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How do I decrease belly fat?

Advice for responding to this common question

This month I'll try to answer a question many patients ask in their quest for weight loss. "What about the fat in my belly? No matter what I do, I still carry this around!"

Two months ago, Nutrition Now discussed body mass index (BMI) and waist-hip ratio as ways to measure obesity in adults. What about the raw truth insofar as how to lose that fat? Can you lose fat in a specific area of the body?

Regardless of what we may read, it is difficult to "spot reduce" from any area of the body. This can be particularly true in the midsection. In most people, abdominal fat increases with age. The reasons are numerous, and the effects are unhealthy. Excess abdominal fat increases patients' risk for type 2 diabetes and cardiovascular disease. An accumulation of belly fat is also associated with certain cancers and the metabolic syndrome.

Abdominal fat is within the general category of obesity, a condition that can also cause a decline in life expectancy. Increased abdominal fat can accelerate or initiate inflammatory processes, which play a role in many of the disorders already mentioned.

Counseling patients

Because our time with patients is usually brief, it's important to focus on key areas. Always praise any strides made and check that facts, not fads, are guiding the patient's weight loss endeavor.

The next point of discussion should be what to eat and how much to exercise. I have covered these briefly in previous columns, but certain information can be specific to abdominal fat. For the patient who is adamant about identifying which foods to consume in order to decrease belly fat, the following nutritionally sound advice can be given:

  • People who consume diets rich in monounsaturated fats (MUFA) and polyunsaturated fats (PUFA) are less likely to store fat in the abdomen. Olive oil, canola oil, avocados, safflower oil, soybean oil and pistachios are some food choices with MUFA and PUFA. Eating foods higher in these fats, which contain antioxidants, help stem abdominal fat stresses leading to inflammatory processes.
  • Consuming more fruit may play a role in decreasing belly fat. Counsel patients to use the Healthy Eating Index at http://www.cnpp.usda.gov/HealthyEatingIndex.htm. For each point increase in the fruit score using the Healthy Eating Index, abdominal obesity risk in women decreased 2.6%.
  • Increased intake of fruits and vegetables may help decrease belly fat overall, and those with anti-inflammatory phytochemicals are particularly powerful. These particular foods may be more helpful: blueberries, cranberries, cherries, cauliflower, cabbage, carrots, and broccoli.
  • Higher intakes of fiber, particularly those from whole-grain sources, are associated with lower total percent body fat as well as lower percent belly fat (in older adults). Whole grains contain the entire grain kernel (the bran, germ and endosperm). Advise patients to select foods that list the first ingredient as whole wheat flour (breads, crackers and pita), bulgur (cracked wheat), whole cornmeal, oatmeal or brown rice.
  • A recent study showed that dietary adjuncts may promote the loss of abdominal fat. When consumed in amounts of four to six brewed cups per day, the catechins in green tea demonstrated the potential to decrease abdominal fat.
  • Encourage patients to eat breakfast. Lower percentages of obesity, inclusive of abdominal fat, have been documented in people who eat breakfast every day.
  • Reducing dietary fat without reducing calories is not sufficient for weight loss in the abdomen or anywhere in the body. Overall portion control is necessary.

What about exercise?

Regardless of what foods we counsel our patients to consume, regular exercise that encompasses cardiovascular and strength training promotes less fat storage overall. The maintenance of a healthy weight and BMI without a yo-yo diet approach to diet and exercise can help decrease belly fat by not allowing fat cells to increase and decrease in size (eventually losing their stretch, if you will).

What not to say?

Counseling our patients about what to do instead of what not to do helps promote a positive outlook on diet and overall well-being. This is especially true when it comes to the sensitive topic of abdominal fat which can be highly de-motivating and with patients at times taking a self deprecating approach. Taking a "Don't do this, don't do that" approach in a short office visit can leave the patient feeling limited in options. By encouraging the ingestion of healthy foods shown to improve outcomes, we help guide our patients toward healthier living. Providing lists of foods to consume can enhance patients' overall intake of healthy foods and encourage exercise - the end result we'd like for all our patients.

Resources

Bouchard L, et al. Differential epigenomic and transcriptomic responses in subcutaneous adipose tissue between low and high responders to calorie restriction. Am J Clin Nutr. 2010;91(2):309-320.

Brown LM, Clegg DJ. Central effects of estradiol in the regulation of food intake, body weight and adiposity. J Steroid Biochem Mol Biol. Epub 2009 Dec 24. PMID 20035866.  

Tande DL, et al. Healthy Eating Index and abdominal obesity. Public Health Nutr. 2010;13(2):208-214.

McKeown NM, et al. Whole-grain intake and cereal fiber are associated with lower abdominal adiposity in older adults. J Nutr. 2009;139(10):1950-1955.

Bluher M. Adipose tissue dysfunction in obesity. Exp Clin Endocrinol Diabetes. 2009;117(6):241-250.

Gossens GH. The role of adipose tissue dysfunction in the pathogenesis of obesity-related insulin resistance. Phsyiol Behav. 2009;94(2):206-218.

Khoury DE, et al. Post-prandial metabolic and hormonal responses of obese dyslipidemic subjects with metabolic syndrome to test meals rich in carbohydrate, fat or protein. Atherosclerosis. 2009; Epub 2009 Nov 20. PMID 20031131.

Heber D. An integrative view of obesity. Am J Clin Nutr. 2010;91(1):280S-283S.

Maki K, et al. Green tea catechin consumption enhances exercise-induced abdominal fat loss in overweight and obese adults. J Nutr. 2009;139(2):264-270.

Robyn Kievit is a family nurse practitioner and registered dietitian in the Boston area. E-mail your nutrition and weight loss questions to robyn@robynkievit.com or visit her website at www.robynkievit.com. On Facebook and Twitter, search for nutritionmentor.


Nutrition Now Archives
 

I agree with this. As a wellness nurse practitioner, I encourage my patients to add fruits and vegetables and add fiber to their diet. It has worked for me as well. It is not about what you shouldn't eat. It is all about all the great foods you can eat!

Mary September 02, 2010




     

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