• Dr Sally Norton

WORRIED ABOUT 'MIDDLE-AGE SPREAD' OR 'BELLY-FAT'?



Jumping on and off the scales may give you an idea of how weight loss attempts are going but certainly doesn’t give you the full picture and doesn’t always reflect whether you are a healthy weight. What's more, it often leaves us feeling demotivated if we don't see the pounds dropping off as quickly as we would like. Or, worse still, going on when we think we've been 'good'. Measuring our waistline may be much more important....

Feeling fruity?

The amount of fat we carry around our waist is a really important indicator of our health – more so, perhaps, than our weight. Even if we are a reasonable weight, a bit of middle age spread or belly fat can be a warning sign that we are at risk of diabetes, heart disease and more. Having a bountiful backside with a classic ‘pear’ shape is better for many aspects of your health than being more of an ‘apple’!

What’s the magic number?

The best way to tell if you are at risk is to take your waist measurement (halfway between the bottom of the ribs and the top of pelvis / hip bone) and divide it by your hip measurement (widest part, incorporating your backside).

If your waist/hip ratio is 0.85 or more as a woman (1 or more as a man) beware.

It means you should really think about shifting a few pounds.

Why?

We know we need to watch our weight if we can ‘pinch more than an inch’. But the fat we carry on the inside is even more of an issue. Having a big belly is an indication of excess fat in the liver and around other internal organs and is associated with the metabolic syndrome – a collection of problems like high blood pressure, fatty liver disease and type 2 diabetes, predisposing to heart attacks, stroke and more.

What causes it?

We don’t fully understand why fat gets distributed in different ways but our sex, genetics, stress, certain drugs like steroids and more can all play a role. Men seem to put weight on around their waist more than women - but around the menopause, as female hormones drop, women may find their waistbands getting tighter too.

What can we do about it?

Shifting a bit of weight is the obvious place to start. We can’t lose fat from certain areas preferentially, but losing a few pounds will reduce fat in internal organs and around the waist, as well as everywhere else – improving our health risk at the same time. So cutting back is the first step.

But it’s not just how much we eat, it’s what we eat.

There is a lot of evidence now that high sugar diets are contributing to this issue – so sticking to​​ the recommendations of 6 teaspoons or less of added sugar per day is one of the best things you can do. Remember, that’s all sugar (including hidden sugars in processed foods) other than sugar found naturally in milk and whole fruit.

There has also been attention focused on a substance called inulin, found in veg like onions, chicory root, leeks, artichokes, and asparagus as well as bananas and wheat. Inulin seems to help glucose control – one of the earliest indicators of metabolic syndrome. It also boosts healthy gut bacteria and may help weight loss in some studies. But don’t go rushing off to buy supplements – there is no good evidence that it is a magic pill for weight loss and it can have side effects, including making irritable bowel syndrome (IBS) worse in some people. Instead, a diet low in processed sugary foods and high in veg and whole grains is a sure-fire way to help your health and shift the belly fat.

Get moving

Exercise has also been shown to help. Even if we don’t lose weight we may reduce the fat in and around our internal organs. Some studies suggest that short bursts of high intensity (HIIT) exercise help more than standard exercise. And, in another study of overweight teens in Canada, a combination of resistance and aerobic exercise led to a decrease in waist circumference of around 7cm compared to 4cm for a single form of exercise – showing that actually a mixture of exercise is the route to success.

Stress less

But try not to get too stressed about it all – as stress and the hormones it releases such as cortisol, can contribute to an expanding midriff too! It may be that there are areas of stress in your life that you can reduce...and see a reduction in your waistline to match.

So, focus on keeping your mind as well as your body in tip-top condition if you want to lose that belly fat. Then, the only thing you will have to worry about as your waistline shrinks is your trousers falling down!


References

Keating SE et al. Effect of aerobic exercise training dose on liver fat and visceral adiposity. J Hepatol. 2015

Lee S et al. Aerobic exercise but not resistance exercise reduces intrahepatic lipid content and visceral fat and improves insulin sensitivity in obese adolescent girls: a randomized controlled trial. Am J Physiol Endocrinol Metab. 2013

R Sigal, A Alberga, G Goldfield, et al. Effects of Aerobic Training, Resistance Training, or Both on Percentage Body Fat and Cardiometabolic Risk Markers in Obese Adolescents. JAMA Pediatrics, 2014Koster A et al. Waist circumference and mortality. Am J Epidemiol. 2008

Björntorp P. Do stress reactions cause abdominal obesity and comorbidities? Obes Rev. 2001

Guess ND et al. A randomized controlled trial: the effect of inulin on weight management and ectopic fat in subjects with prediabetes. Nutrition & Metabolism. 2015

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