The Shriver Report – Women and their Waistlines: “Muffin Tops” Should be the Least of our Concern
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Women and their Waistlines: “Muffin Tops” Should be the Least of our Concern

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Our ever-expanding waistlines have implications for women of all ages. While most of us don’t like the look of a “muffin top” hanging over our pants, the real concern is the underlying health implications, which can be very serious. The National Institutes of Health warns that women with a waist circumference exceeding 35 inches are at higher risk of developing health problems.

There are two types of fat; subcutaneous and visceral. The fat surrounding the liver and the other abdominal organs is called visceral fat, as opposed to the subcutaneous fat that is under the skin of the belly.  Visceral fat in particular appears to be associated with insulin resistance and adverse lipid profiles. This fat is very metabolically active and releases fatty acids (such as LDL, the bad cholesterol), inflammatory agents and hormones such as angiotensin (which can lead to high blood pressure).

The more visceral fat, the more glucose is released to the blood stream and the higher incidence of metabolic syndrome, a precursor to diabetes.  The increase in visceral fat is directly proportionate to the development of type II diabetes, heart disease and even colon cancer.  A recent study showed that there is a direct link between increased abdominal girth and the incidence of breast cancer (due to increased release of estrogen substances released from visceral fat).

Several large multinational studies, involving thousands of people, have confirmed that measurement of abdominal obesity and central fat accumulation is an important tool in assessing risk of heart disease, type 2 Diabetes and the risk of death.  A study that was published in the Lancet in 2004 determined that abdominal obesity contributed as much risk to developing heart disease as smoking.

In a study dated August 2010, in the Annals of Internal Medicine, participants filled out a detailed questionnaire and measured their waistlines with a tape measure. The results were over a 9-year period. It was found that abdominal fat tissue is strongly associated with type 2 Diabetes and coronary heart disease.

Researchers at the University of Queensland in Australia published a study in January 2011 of the European Heart Journal that showed sitting for prolonged periods was an indicator of larger waist circumference. Sedentary people who took frequent breaks to stretch and walk around had small waistlines.

If you have an oversized belly, figuring out how much is visceral and how much is subcutaneous isn’t as important as recognizing that a big belly is unhealthy. It is probably a combination of genetics, nutrition and exercise that determines how you store fat and where you store it.

Ongoing studies are currently looking at factors that could influence the storage of fat.  Much more work is needed in this research field, but what is currently known, is that as women age, the storage of fat changes.  Younger women tend to store their fat in their hips, buttocks and thighs, which is actually healthier. As women approach menopause, and estrogen levels drop, the fat storage shifts to the abdominal region. Since this is a natural part of aging, what can women of all ages do to prevent this or reverse it if it has already begun?

Research has shown that the best way to reduce belly fat is to balance caloric intake with physical activity. Diet and exercise prevent the development of excess visceral fat in premenopausal women and help to reduce it in post-menopausal women. So how much do we women have to change our routines? The formula is relatively simple; avoid saturated fats, avoid simple carbs and avoid excess calories. Fruits and vegetables are great additions to your diet. Add some strength training to your exercise routine, as the more muscle you have, the less room there is for fat! Only doing sit-ups or other abdominal exercises to tone and strengthen the muscles around your waist will not reduce your waist circumference. Spot reduction does not work. When you exercise and burn enough calories to create a caloric deficit, you lose fat over your entire body.

So an easy to follow technique to prevent excess harmful belly fat is to exercise at least 3 days a week with 30 minutes of cardio activity and 15-20 minutes of strength training. The choice of cardio activity can be walking, running, biking, swimming, hiking etc. The strength training portion of the workout can be light weight training, Pilates, bar class etc.

Current medical treatment can also include medication to help reduce belly fat. If, for example, insulin resistance occurs, meaning that your glucose and insulin are not “matched up” accurately in your body.  There is currently a drug, metformin, that is used to regulate glucose/insulin metabolism and to help prevent the onset of Diabetes. This drug has a direct correlation to the decrease in abdominal fat.  There are numerous drug trials, that are currently ongoing, to identify any other medication that could help reduce belly fat. Currently, cosmetic procedures such as liposuction, only eliminate subcutaneous fat.

Although all of us would like to look better in our bathing suits, the true gift of losing weight around our middle is prevention of life threatening diseases. Abdominal fat is a precursor to many health issues and easy to avoid. Eat healthy and move your bones!! Your body and your healthy future will thank you!

Dr. Nancy Simpkins is a Reporter for The Shriver Report.
For more than 25 years, Dr. Nancy Simpkins, a Board Certified Internist with a practice in Livingston, NJ, has been involved in all aspects of internal medicine with a focus on women’s health. Known for her diagnostic ability coupled with her wit, Dr. Simpkins has garnered a huge following and become a sought after speaker, guest and consultant for women’s groups. She is dedicated to raising awareness by providing the most current and up to date information that women at any age (even those over 40) can utilize to feel and look their best. Recently, Dr. Simpkins appeared with Dr. Mehmet Oz on his syndicated television show, The Dr. Oz Show, where she debunked “medical myths” including the myth that caffeine stunts your growth.
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