length of time it has been available that bariatric surgery is one of the safest and most effective ways to address obesity. This includes, in particular, the health risks related to obesity, which have been shown to dramatically decrease with the weight loss that occurs as a result of this surgery.

Explore bariatric surgery with one of our experts at Advanced Laparoscopic Associates by requesting an appointment today. We can determine if bariatric surgery is right for you and give you the options for the form of surgery most appropriate for you. We’ll care for you every step of the way, from consultation to postoperative follow-up and beyond.

ALA Surgeons Help Future Doctors Learn

ALA Surgeons Help Future Doctors Learn

At Advanced Laparoscopic Associates, we take our responsibilities for training the next generation of doctors seriously. Many of our clinicians hold prestigious teaching posts at area medical schools to ensure future colleagues are well-trained professionals. But just as important is fostering a love of medicine even earlier in prospective physicians’ academic careers. That’s why ALA surgeons Dr. Amit Trivedi and Dr. Sarah Wong hosted undergraduates in the Stewart Alexander internship program on July 24 and 25.

The Stewart Alexander internship program takes place at Pascack Valley Medical Center. Interns are undergraduate college students who shadow working doctors for six weeks in the summer. They are exposed to a variety of medical specialties, including:

  • Bariatric surgery
  • General surgery
  • Anesthesiology
  • Orthopedic surgery
  • Cardiology
  • Pediatrics

…and more.

On July 24, Dr. Trivedi and Dr. Wong exposed interns to one of the most fundamental skills in surgery: suturing. They set up a suturing lab at Pascack Valley Medical Center and oversaw interns practice suturing on pigs’ feet.

The next day, the interns got to see in action some of the most exciting medical technologies in current use with a full robot simulation lab. Pascack Valley Medical Center is one of only six hospitals in the United States to use the TransEnterix Senhance Surgical System. Students sat at the console and practiced controlling the robot to perform surgical skills.

Dr. Trivedi and Dr. Wong said it was a pleasure to work with the bright, enthusiastic young people in the Stewart Alexander internship program. ALA is proud to work with Pascack Valley Medical Center and the Stewart Alexander program.

If you are considering general or bariatric surgery, request an appointment at Advanced Laparoscopic Associates. With now five locations, we are the most comprehensive surgical practice in northern New Jersey and we can help you choose a path of treatment that is both effective and right for you and your life.

Is Honey Healthy? Health Benefits of Eating Honey

Is Honey Healthy? Health Benefits of Eating Honey

Sugar is sugar, right? Don’t be so sure. Packaging matters, and we’re not talking about 45-calorie packets from Starbucks. White sugar is so processed and refined that almost no nutritional value is left by the time it hits your tea or yogurt.

You have options, though. Forget the synthetic sugar substitutes. For the best nutritional bang for your buck, look to honey.

Watch Your Sugar

No one is saying an excess of sugar is good for you. In fact, overconsumption of sugar (especially added sugar, as opposed to sugar found naturally in foods) is one of the biggest public health risks of the 21st century. The average American consumes more than 150 pounds of sugar per year.

Too much sugar has been linked to:

  • Obesity
  • Type 2 diabetes
  • Heart disease

…and more.

It is important to cut sugar where you can. But, if you like things sweet, honey is one of the best choices available.

Types of Sugar

Gram for gram, all types of sugar have the same number of calories: 4 calories. That doesn’t mean all sugars are created equal, as we mentioned earlier. Honey’s main advantage here is its chemical structure.

Honey and white granulated sugar both contain glucose and fructose (two forms of sugar), but while white sugar has them both hooked together, in honey they are in separate molecular packets.

Glucose fuels cells. Insulin brings it into the cells where it is used for energy. When it is not immediately used, glucose is converted to glycogen and stored in the liver or muscles. Fructose, on the other hand, has to be converted into a useable form by the liver, and if it is not used immediately, it gets stored as cholesterol and triglycerides, both of which can be harmful to the heart in excess quantities.

Honey having both glucose and fructose present is a clear advantage over regular sugar.

Health Benefits of Honey

Honey is easier on the body than sugar, but the benefits don’t stop there. Because it is less processed, honey can often have more beneficial compounds taken from the plants from which it is made, which are called phytochemicals. Some types of honey can have more than 70 phytochemicals.

These phytochemicals, especially the ones known as antioxidants, may provide a range of benefits. Antioxidants such as polyphenols fight against free radicals, which cause a process called oxidation that destroys cells’ DNA.

Although definitive scientific evidence is hard to come by when discussing the medicinal effects of food, some studies have suggested that honey can cut the risk of certain dangerous diseases. A 2008 study in Scientific World Journal examined data from 55 obese or overweight people, some of whom took 70 grams of honey a day for 30 days.

The patients in the study who took honey saw a slight reduction in weight and body fat. They also had reductions of total cholesterol levels and LDL cholesterol levels (the “bad” kind of cholesterol), and an increase in HDL cholesterol (the “good” kind).

Another study, this one published in 2016 in Journal of Food Biochemistry, identifies a number of phytochemicals in honey that may protect against colon cancer, and concluded that honey may decrease colon cancer cells’ tendency to reproduce. A 2018 study in Food and Function suggests honey may induce cell death in colon cancer cells.

What Type of Honey Is Best?

You want your honey to be as minimally processed and as fresh as you can get it, and it doesn’t get any fresher than straight from the hive. Watch as our own Dr. Trivedi sets up his new beehive!

ALA Announces New Location in Wayne

ALA Announces New Location in Wayne

Advanced Laparoscopic Associates (ALA) is proud to announce that we are opening a new location in Wayne, NJ. We will begin seeing patients at the Wayne location in August 2019.

With offices in Paramus, Jersey City, Westwood, North Bergen and now Wayne, we now provide coverage for most of northern New Jersey.

Our new office’s address is:

246 Hamburg Turnpike

Suite 203

Wayne, NJ 07470

Adding a fifth location allows our patients to obtain the appointment they need at the time and location most convenient to them. Now patients all over New Jersey can schedule time with one of our surgical pioneers easier than ever.

ALA has been at the forefront of bariatric and general surgery since our founding. We offer procedures for weight loss and abdominal surgery that are both innovative and stand the test of time. If you are ready to take control of your health through weight loss surgery, or if you have a health condition that needs treatment, request an appointment at ALA today.