June 2011 Volume 15, Number 6 TOOLS FOR HEALTHIER LIVES Belly Fat What Your Waistline May Say About Your Health An expanding waistline is sometimes seen to decreasing levels of estrogen, which as the price of getting older. For women, appears to influence where fat is distrib- this may be especially true after meno- uted in the body. The tendency to gain pause, when body fat tends to shift from or carry weight around the waist — have the arms, legs and hips to the abdomen. an “apple” rather than a “pear” shape — Yet an increase in belly fat may do can have a genetic component as well. more than make it hard to zip up your More than skin deep jeans. Research indicates that it also can raise your risk of numerous health con- Although putting on too much weight, in general, can have negative effects on your Visceral fat sequences. The good news is that this health threat can be cut down to size. health, abdominal weight gain is con- Subcutaneous fat sidered particularly unhealthy. In fact, Battle of the bulge research has shown that having a wide Belly fat isn’t limited to Your weight is largely determined by how waist measurement — 35 inches or the extra layer of padding you balance the calories you eat with the more in women and 40 inches or more located just below the energy you burn. Overeating and lack in men — is an important, independent skin (subcutaneous fat). of physical activity are the main reasons risk factor for disease. It also includes visceral why people pack on excess pounds. The trouble with belly fat is that it’s fat — which lies deep inside your abdomen, However, aging also can contribute to not limited to the extra layer of padding surrounding your inter- weight gain as well as to an increase in located just below the skin (subcuta- nal organs. Visceral fat body fat. That’s because as you age, you neous fat). It also includes visceral fat — is associated with far gradually lose muscle and fat accounts for which lies deep inside your abdomen, more dangerous health a greater percentage of your weight. Less surrounding your internal organs. consequences. muscle mass also leads to a decrease in Subcutaneous fat is hard to ignore the rate at which your body uses calories, because you can see and grab hold of which can make it more challenging to the extra layer of cushioning it creates. lose or stay at the same weight. However, research has shown that vis- Contents At midlife, many women see their ceral fat, although not clearly visible, is midsection start to widen, even if they associated with far more dangerous health 3 Headline Watch aren’t gaining weight. This is likely due consequences. That’s because an excessive 4 Heartburn Subcutaneous fat The CT scan at left shows the 6 Prophylactic belly fat distribution in a woman Oophorectomy with a normal body mass index (BMI). The scan at right shows 7 Choosing a belly fat in an obese woman. Note Bicycle the increase in the fat located just below the skin (subcutaneous fat) 8 One on One as well as the fat surrounding the Visceral fat internal organs (visceral fat). Visit us online, where you’ll find more health information, great offers and more! Mayo Clinic amount of this fat produces substances have on your health. The Department of Women’s that can raise blood pressure, negatively Health and Human Services recommends HealthSource alter good and bad cholesterol levels, and that healthy adults engage in moderate Medical Editor impair the body’s ability to use insulin aerobic activity for 150 minutes a week Julie Abbott, M.D., M.P.H. Preventive and Internal (insulin resistance). All of this can increase or vigorous aerobic activity for 75 min- Medicine the risk of cardiovascular disease, stroke, utes a week. It’s also recommended that Associate Medical Editors Stephanie Faubion, M.D. type 2 diabetes and other serious health you do some strength training at least Preventive and Internal Medicine problems. An excessive amount of any twice a week. Moderate physical activity Adamarie Multari, M.D. fat, including visceral fat, also boosts includes activities such as brisk walking, Preventive and Internal Medicine estrogen levels. This can increase the risk hiking, gardening and bicycling; vigor- Managing Editor of breast and colorectal cancers. ous physical activity includes running Jennifer Jacobson Contributing Writers Research has also associated belly fat or jogging, swimming and fast walking. Lee Engfer with an increased risk of premature death Keep in mind that you may need to Julie Freeman Medical Illustration — regardless of weight. In fact, some increase the amount of time you devote Michael King studies have found that even when to physical activity each week to lose Research Librarians Anthony Cook women were considered a normal weight, weight or keep it off. However, before Amanda Golden Deirdre Herman according to standard body mass index starting any new activity program or Customer Service Manager (BMI) measurements, a large waistline increasing your current activity level, Ann Allen Proofreading elevated the chance of dying of cardio- check with your doctor to find out what Miranda Attlesey vascular disease, cancer and other causes. might be best suited to your current Donna Hanson health condition and weight-loss goals. I Julie Maas Trimming the fat Administrative Assistant Beverly Steele You can firm up abdominal muscles with Measuring Your Middle Editorial Board exercises such as sit-ups. However, this Breast Health won’t get rid of belly fat. Fortunately, Like it or not, waist size matters. That’s Dietlind Wahner-Roedler, M.D. Cardiology visceral fat responds to the same diet and because your waist measurement is a good Birgit Kantor, M.D., Ph.D. Dermatology exercise strategies that can help you shed indicator of whether you’re carrying too Rochelle Torgerson, M.D., Ph.D. Endocrinology pounds and lower your total body fat. much fat around your belly. Diana Dean, M.D. When it comes to your diet, emphasize Other measurements — such as your Gynecology Douglas Creedon, M.D., Ph.D. plant-based foods, such as fruits, veg- body mass index (BMI) or waist-hip ratio Matthew Hopkins, M.D. Nutrition etables and whole grains, and choose lean — can be helpful. Yet they may not be as Charla Schultz, R.D. sources of protein and low-fat dairy prod- good at showing your body fat percentage Physical Medicine and Rehabilitation ucts. Dietary guidelines also recommend or fat distribution, particularly after meno- Carmen Terzic, M.D., Ph.D. Physical Therapy limiting saturated fats — which can be pause. To measure your waist circumference: Timothy Madson, P.T. found in meat and high-fat dairy prod- Psychiatry & Psychology • Place a tape measure around your bare Karen Grothe, Ph.D., L.P. ucts, such as cheese and butter. stomach, just above your hipbone (at Barbara Rohland, M.D. Monounsaturated and polyunsaturated Radiology about the level of your navel). Robert Maxwell, M.D. fats found in fish, nuts and vegetable oils Section of Patient Education Rita Jones — such as olive, safflower, peanut and • Pull the tape measure until it fits snug- Women’s Health ly around you, but doesn’t push into Priscilla Flynn, Dr.P.H. corn oils — are a good substitute for Jacqueline Thielen, M.D. saturated fats. In fact, these “good” fats your skin. Mayo Clinic Women’s HealthSource actually can improve blood cholesterol • Make sure the tape measure is level all (ISSN 1091-0220) is published monthly by Mayo Foundation for levels, which can decrease your risk of the way around. Medical Education and Research, a cardiovascular disease. However, even subsidiary of Mayo Foundation, 200 • Relax, exhale and measure your waist, First St. SW, Rochester, MN 55905. these fats should be used in moderation Subscription price is $29.55 a year resisting the urge to suck in your stomach. and includes a cumulative index to avoid taking in too many calories. published in December. Periodicals If you want to lose weight, reduce your Having a waist circumference of 35 postage paid at Rochester, Minn., and at additional mailing offices. portion sizes and cut back on calories. inches or more indicates that you have an POSTMASTER: Send address unhealthy concentration of belly fat and changes to Mayo Clinic Women’s Slow and steady weight loss — 1 to 2 HealthSource, Subscription Services, are at a greater risk of problems such as P.O. Box 9302, Big Sandy, TX pounds a week — is the best way to lose 75755-9302. excess fat and keep it from coming back. cardiovascular disease, high blood pres- Your doctor can provide more information sure and type 2 diabetes. For men, a waist on how to get started and stay on track. measurement of 40 inches or more is con- Regular physical activity also can help sidered cause for concern. I reduce belly fat and the impact it can M AYO C LINIC W OMEN’ S H EALTHS OURCE 2 J UNE 2011 News You Can Use Diabetes Plus Depression Can Be Other medications can help ease some Deadly Combination in Women signs and symptoms of IBS, but they work Diabetes and depression are serious ill- only while they’re being used. Rifaximin nesses on their own. Yet in combination, may provide longer relief by altering an they can be quite deadly, according to overgrowth of bacteria in the small intes- a study in the January 2011 Archives of tine or affecting the type or quantity of General Psychiatry. bacteria living in the colon. Researchers collected data on more than It’s still not clear who might benefit 78,000 women, ages 54 to 79, participating most from taking rifaximin or whether in the Nurses’ Health Study.