Sue Ann Says: Understand Belly Fat and the Dangers It Poses 

For years now we at the Wisconsin Women’s Health Foundation have been educating women about how belly fat can increase their risk of cardiovascular disease, diabetes, certain cancers — even premature death. But it's not only the amount of fat that makes the difference between being healthy and unhealthy, it's the type of fat, and where it's distributed in your body.

What's behind belly fat
Your weight is largely determined by how you balance the calories you eat with the energy you burn. If you eat too much and exercise too little, you're likely to gain weight, including belly fat. In addition, many women notice an increase in belly fat as they get older even if they aren't gaining weight. This is likely due to a decreasing level of estrogen, which appears to influence where fat is distributed in the body. The tendency to gain or carry weight around the waist — have an "apple" rather than a "pear" shape — can have a genetic component as well. Guess that means I can blame my mother for my tummy rolls instead of those sweet rolls I enjoy so much!

Visceral Fat vs. Subcutaneous Fat
There are two types of fat: subcutaneous and visceral. Subcutaneous fat is the type found just underneath the skin, which may cause dimpling and cellulite. Frankly, it’s the mushy stuff that hangs over the waist of our pants (muffin top, anyone?). Visceral fat is located in the abdomen and surrounding vital organs. It can infiltrate the liver and other organs, streak through your muscles and even strangle your heart; and you can have it even if you appear to be thin. It is the visceral fat that we need to worry about the most.

Why belly fat is more than skin deep
Although subcutaneous fat poses cosmetic and some health concerns, visceral fat is associated with far more dangerous health consequences. That's because an excessive amount of visceral fat produces hormones and other substances that can raise blood pressure, negatively alter good and bad cholesterol levels and impair the body's ability to use insulin (insulin resistance).

An excessive amount of any fat, including visceral fat, also boosts estrogen levels. All of this can increase the risk of serious health problems, including:
• Cardiovascular disease
• Stroke
• Type 2 diabetes
• Breast cancer
• Colorectal cancer

Recent research also has associated belly fat with an increased risk of premature death — regardless of overall weight. In fact, some studies have found that even when women were considered a normal weight based on standard body mass index (BMI) measurements, a large waistline increased the risk of dying of cardiovascular disease, cancer and other causes.

Measure your middle
So how do you know if you have too much belly fat? Simply measure your waist:
• Place a tape measure around your bare stomach, just above your hipbone.
• Pull the tape measure until it fits snugly around you, but doesn't push into your skin.
• Make sure the tape measure is level all the way around.
• Relax, exhale and measure your waist, resisting the urge to suck in your stomach.
For women, a waist measurement of 35 inches or more indicates an unhealthy concentration of belly fat and a greater risk of problems such as heart disease, high blood pressure and type 2 diabetes. For men, a waist measurement of 40 inches or more is considered cause for concern.

Trim the fat by sticking to the basics
You can tone abdominal muscles with crunches or other targeted abdominal exercises, but these exercises won't get rid of belly fat. Fortunately, however, visceral fat responds to the same diet and exercise strategies that can help you shed excess pounds and lower your total body fat. To fight back the bulge, stick to the basics:
• Eat a healthy diet. Emphasize plant-based foods, such as fruits, vegetables and whole grains, and choose lean sources of protein and low-fat dairy products. Limit saturated fat, found in meat and high-fat dairy products, such as cheese and butter. Instead, choose moderate amounts of monounsaturated and polyunsaturated fats found in fish, nuts and certain vegetable oils.

• Watch portion sizes. Even when you're making healthy choices, calories add up. At home, slim down your portion sizes. In restaurants, share meals — or eat half your meal and take the rest home for another day.

• Include physical activity in your daily routine. For most healthy adults, the Department of Health and Human Services recommends moderate aerobic activity, such as brisk walking, for at least 150 minutes a week or vigorous aerobic activity, such as jogging, for at least 75 minutes a week. In addition, strength training exercises are recommended at least twice a week. If you want to lose weight or meet specific fitness goals, you may need to exercise more.

To lose excess fat and keep it from coming back, aim for slow and steady weight loss — up to 2 pounds a week. Consult your doctor for help getting started and staying on track. Your patience and effort will pay off in a lifetime of better health.

Because it all begins with a healthy woman…
Sue Ann Thompson is founder and president of the Wisconsin Women’s Health Foundation (WWHF), a statewide non-profit organization whose mission is to help Wisconsin women and their families reach their healthiest potential. WWHF provides programs and conducts forums that focus on education, prevention, and early detection; connects individuals to health resources; produces and distributes the most up-to-date health education and resource materials; and, awards grants and scholarships to women health researchers and related community non-profits. To learn more, visit wwhf.org or call 1-800-448-5148.