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What does your waistline say about your health? Find out why belly fat is more common after menopause, what dangers it poses — and what to do about it.
By Mayo Clinic staffAn expanding waistline is sometimes considered the price of getting older. For women, this might be especially true after menopause, when body fat tends to shift from the arms, legs and hips to the abdomen. Yet an increase in belly fat can do more than make it hard to zip up your jeans. Research indicates that belly fat also increases the risk of cardiovascular disease, diabetes, certain cancers — even premature death. The good news? The threats posed by belly fat can be cut down to size.
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 pack on excess pounds — including belly fat. However, aging also plays a role. Muscle mass gradually diminishes with age, and fat accounts for a greater percentage of your weight. Less muscle mass also decreases the rate at which your body uses calories, which can make it more challenging to maintain a healthy weight or lose excess pounds.
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.
Why belly fat is more than skin deep
The trouble with belly fat is that it's not limited to the extra layer of padding located just below the skin (subcutaneous fat). It also includes visceral fat — which lies deep inside your abdomen, surrounding your internal organs.
Although subcutaneous fat poses cosmetic 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.
Measuring 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 (89 centimeters) 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 (102 centimeters) or more is considered cause for concern.
Trimming the fat
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. Choose moderate amounts of monounsaturated and polyunsaturated fats — found in fish, nuts and certain vegetable oils — instead.
- Keep portion sizes in check. 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 (1 kilogram) 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.
- Ferrara CM, et al. Differences in adipose tissue metabolism between postmenopausal and perimenopausal women. Journal of Clinical Endocrinology and Metabolism. 2002;87:4166.
- Snijder MB, et al. What aspects of body fat are particularly hazardous and how do we measure them? International Journal of Epidemiology. 2006;35:83.
- Understanding adult obesity. Weight-Control Information Network. http://www.win.niddk.nih.gov/publications/understanding.htm. Accessed March 21, 2011.
- Jacobs EJ, et al. Waist circumference and all-cause mortality in a large US cohort. Archives of Internal Medicine. 2010;170:1293.
- Abdominal obesity and risk of all-cause, cardiovascular, and cancer mortality: Sixteen years of follow-up in US women. Circulation. 2008;117:1658.
- Overweight, obesity and weight loss. U.S. Department of Health and Human Services. http://www.womenshealth.gov/faq/overweight-weight-loss.pdf. Accessed March 21, 2011.
- Fat. American Heart Association. http://www.americanheart.org/print_presenter.jhtml?identifier=4582. Accessed March 21, 2011.
- 2008 Physical Activity Guidelines for Americans. U.S. Department of Health and Human Services. http://www.health.gov/PAGuidelines/pdf/paguide.pdf. Accessed March 21, 2011.
- Assessing your weight and health risk. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/risk.htm. Accessed March 21, 2011.
- Weight and waist measurement: Tools for adults. Weight-Control Information Network. http://win.niddk.nih.gov/publications/PDFs/Weightandwaist.pdf. Accessed March 21, 2011.
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