Eat Well to Be Well: Battle of the (belly) bulge can be won

Call it what you want – belly bulge, belly fat, beer belly, pot belly, spare tire – most of us have some and would like to get rid of it. Fighting unwanted excess fat around the abdominal area can be a long, difficult battle many combat for years, often without success. Countless people usually give up, believing it’s not worth the hassle and that they are being too vain. Don’t think of this as just a vanity issue – this is a battle worth fighting as too much belly fat can negatively affect your health.

Know your types of body fat

All of us have fat stored in various areas of the body. One type is called subcutaneous fat, stored directly under the skin. Subcutaneous fat is more for insulation and relatively harmless. Another type of fat is called visceral fat, stored within the abdominal cavity and is what surrounds and cushions organs in that area and what gives us that belly bulge.

“Belly fat, a.k.a. visceral fat, is serious business,” said Dr. David Samadi, chairman of urology and chief of robotic surgery at Lenox Hill Hospital in New York City. “Visceral fat actually works like an organ in the body, similar to your thyroid or pancreas. It can actually secrete hormones, causing inflammation on the vessels and around the heart, which could lead to cardiovascular disease. It’s considered the most harmful form of fat in the body, and can be present even among those deemed ‘skinny’.”

Visceral fat is more metabolically active, releasing hormones called adipokines that increase inflammation and insulin resistance of tissues. This chronic inflammation and insulin resistance can lead to atherosclerosis (a cause of heart disease), type 2 diabetes, high blood pressure and possibly certain cancers, including breast, colon and prostate. Having too much visceral fat, also called central abdominal obesity, causes health problems and needs to be reduced.

How to determine belly fat

“Deep belly fat is only identifiable through a CT or MRI scan,” said Dr. Samadi. “This stems from research which shows fat in this area may be folded deep inside the abdomen around the stomach organs.”

However, there are two simple methods to determine visceral or belly fat that can be done at home and are also fairly accurate. One is waist circumference and the other waist-to-hip ratio.

To measure waist circumference: Using a cloth measuring tape, measure around the body slightly above the belly button. Exhale while taking the measurement. Compare the measurement with these standards:

  • Men: 102 cm (40 inches)
  • Women: 88 cm (35 inches)

If the waist measurement is larger than the standards, it indicates too much visceral fat and possible increased risk of disease.

“For men, a waist measurement of more than 40 inches indicates an unhealthy concentration of belly fat, increasing risk,” Dr. Samadi said. “For women, a waistline more than 35 inches will signal significant risks as well. Your waistline should measure the same as your height in inches divided by 2.”

To measure waist-to-hip ratio: Using a cloth measuring tape, measure the circumference of your hips at the widest part of your buttocks. Calculate your waist-to-hip ratio by dividing your waist circumference by your hip measurement.

For example: If your waist measures 28 inches and hips measure 39 inches, 28 divided by 39 equals 0.7.

Waist-to-Hip Ratio and Risk:

Male Waist-Hip Ratio Female Waist-Hip Ratio Health Risk
0.95 or below 0.80 or below Low risk
0.96-1.0 0.81-0.85 Moderate risk
1.0+ 0.85+ High risk

Strategies for losing belly fat

To be perfectly clear, there is no magic solution to losing excess belly fat. But, there are strategies that can and will help if you make them a regular part of your lifestyle. The more strategies incorporated on a frequent basis, the more likely the battle can be won.

Strategy One – Self-motivation and self-determination

Self-motivation and self-determination have to come from within. No one but you knows if you are ready to make the important changes necessary to achieve whatever goal you’re aiming for. Without self-motivation and self-determination, the likelihood of reaching your goal is not very high. Assess this strategy first and then move on.

Strategy Two – High-intensity interval training

Any type of exercise is always encouraged but to mobilize belly fat, it may need to be ramped up a bit. High-intensity interval training (HIIT) is a very effective workout that rotates periods of short intense anaerobic exercise with less intense aerobic exercise. It can be designed for all age groups and ability levels. If you are a beginner, start with less intense intervals and work up from there. A good starting point for incorporating HIIT would be a 20-minute brisk walk interspersed with 3 brief jogs.

A 2015 intervention study demonstrated that HIIT is an effective and time efficient training method that improved both total and visceral fat levels and was superior in reducing more visceral fat levels than with regular exercise training by itself. At least 30-60 minutes of exercise most days of the week is recommended. Another benefit of regular exercise is relieving stress. This helps you feel healthier and better prepared to handle life situations.

Strategy Three – Eat regular, nutritious meals

To have sufficient energy for day-to-day tasks, we need energy. Energy comes from food – we need to eat regularly throughout the day. Skipping meals may seem like a harmless way to cut back on calories but eventually hunger pangs flare, causing us to crave high-calorie, convenience food such as chips, sweets or other foods high in fat, sugar and salt.

It’s wiser to eat regular meals and snacks each day, choosing less processed foods. By doing this, you’re less likely to eat too much or too little and it maintains blood glucose levels better. Skipping meals or eating at irregular times can cause blood glucose levels to be either too high or too low, causing excess weight gain in the abdominal area. A 2014 study showed that skipping breakfast resulted in people having a higher waist circumference and body mass index.

Another factor to consider is stress.

“Stress is a major reason belly fat can creep up on you,” said Dr. Samadi. “If you begin to gain weight around the belly and your diet hasn’t really changed, it could be an indication that your stress response is affecting hormone levels. The adrenal glands help to manage our stress response but if they’re overworked, they prepare the body to store fat.”

Strategy Four – Focus on 30 grams of fiber each day

Each semester, students in my nutrition classes keep a 3-day diet history of everything they eat and drink. They then analyze the nutritional content of their diet with one of the components looked at being fiber. Unsurprisingly, the average fiber intake among the students is about 14.5 grams a day. This is slightly below the average for Americans which is just 16 grams of fiber a day. We fail miserably on getting in sufficient fiber.

Why focus on fiber? Fiber rich foods are usually low in fat and calories. They also are more filling, taking longer to leave the stomach and attract water, giving a feeling of fullness. Consider this: When you compare consuming an apple, applesauce or apple juice, they each have about the same calorie content but different amounts of fiber. The apple contains 5 grams of fiber, ½ cup of applesauce contains 2 grams and ¾ cup of apple juice contains 0.2 grams of fiber.

Most people would find the apple to be more fulfilling than the applesauce or apple juice.

When we focus on getting in 30 grams of fiber each day, we automatically will be consuming the healthier foods we need. It’s pretty hard getting up to 30 grams of fiber a day when mainly consuming highly processed, refined food such as chips, soda, white bread or frozen pizza. Highly processed, refined foods also trigger a rapid rise in blood glucose levels followed by an increased insulin response causing fat to be deposited, particularly in the abdominal area. Eating more high fiber foods improves insulin sensitivity, controlling blood glucose levels and reducing visceral fat deposits.

The more fiber-rich foods we eat, the higher our intake of important nutrients such as vitamins, minerals and phytochemicals, and a lessening of inflammation in the body. The less inflammation, the easier it is to lose weight and reduce belly fat. Here’s a list of some high fiber foods to include in your diet:

FOOD PORTION SIZE FIBER CONTENT (grams)
GRAINS:
Amaranth ½ cup 9.1
Oat Bran ½ cup 7.2
Quinoa ½ cup 5.9
Barley ½ cup 3.0
100% Whole Wheat Bread 1 slice 2.8
FRUITS:
Avocado ½ cup 7.8
Pear 1 5.1
Raspberries ½ cup 4.0
Blackberries ½ cup 3.8
Dates ¼ cup 3.6
Banana 1 3.1
VEGETABLES:
Artichoke hearts ½ cup 7.2
Peas, frozen, cooked ½ cup 4.4
Sweet Potato, baked ½ cup 3.3
Brussel Sprouts ½ cup 3.2
Broccoli ½ cup 2.8
Spinach, raw 1 cup 2.8
Collard Greens ½ cup 2.7
BEANS:
Navy beans, cooked ½ cup 9.6
Refried beans ½ cup 6.7
Lima beans, cooked ½ cup 5.4
Pinto beans, cooked ½ cup 4.0
Edamame ½ cup 4.0
NUTS/SEEDS:
Flax seed ¼ cup 11.9
Soy nuts ¼ cup 4.9
Almonds ¼ cup 4.1
Pistachios ¼ cup 3.2
Peanuts, dry roasted ¼ cup 2.9
Pecans, dry roasted ¼ cup 2.6
Pumpkin seeds ¼ cup 2.2
Walnuts ¼ cup 2.1

Table of food composition – USDA Nutrient Database

Fight for your health

As Dr. Samadi reminds us, “Deep belly fat is one of the biggest proponents of heart disease, diabetes, high blood pressure, stroke and even cancer, compared to people who have a similar body mass index but carry their fat throughout other areas of the body. Abdominal fat breaks down easily into fatty acids which flow directly into the liver and muscles. When these acids drain into the liver, they can trigger an increase in LDL (bad cholesterol) levels, lower HDL (good cholesterol) levels, and create insulin resistance.”

Waging war on belly fat takes work and willpower but it can be done. Enlisting the four strategies can be a beginning tactic towards defeating belly fat. Planning a good offense can go a long way in defeating and claiming victory over visceral fat and reclaiming your health.

Sources: Giannaki, C.D., Aphamis, G., Sakkis, P., Hadjicharalambous, M. (2015) Jan 8. Eight weeks of a combination of high intensity interval training and conventional training reduce visceral adiposity and improve physical fitness: a group-based intervention. J Sports Med Phys Fitness; www.whyiexercise.com; Watanabe, Y., Saito, I., Henmi, I., Yoshimura, K., Maruyama, K., Yamauchi, K., Matsuo, T., Kato, T., Tanigawa, T., Kishida, T., Asada, Y. Skipping breakfast is correlated with obesity. J Rural Med 2014; 9(2): 51-58; USDA Nutrient Database.


Cheryl_Mussatto_pictureCheryl Mussatto MS, RD, LD, is a registered dietitian and an adjunct professor at Allen Community College, Burlingame, where she teaches Basic Nutrition, and at Butler County Community College, Council Grove, where she teaches Therapeutic Nutrition. She is also a certified health and wellness coach. She writes Eat Well to Be Well, a column about health and nutrition, and is also a blog contributor for Dr. David Samadi at www.samadimd.com. Contact her at [email protected].

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