During mid-life women tend to gain 1 lb or .5 kg per. Men too, find weight gain and more specifically a growing waist circumference almost inevitable approaching 40-year-old. This, more than just an aesthetic concern of not fitting into your favorite jeans, is a major health concern. Hormones, stress, genetics all play a role, but they should not be used as an excuse to embrace a life of increased health risks. You owe it to yourselves and to your families, to put up a fight. By educating yourself you can be proactive and take the right measures to getting fit and healthy. A healthy waistline will allow you to be the positive support and role model for those you want to enjoy life with.
Most concerning about being overweight, is not the weight in general (which is still associated with increase cardiovascular disease and diabetes) but where you accumulate the fat. The shift in fat stores to your abdomen and waist most probably translates to the biggest life risk factor to your health and longevity.
Although many tend to point blame at hormones and genetics when it comes to unexplained weight gain, there are other factors we need to be aware of so we can change our bodies tendencies. It’s the way our body ages and the way we let our environment (stress, diet and lifestyle) influence our health, that becomes key to a quality long life.
The Scary Fat: Visceral Fat
The fat most likely contributing to an increased waist line is one called visceral fat. This fat, unlike the subcutaneous fat you can pinch and found just underneath your skin, contributes to most of our health related risks. Visceral fat is the fat underneath your muscles and found around organs. It is a “metabolically active fat” that’s directly linked to health concerns such as immunological diseases, heart disease, diabetes, and colon and breast cancer. It is one of the few independent factors that put you at risk for premature death. By metabolically active we mean that it works as a gland which produces hormones like other organs. An example of it’s’ activity is its production of adiponectin. Adiponectin is a hormone which inhibits leptin, another hormone which is normally released after a meal to make us feel full. It is therefore visceral fats fault that those who have a thickened waist tend to feel the less full after eating a meal, eat more and continue to put on weight. Adiponectin also makes cells less responsive to insulin. Insulin is the hormone which controls how we use glucose (sugar) for energy. Normally the pancreas releases insulin in response to increase glucose associated with a carbohydrate meal. Insulin maintains healthy blood glucose levels by bringing glucose into cells. Cellular responsiveness to insulin is important because if impaired cells don’t help decrease blood glucose as they should, we call this insulin resistance. Insulin resistance ultimately means we are often put in a state of hyperglycemia (high blood sugar). Hyperglycemia is terrible for the body as it means damage to organs such as the kidneys, increased glucose storage as fat and increased risk for diabetes. As a result our bodies also make more cholesterol, control blood pressure worse (leading to high blood pressure), have increased risk of heart disease and stroke.
Visceral fat activity also negatively affects how our immune system functions by pumping out excess levels of cytokines, especially two known as tumor necrosis factor and interleukin-6. These cytokines are bad news in excess as they promote chronic inflammation and also further cellular resistance to insulin. This puts our body in more risk of a hyperactive immune system and autoimmune diseases and once again issues related to diabetes.
In addition, visceral fat cells also produces biochemicals which could contribute to increased blood pressure, problems with blood clotting and increased cholesterol.
Visceral fat activity therefore can be blamed for a variety of hormonal, biochemical and immune disruptions which throw our body into a chaotic cycle of imbalances resulting in mismanagement of vital systems needed to keep our metabolism, weight and overall health in check. The less we have of it, the better overall we are going to feel, look and function.
The Measurements that put us at risk: When should we worry?
A waist measurement of 40 inches (102 cm) for men or 35 inches (88 cm) for women equals abdominal obesity. New England Journal of Medicine reported when your waist is over 120 cm (men) or 100cm (women) you are twice as likely as those below 80 cm (men) or 65 cm (women) for premature death.
Ideal waist measurements correlating to quality and healthy lives have been reported below American Heart Association standards ( 35 inches for women and 40 inches for men).
Even if you are above or even at the ideal waist circumference limits there are enough reasons for you to be conscious of the consequences related to correlated health concerns. Get educated as to why this may be happening and start the process of slimming down and taking control of your health.
So what are the contributing factors to increased visceral fat?
Visceral fat is accumulated due to a combination of factors including environmental, genetic and hormonal influences. Below I outline some of the biggest contributors to dangerous belly fact.
- Stress /Cortisol
Cortisol is a hormone made by the adrenal glands above the kidneys. Cortisol affects almost every system in the body but its main functions include increasing blood sugar (by breaking down glycogen to glucose in liver), aiding in fat, protein, carbohydrate metabolism and suppressing the immune system. Most of these functions aim to help the body focus effort on those processes which will help the body have fast energy and also prepare itself for some stressful event. In regards to our waistline concerns, cortisol is one of our main villains. When chronically elevated, cortisol is responsible for relocating fat cells into visceral cavities of the abdomen.
This brings me to explain how cortisol levels get increased to begin with.
- Increased Stress–>Increased Cortisol
When you are confronted with stress, your body’s initial response is “fight or flight.” Its signals your body to release the hormones norepinephrine and epinephrine to deal with the stressful situation most effectively. It helps us get the energy our body feels it needs quickly and reverts the body from utilizing the energy inefficiently in things like digestion and reproduction. If the stressful situation is long term and you begin to feel distressed and defeated, the hypothalamus in the brain becomes involved, eventually leading to the release of cortisol from the adrenal glands. Along with cortisol we experience increase appetite and increase insulin levels so that we not only intake more calories but we get them stored to prepare for what the body perceives as a “dramatic event” which may require extra physical efforts. Cortisol then stimulates additional glucose production from glycogen stores in the liver. In addition, chronic cortisol increased inhibits normal metabolism of fat. The results of this all means excess un-utilized calories stored as fat, decreased fat burning and inevitable weight gain.
Cortisol’s influence increases appetite by making us less sensitive to a hormone called leptin, the hormone that makes us feel full, this results in eating more. Again, the excess calories are stored as fat around the abdomen.
- Estrogen Excess/Depletion:
The Estrogen Saga; How levels affects how we produce and store fat!
Estrogen is in balance with other hormones in the body such as progesterone in women and testosterone in men. A balanced hormonal level helps to maintain our metabolic functions. When these hormones are present in unbalanced proportions, disorders and diseases can occur.
Natural Estrogen, when in correct levels and appropriately counter-balanced with other hormones, is vital to, especially women’s health. The issue occurs when we are exposed to, or ingest exogenous sources of estrogens which throw our body into disarray and in a state of estrogen excess. Exogenous estrogens are everywhere.They’re in the air, car emissions, detergents, paints, nail polishes, lotions, soaps, plastics, food and water. Most notable sources of estrogen chemicals are petroleum based products, pollutants, pesticides, herbicides, fungicides and plastics (found in our air, on our food, cleaning supplies, toys and storage containers for food and water). Exposure to these estrogenic chemicals are virtually unavoidable and they are the source of many health mysteries. They when ingested mimic our natural estrogen and have been linked to a variety of problems such a slowed fat metabolism, increased abdominal fat deposition, allergies, low immunity, fatigue and mood swings.
If progesterone and testosterone hormone levels are not where they should be, and our diet doesn’t include certain nutrients, we are unable to offset this estrogen excess. As a result we are we are thrown into a metabolic disarray and the problems listed above.
Most often as we age an additional problem contributes to this already concerning issue. Progesterone and androgen hormones which normally help balance estrogen, are converted into renegade estrogen. This puts many peri-menopausal women into a paradoxyl estrogen excess just as they start to produce less natural estrogen. Losses of androgen hormone levels in men also result in accumulation of abdominal fat and its related health issues. These concerns are the focus of anti-aging medicine doctors and their commitment to treatment through bio-identical hormone replacement (discussed below)!
Some signs you may be in estrogen excess? Symptoms of excess may include: craving of carbs and sweets, fat selectively deposited in the center of your body, low energy, headaches, digestion issues, water retention, lack of clear thinking, depressed mood. The “thickening” of women’s bodies and the “softening” of men’s bodies are often related to excess estrogen.
To avoid estrogen excess we must avoid sources of exogenous estrogens. This means avoiding toxins and chemicals at all costs. It also means eating smartly to avoid processed, hormone pumped and toxic foods. See diet consideration in the Diet section outlined below!
The estrogen saga thickens: What about those of you in Menopause? Unlike pre-menopausal concerns relating to estrogen excess, the problems associated with first 10 years of menopause are actually related to an estrogen decrease. Natural estrogen production has found to have many protective qualities to women. One of them have to do with preventing visceral fat accumulation. Women have an enzyme that when activated by high fat diet, slows the way we metabolize and burn fat. This enzyme is more active in the abdominal visceral fat. Estrogen suppresses the enzymes activity and therefore women in menopause have a greater tendency to suffer from the enzymes overactivity when exposed to high fat diets. Its is for this reason why women tend to accumulate more fat around their waists and more so after menopause. The mechanism of action seems to be related to the enzymes effect on Vitamin A metabolism. When the enzyme is present and active, it promotes Vitamin A metabolism to retinoic acid. Retinoic acid production has shown to be directly linked to visceral fat development. This enzyme has been identified as Aldh1a. And studies in mice have shown that those without it dont produce retinoic acid and therefore didn’t have ability to produce visceral fat. At least one function for this enzyme is the production of a powerful hormone, which then drives up the formation of visceral fat cells. The source of this hormone is vitamin A. A study in the Journal of Diabetes published that this enzyme was more present in obese womens visceral fat than in lean women. In summary, although genetics, gender and hormone levels all play a role in visceral fat formation, your can limit activation of Aldh1a by avoiding high fat foods. Women can also see their doctor and discuss custom bio-identical hormone therapy to balance estrogen and other hormones which may affect the way you develop and burn fat. Doctors and researchers are also now putting efforts in finding medications who can block the enzyme Aldh1a, in hopes to prevent retinoic acid effects on producing visceral fat.
- Poor Diet Habits
In general, we need to eat in order to our bodies natural circadian rhythm which is dictates by our adrenals system cortisol release. Adrenal health is vital for a healthy metabolism and in otherwise healthy individuals should dictate how, what and when we eat. There are two ways to do this. First eat when cortisol levels are naturally high and second making sure to eat well consistently throughout the day to avoid the body not signally a “starvation mode” which is perceived as stress to the adrenal system and therefore outputs cortisol. Cortisol is naturally highest in the morning and therefore eating the most in the morning naturally follows the body’s natural tendencies to create more natural energy. Snacking correctly maintains healthy blood sugar and helps moderate the natural downward slope of cortisol through the day. Low carb snack at 3 pm helps avert an energy slump and eating light and early dinners helps us maintain the natural low quantities of cortisol our body sends out in the evening. Keeping with this natural cortisol output puts our body at easy and our metabolism in check. Avoiding hunger also makes sure not to stress our body into releasing cortisol when not necessary and therefore prevents fat cells deposition into the visceral area.
Ok so now you know the culprits. Let’s go over some of the ways we can decrease stress, cortisol, balance estrogen, improve your diet, implement lifestyle practices and get your doctor involved!!!
- Decrease Stress
As seen above cultivating low stress lifestyle is key to limiting the bodies stress response and high cortisol levels. Stress and cortisol promote visceral fat storage. Making time for activities and practices to help you deal with stress are extremely important for you and your family’s life. Some studies have specifically been linked to help control cortisols’ influence on our health. Supplements shown to decrease cortisol levels include magnesium, omega 3 fatty acids and black tea. Activities such as music therapy, massage therapy, laughing and dancing have also shown to positively affect cortisol levels. Make time for whatever you feel helps you manage your life. Walks, meditation, shiatsu, tai chi, yoga, tea breaks with your best friend are to be made mandatory if they help you remain calm and balanced when dealing with life.
- Diet Modifications/ Toxin Avoidance
Diet is essential when living in a world of chemicals, toxins and impure foods. We need to be picky about the food we ingest and the products we buy. You may not realize the health benefits “eating organic” or using eco-friendly cleaning products may bring you, but the cumulative detrimental effects creep up on you in the form of unexplained weight gain, low energy and diseases. Be mindful when deciding what to feed yourself and your family…. you will be happier healthier and live longer for certain!
Our objective is to avoid accumulation of estrogen and limit its effects on our fat deposition, metabolism and side effects. The solution to excess estrogen requires the means to counterattack estrogen and its excess in a natural and safe way. To effectively defend the body against excess estrogen, one should increase the intake of estrogen inhibiting compounds, and decrease the intake of estrogen promoting compounds in the diet.
- Avoid toxins, hormones which lead to estrogen excess….Simply Choose Organic! The key is to avoid estrogen excess is to avoid foods high in estrogenic compounds. Anything that is processed increases the concentration of food estrogenic component. Non organic meat, processes soy, licorice, pesticides found on non organic fruits and vegetables, non organic meats and dairy, plastic derivatives in found in packed food and water, diets high in animal fat and excessive consumption of omega 6 oils such as canola, corn and safflower can all lead to estrogen excess and therefore more deposit of visceral fat.
- Incorporate estrogen inhibiting compounds: Eating more plant-based food such as leafy greens can help combat excess estrogen. Plant compounds from the flavonoid and indole family can help the liver metabolize estrogen and therefore prevent its negative effects. These estrogen inhibitors work not only to inhibit estrogen production but lower receptor sensitivity and shift estrogen metabolism to more beneficial metabolites.Flavonoids and indoles, are also potent antioxidants and have anti-cancerous properties.
•Estrogen inhibitors can also be found in any of the following: passiflora, chamomile, bee products, citrus fruits, onion, garlic, and cruciferous vegetables (broccoli, cauliflower, brussels sprouts and cabbage). It is for this reason it is pertinent to healthy fat metabolism to include these sources in your diet.
•Other foods which help limit the effect of estrogen excess on the body are omega 3 fatty acids which can be found in flax seeds, hemp seeds and fatty fish.
3. Balance the effects of estrogen excess by eating food which encourage progesterone production. Progesterone will help balance estrogens. Good fats like avocados, olives, nuts and seeds are great simulators for healthy progesterone levels.
4. Incorporate detoxifying spices like curry and ginger can help clear the body of excess estrogen.
Additional diet considerations for Post Menopause: In addition to the pre-menopause tips, women after menopause have an additional concern once natural estrogen levels start to drop. It becomes exceedingly important to avoid high fat diets.
Diet low in saturated fats and high in nutritional foods such as vegetables, grains, good oils and lean proteins can help keep metabolism in check and avoid high fat food binges. As mentioned above drastic diets that keep calories to minimum do not work! We need to avoid being hungry at all costs! Starvation mode, slows metabolism and paradoxically signals a stress response and causing it to store fat rather than to burn it for energy. Eating smartly is the key. Find a way to enjoy eating for health. If you can’t figure it out, there is no better investment than seeing a nutritional specialist. Remember the is no price for a quality healthy life…. There is no better time than the present to invest in your health.
- Whole Body Workout
Exercise is a great way to combat visceral fat. Studies from Duke University Medical Center and University of Pennsylvania showed how cardiovascular and weight training can combat abdominal fat. Walking or jogging 12 miles/week helped subjects lose up to 9 % of visceral fat in 6 months and that weight training twice a week can reduce body fat by an additional 4%. What was not seen was visceral fat loss by doing abdominal specific excercise. A whole body work out effort is necessary to effectively address abdominal/visceral fat concerns.
BHRT is a method of alternative medicine which uses hormones, which are bio-identical to the ones our body naturally makes, to compensate and balance the body of certain hormones which decline with age. The aim is to treat symptoms related to aging and help restore patients health found in youthful years. By implementing BHRT doctors have been able to give patients those hormone ratios needed for ideal bodily function. Declining estrogen, DHEA, and testosterone have all been linked to increased body weight, waist circumference, and an overall decreased metabolic profile. Those doctors who have been certified in the practice of BHRT can measure patients specific hormonal profiles and supplement with the bio-identical hormones to improve energy, weight, mental and physical function, and the defenses to help minimize the effects of stress and cortisol. SInce these hormones are indistinguishable from the ones our body naturally makes, they unlike other forms of hormone replacement, implicate no risks of health concerns. If you are over 35 and feel that your body and energy level are changing beyond the control of exercise and diet, I suggest you seek out an anti-aging physician who can run tests and offer you council on BHRT.
In short, our best anti-aging tool when it comes to overall health come down to a fey key practices. Don’t smoke, avoid excess alcohol intake, exercise, RELAX, watch your diet carefully and DON’T GAIN WEIGHT!!! Again if you feel you can’t manage it alone there are people who can help.
Also, for those who have mothers, aunts, fathers and loved one’s who just are too easily accepting of their new body and waist…..PASS ON THE POST!!! We love them too much not to help them see it’s more than just an increase dress or pants size they need to worry about!