Ask a Really Smart Doctor: How Do I Lose Belly Fat?
Dr. Kashyap: I hear that all the time from women your age. In the years before menopause, estrogen decreases and your metabolism starts to slow down. Your muscles don't burn calories as efficiently, so many women store those calories as belly fat.
Dr. Mathur: Women tend to be either apple-shaped or pear-shaped. Pears store fat more in their hips and butt. If you're an apple, you store more fat around your middle, which can be the dangerous "visceral" type that releases hormones, influences your metabolism, and can lead to disease.HOW DO I KNOW IF I HAVE THE BAD KIND OF BELLY FAT?
Dr. Kashyap: Start by measuring your waist. If it's more than 35 inches around, you have a much higher risk of developing diabetes and metabolic syndrome.WHAT THE HECK IS METABOLIC SYNDROME?
Dr. Kashyap: It means you have any three of the risk factors for heart disease and diabetes: a large waistline, low HDL cholesterol, high blood pressure, high triglycerides, and high blood sugar.
Dr. Mathur: If you have high blood sugar as one of the three factors, you're more likely to get type 2 diabetes. Here's how it happens: Normally your pancreas makes a hormone called insulin, which allows sugar to enter your cells for use as energy and fuel. With metabolic syndrome, your body can become resistant to the insulin, so the sugar has a hard time getting into the cells and builds up in your blood. Complications include heart disease, kidney problems, eye disease, and nerve damage -- even dementia.I HAVE SOME RISK FACTORS, SO WHAT SHOULD I DO?
Dr. Kashyap: Your blood sugar can be out of whack for years before it causes any symptoms. So tell your doctor you're worried about the weight you've gained in your middle and have her run tests to figure out your blood sugar, cholesterol, and insulin numbers.
Dr. Mathur: In a fasting blood glucose test, 100 to 125 is pre-diabetes; above 126 means you have diabetes. Another test, called A1C, determines your average blood sugar over the past three months. If your number is 5.7 to 6.4, that's pre-diabetes. If your number is 6.5 or higher, you get a diagnosis of diabetes.IF MY BLOOD SUGAR IS HIGH, DOES THAT MEAN I HAVE TO KISS CUPCAKES GOOD-BYE?
Dr. Mathur: You've got to cut back on all the junk food, especially sugar and refined carbs, like cupcakes, candy, and soda -- even white bread, rice, and pasta.
Dr. Kashyap: You want to eat fish, skinless chicken, vegetables, fruits, and whole grains. Focus on lean protein and lots of fiber. You'll be doing your metabolism a favor if you cut out the extra carbs and fat.ARE YOU GOING TO TELL ME I HAVE TO EXERCISE, TOO?
Dr. Kashyap: Doing cardiovascular exercise like walking or jogging can help, but to rev your metabolism you need to build muscle with resistance training. I send many of my patients to a personal trainer because yes, you have to burn calories, but you need to do more than just move.
Dr. Mathur: The good news is that people who drop just 7 percent of their weight and exercise for 30 minutes five days a week can cut their diabetes risk by more than 50 percent. By changing your lifestyle, you really do have the power to stop diabetes -- and pare off some of that pesky belly fat, too.MEET THE DOCTORS
Sangeeta Kashyap, M.D., staff physician at the Endocrinology and Metabolism Institute and associate professor of medicine at the Cleveland Clinic Lerner College of Medicine
Ruchi Mathur, M.D., director of the Diabetes Outpatient Treatment and Education Center at Cedars-Sinai in Los Angeles and associate professor of medicine at UCLA