Belly fat and diabetes

Lose Belly Fat Fast With This Diabetes-Friendly Exercise Routine

How Excess Belly Fat Can Increase the Risk of Diabetes Complications

So what are those conditions that belly fat influences? The first and most notable one for anyone with diabetes is insulin resistance, she says. One of the many factors at play is retinol-binding protein 4 (RBP4), a compound that visceral cells secrete, dulling the body’s sensitivity to the hormone insulin, encouraging the development and progression of type 2 diabetes and its complications. Those complications range from peripheral and central diabetic neuropathy to cardiovascular disease and even cancer.

Meanwhile, recent research shows that an excess of belly fat can significantly increase the risk of heart disease and cancer all on its own. For instance, in a study published in August 2017 in the journal Oncogene, visceral fat cells were found to produce high levels of a protein called fibroblast growth factor 2, or FGF2, which can trigger cancer formation. What’s more, it’s important to remember that visceral fat sits right next to (and even inside of) your organs, meaning that it can directly affect the health and function of your liver, heart, and lungs.

Do You Have Too Much Belly Fat? A Simple Way to Find Out

The easiest way to gauge your belly fat levels and risk of abdominal obesity-related conditions is to measure the circumference of your waist at the top of your hipbones. According to a statement published in the journal Circulation by the American Heart Association and the National Heart, Lung, and Blood Institute, measurements greater than 35 inches in women and 40 in men denote abdominal obesity and chronic health risk.

Why Exercise Might Be More Important Than Cutting Calories for Losing Belly Fat

While everything from slashing stress to eating fewer processed foods has been shown to help combat belly fat, exercise is one of the best things you can do to reduce weight in this area and live healthier with diabetes, says Pat Salber, MD, an internist and founder of The Doctor Weighs In.

She notes that in a meta-analysis published in February 2013 in the journal PLoS One, exercise was found to significantly lower people’s visceral fat levels, even if they didn’t cut calories. What’s more, when it comes to the best forms of exercise, research suggests that high-intensity strength training is where it’s at.

What Research Says About the Benefits of High-Intensity Strength Training

For instance, according to a study published in February 2015 in the journal Obesity, when researchers at the Harvard School of Public Health followed 10,500 men for 12 years, they found that, minute per minute, strength training targets belly fat better than cardio does. And in a study published in October 2013 in the Internal Journal of Cardiology, high-intensity resistance training was found to be significantly better at reducing visceral fat levels and preventing symptoms in people with metabolic syndrome, compared with more endurance-based workouts. Metabolic syndrome is a cluster of conditions, including hypertension, high blood sugar, excess belly fat, and abnormal cholesterol or triglyceride levels.

Think you don’t have time to reap the potential benefits of exercise? Not true. “The beauty of high-intensity workouts is that the total amount of time to achieve fitness benefits is shorter than working out at lower intensities,” Dr. Salber says.

What People With Diabetes Should Know Before Giving It a Try

Don’t worry: High-intensity resistance exercise is all about moving your body in a way that feels challenging to you, and it doesn’t have to be high-impact. Remember it’s important to keep your feet safe, and pounding the pavement or gym floor with high-impact exercise can increase your risk of cuts, blisters, and infection. No one wants that.

The best way to structure high-intensity resistance exercise depends on your current fitness level. After all, the fitter you are, the more weight you can move with each rep and the less you need to rest between sets. But as a general rule of thumb, you should be able to perform 15 to 20 reps per set with proper form, according to an article published in 2013 in the ACSM’s Health & Fitness Journal. Rest for 30 seconds or less between sets.

And, just like with any type of exercise, it’s important to warm up before and cool down after your high-intensity resistance training. Spend 5 to 10 minutes walking, jogging, or performing gentle bodyweight exercises. Save any stretching for after your training session.

Ideally, you’d strength train at least three times per week, on nonconsecutive days. That will give your body the rest time it needs to spring back from each workout stronger and healthier than before.

The Best Diabetes-Friendly Exercises to Help You Lose Belly Fat Fast

Here, we share five high-intensity (but low-impact) resistance exercises that will help you reduce your belly fat levels for better diabetes management and health. As always, make sure to check your blood sugar levels before, during, and after your workouts. Sprinkle them throughout your regular workouts or perform them all together, making sure to rest for two to three minutes between each exercise, for a real challenge:

1. Dumbbell Squat to Overhead Press

What you’ll need: a pair of dumbbells at your choice weight

Stand tall with your feet shoulder-width apart and hold a pair of dumbbells in front of and against your shoulders, palms facing each other and your elbows pointed down toward the floor. Pull your shoulders back and brace your core. This is your starting position.

From here, push your hips back and bend your knees to lower your body as far as you comfortably can down into a squat, keeping your torso up as you do so. As soon as you hit the lowest point of your squat, immediately push through your heels to return to standing, and simultaneously press the dumbbells up overhead until your arms are straight, but not locked out. This is your starting position for the rest of your reps.

2. Reverse Lunge to Single-Arm Cable Row

What you’ll need: a cable machine (found at most gyms) with a D-shaped handle

Attach a D-shaped handle to a cable machine at knee height. You can also use a resistance band secured to a sturdy object. Stand tall facing the anchor point with your feet spread hip-width apart, and hold the handle with your right hand, your arm fully extended and palm facing in. Pull your shoulders back and brace your core. This is your starting position.

From here, take a giant step back with your right foot, then bend your knees to lower as far as you comfortably can into lunge. Pause, then pull the handle to meet the side of your torso, keeping your elbow pointed straight back behind you as you do so. Pause, reverse the row, then press through your front foot to return to standing. That’s one rep. Perform all reps and then repeat on the opposite side.

3. EZ-Bar Deadlift

What you’ll need: an EZ-bar of your choice weight (also available in most gyms)

Stand with your feet hip-width apart and hold a loaded, EZ-bar (it’s a short barbell with two curves where your hands go) against your thighs, hands shoulder-width apart and palms facing your body. This is your starting position.

From here, keeping your core tight, back flat, and shoulders pinned back, push your hips behind you and, allowing a slight bend in your knees, slide the bar down your legs until it’s just below your kneecaps or you feel a slight pull in your hamstrings. The bar should stay in contact with your legs throughout the entire move, and your shins should remain vertical. Pause, then thrust your hips forward to return to standing.

4. Incline Push-Up

What you’ll need: a kitchen counter, a sturdy bench, a piece of furniture, or a wall

Place your hands on your surface of choice so that they’re slightly wider than your shoulders, and step your feet back behind you. Your body should form a straight line from head to heels. Pull your shoulders back away from your ears, and brace your core. This is your starting position.

From here, bend your elbows and lower your chest between your hands until it nearly touches the bench. Allow your elbows to flare out diagonally from your torso; they should not be tucked behind you or out straight to the sides. Pause at the bottom, then push through your hands to return to start, making sure to keep your body in a straight line as you do so. That’s one rep.

5. Kettlebell Swing

What you’ll need: a kettlebell of your choice weight (also available at most gyms)

Stand with your feet about shoulder-width apart and a kettlebell between your feet, about one foot in front of you. Keeping a flat back, push your hips back, and bend your knees just slightly (keeping your shins vertical) to grip the bell with both hands, palms facing you. With the bell still on the floor, squeeze your shoulder blades down and together so that the top of the bell tilts toward you. This is your starting position.

From here, hike the bell back between your legs. As the bell begins to come back forward, explosively thrust your hips forward to return to the standing position and drive the bell straight out in front of your body at shoulder height. (Do not pull the bell with your arms.) Allow the bell to lower on its own then, as it nears your body, push your hips back to move immediately into the next rep.

For more on weight management, and how to talk to your doctor about weight loss, check out Diabetes Daily’s article “Why Aren’t More Physicians and Patients Bringing up the Topic of Weight?”!

Is There ‘One Trick’ to Losing Belly Fat?

First of all, what is belly fat?

There are different types of fat:

Subcutaneous fat

Subcutaneous fat is the looser fat that lets you “pinch an inch” and can accumulate just under the skin

Intramuscular fat

Intramuscular fat is found within the skeletal muscles

Visceral fat

Visceral fat is the packed between your abdominal organs (stomach, liver, kidneys, etc.), which is what we call intra-abdominal or belly fat

Is there really ‘one trick’ to losing belly fat?

When ads claim a “one trick” solution, remember that their main objective is to sell their product rather than to help you. Good marketing means one message, because it is hard to follow too many things at once. So they focus on one fad, and that tickles your curiosity and you click on the link to go their website.

So, no, there’s not. But here’s what you can do.

Typically there are many things you may need to improve to lose belly fat. But start by focusing on changing or improving just one thing. Then, once you conquer that first objective, you can move on to the next thing, and so on.

2. Target sugar

One good place to begin improving your food choices is to eliminate sugary drinks — and not just soda, but juices. Sugar increases belly fat and fiber reduces belly fat; thus when you’re juicing fruits, you’re removing the fiber, leaving pure sugar. So one quick fix, a very concrete fix, would be eliminating sugary drinks.

Replacing sugary beverages with water will help dramatically cut down your sugar intake, and then once you’ve taken that step, you can figure out how to cut down on foods that are high in sugar.

If you have a sweet tooth and need to put that final accent to your meal, eat an apple, melon or fresh berries. Just remember, fruit is not a substitute for vegetables.

3. Go Mediterranean

The popular “flat belly diets”embrace much of the wisdom found in eating a Mediterranean diet, which helps everything from brain health to hearth health. The basic premise for both diets is eat foods rich in monosaturated fatty acids (MUFA) that may help reduce your belly fat storage. MUFA-rich foods include olive oil, nuts and seeds, avocodos, and fish. Eating yogurt regularly has also been found to be helpful in reducing belly fat.

Another diet trend that promises results when it comes to belly fat: the apple cider vinegar diet. While animal studies have been promising, current research in humans has yet to show impressive results. The data supporting the benefits of the Mediterranean diet, however, are real and cause for making some dietary changes.

4. Front-load your meal

Start your meal, especially your largest meal, with seasoned vegetables, be it vegetable soup or the vegetables on your entrée plate. And remember that vegetables should always comprise at least half of your plate and be a mix of starchy (like potatoes) and nonstarchy ones (your leafy greens, broccoli, etc.).

Eating the vegetables first will leave less room for other foods that aren’t as healthy, because vegetable fiber is filling.

5. Commit to a physical lifestyle

The single most important thing people can do to prevent the buildup of belly fat and get rid of existing belly fat is commit to physical activity, and better yet, a physical lifestyle.

For both men and women, the first fat you lose when you exercise is visceral fat.

In a way, moderate-intensity physical activity is that “magic pill” a lot of people are looking for, because the health benefits go beyond keeping your waistline trim: Not only can it reduce your risk of cancer, stroke, diabetes and heart attacks, but studies have shown that physical activity can significantly improve the moods of patients with major depressive disorders.

Overtraining, though, can be problematic when it comes to fighting belly fat because it can lead to coristol overproduction. Excess amounts of this stress hormone has been found to be associated with belly fat.

Simply walking briskly an hour each day can have an impact by boosting your metabolism, as can adding an incline to your treadmill routine.

The bottom line is that when it comes to belly fat, the answer is not in drugs or supplements.

Here’s something else most people probably don’t know: Fidgeting is good for you. It’s considered a nonexercise physical activity, and it’s an important way to burn energy. You get more health benefits if, in addition to exercising, you are a more fidgety, more active person the rest of the day. This means gesturing while you’re talking, tapping your foot, just moving around.

7. And try not to sit too much

Studies have shown that people who sit eight to nine hours a day, even if they exercise the recommended 150 minutes per week, do not get the same benefits of exercising as people who are more active throughout the day.

If you have to sit most of the day for your job, try to find some ways to move:

  • Take small breaks throughout the day to walk around
  • Use your lunch hour to take a longer walk
  • Take the stairs instead of the elevator, if possible
  • Do stretching exercises at your desk
  • Just do your best to move around as much as you can

8. Redefine ‘rest’

Having an active hobby — and if you don’t already have one, developing one — is important. Get engaged in some kind of sport, whether it’s a group activity or something you can do alone. Essentially, if an activity is pleasant to you, you’ll continue to do it.

If your leisure time involves sitting around on the sofa or in a chair, you might actually be offsetting the positive health effects of exercising even if you’re working out regularly.

Unfortunately, the general understanding of rest is relaxing in front of TV or dining out — what we call “passive rest.” But really, our rest should consist of sleep, and our leisure time should consist of fun physical activity, which is active rest.

Statistics suggest that out of 900 months in his life, the average man in the U.S. spends approximately 198 months watching TV, five months complaining about his boss, and five months waiting on hold.

Think of the other things you could do with those 208 months of your life. You could find activities that are better for your health and will help keep the belly fat away.

9. Don’t rely on sit-ups to give you a six-pack

Unfortunately, sit-ups and crunches can’t eliminate visceral fat directly. You can’t reduce fat from specific parts of your body by exercising that body part; our bodies simply don’t work that way.

With sit-ups or other abdominal exercises, you’re toning the abdominal muscles but not burning intra-abdominal fat. The key is to lower your overall body fat with moderate-intensity physical activity and a healthy diet; when you reduce your total body fat, you’ll also be reducing your belly fat.

So if you want to do abdominal exercises, make them part of your fitness routine. Just don’t treat them as a substitute for the recommended 150 minutes of weekly moderate-intensity physical activity.

10. Develop more muscle

While sit-ups can’t “target” belly fat, what they can do is help you burn calories, strengthen your core and develop more muscle. Because muscle is more metabolically active than fat, the more muscle you have, the more calories you’ll burn when you’re at rest.

You can also try lifting heavier weights and resting less between repetitions, which can promote calorie burning after you leave the gym.

Burning those extra calories can help you achieve and maintain a healthier weight in conjunction with regular cardiovascular exercise and a healthy diet.

11. Get some sleep

A recent study of 70,000 individuals showed that those getting less than five hours of sleep were more likely to gain 30 or more pounds.

12. Forget about weight loss drugs or supplements claiming ‘one trick’

So far, there is not one single drug that is approved by the Federal Drug Administration for the reduction of belly fat. Supplements claiming a “one trick solution” to belly fat are not strictly regulated, and a lot of the claims made in the ads are not backed up by research.

The bottom line is that when it comes to belly fat, the answer is not in drugs or supplements. Enjoying a healthy lifestyle should be the focus. And while that’s not as simple as swallowing a pill, the benefits will last a lifetime.

Skipping meals can lead to abdominal weight gain and insulin resistance which can increase the risk of type 2 diabetes, a study finds.
Ohio State University researchers conducted a study on mice in which one group consumed their day’s food in one single meal, fasting for the rest of the day.

They went on to develop insulin resistance, which is a key risk factor in prediabetes. A control group of mice, meanwhile, had unlimited access to food.
The first group on the restricted diet had calories added back into their diets which helped them regain weight. By the end of the study, their weight had nearly matched the mice in the control group.
However, the fat around their abdomen weighed more among the mice in the restricted diet. When this fat is excessive in its amount, it is associated with insulin resistance and the risk of type 2 diabetes and heart disease.
Remaining glucose
The researchers observed that glucose remained in the blood of the mice that ate the one big meal. Glucose production normally stops after a meal, when the pancreas releases insulin to remove the glucose. But in these mice, the liver reacted differently.
Martha Belury, senior author and professor of human nutrition at The Ohio State University explained: “These mice don’t have type 2 diabetes yet, but they’re not responding to insulin anymore and that state of insulin resistance is referred to as prediabetes.
“This does support the notion that small meals throughout the day can be helpful for weight loss, though that may not be practical for many people. But you definitely don’t want to skip meals to save calories because it sets your body up for larger fluctuations in insulin and glucose and could be setting you up for more fat gain instead of fat loss.”
The results of this study were published online in the Journal of Nutritional Biochemistry.

Don’t self-adjust the dosage or timing of your insulin in order to accommodate eating more calories. You can end up with bigger problems than just needing to lose a few pounds if you go that route. However, it is good to self-adjust insulin for the purpose of fine-tuning the dosage. Of course, you want to keep your doctor informed and continually work on good diet and exercise habits.

RELATED: Diabetes and Your Diet: Busting 7 Myths

2. Take a closer look at your medications

If you aren’t able to offset the weight gain by reducing calorie intake and adding more activities, try evaluating what type of insulin you’re taking. Insulin analogs (modified human insulin) are the latest and may cause less weight gain.

There also are other medications you can take instead of (or in combination with) insulin therapy.

Metformin, an oral diabetes medication, can also be used with or without insulin and may help control weight.

The reverse is true as well. If you’re taking other diabetes medications with your insulin, find out if weight gain is a side effect of those medications, too. Ask your doctor if there are alternatives you can try.

3. Work out the details with your doctor

The best thing a patient can do is ask questions. Make sure you understand all the reasons you might be gaining weight, what medications you’re taking that have that side effect and what alternatives are available.

You’ll also want to find out the out-of-pocket costs for each specific drug. Some are costly and you’ll need to consider whether you can easily afford these medications long-term.

Managing diabetes is a challenge, and your treatment plan has to work for you. Talk to your doctor and other healthcare providers and make adjustments until your plan is working well.

If you can effectively make the right lifestyle choices, you can minimize your need for medication. This means less cost, less side effects and an overall feeling of well-being.

RELATED: Missing Meals? Avoid Dangerous Blood Sugar if You Have Diabetes

Belly fat promotes diabetes under orders from liver

Credit: CC0 Public Domain

The fat that builds up deep in the abdomen—more than any other type of body fat—raises the risk of insulin resistance and type 2 diabetes. Researchers have known that abdominal fat becomes dangerous when it becomes inflamed but have had a hard time determining what causes the inflammation.

A new study at Columbia University Irving Medical Center (CUIMC) has revealed that at least one of the culprits for this mysterious inflammation comes from the liver. The researchers found that, in obese mice, the liver increases its production of an enzyme called DPP4. This enzyme travels through the blood stream to abdominal fat. Once inside fat tissue, DPP4 helps to activate inflammatory cells.

The good news is that this inflammation can be soothed by turning off DPP4 production in the liver, as the researchers demonstrated in mice. And even though the animals remained obese, soothing inflamed abdominal fat improved their insulin resistance.

Additional, unpublished data suggests the pathway also exists in people.

“If we can develop ways to target liver DPP4 in people, this may be a powerful new way to treat obesity-induced type 2 diabetes,” said study leader Ira Tabas, MD, PhD, the Richard J. Stock Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons. “Inhibiting DPP4 specifically in liver cells attacks insulin resistance—the core problem of type 2 diabetes—at least in our preclinical models.”

The study by Tabas’s team—including lead author Devram Ghorpade, PhD, associate research scientist, and co-corresponding author, Lale Ozcan, MD, assistant professor of medical science—was published online today in Nature.

Current DPP4 inhibitors do not reduce inflammation in fat or improve insulin resistance

Many patients with type 2 diabetes are given oral DPP4 inhibitors (known as gliptins) to help manage their disease. These drugs lower blood sugar by preventing DPP4 from interfering with a hormone that stimulates insulin production. But surprisingly, these drugs had no effect on inflammation in the abdominal fat of obese mice, the researchers found.

“Gliptins inhibit DPP4 in the blood and so they should, in theory, prevent fat inflammation,” Tabas said, “but we didn’t find that in our study.”

The reason for this shortcoming of gliptins, Tabas believes, may be related to their effects in the gut versus the liver. “DPP4 inhibitors lower blood sugar by inhibiting DPP4 in the gut. But we have some evidence that DPP4 inhibitors in the gut also end up promoting inflammation in fat. That cancels out the anti-inflammatory effects the drugs may have when they reach inflammatory cells, called macrophages, in the fat.”

When the researchers selectively blocked DPP4 production inside liver cells, they were able to reduce fat inflammation and improve insulin resistance, while also lowering blood sugar.

The findings suggest that DPP4 inhibitors could be more potent if they were redirected to liver cells and away from the gut.

Delivering DPP4 inhibitors directly to the liver

In theory, current DPP4 inhibitors could potentially be redirected by packaging the drug into nanoparticles that are delivered to the liver. However, the CUIMC team is studying an alternate approach that uses small interfering RNAs (siRNAs)—snippets of genetic material that silence particular genes—to turn off liver cell DPP4. To ensure that the siRNAs reach the appropriate target, they could be attached to certain sugars with a specific affinity for liver cells, Tabas said.

A complementary approach would be to block DPP4 activity in the macrophages of abdominal fat. “From our studies, we know that DPP4 interacts with a molecule on these cells to increase inflammation. If we could block that interaction, we might be able stop the enzyme from causing inflammation and insulin resistance,” Tabas said.

“This study reveals a potential new target for the treatment of type 2 diabetes and cardiometabolic disorders,” said Ahmed A Hasan, MD, PhD, a medical officer and program director in NHLBI’s Atherothrombosis & Coronary Artery Disease Branch, who serves as the project officer for the study grant. “These findings may pave the way for a future clinical trial to test whether a new treatment approach based on this target could improve insulin resistance in diabetic patients. More research is needed.”

Explore further

Enzyme produced in the liver promotes obesity, fatty liver disease and insulin resistance More information: “Hepatocyte-Secreted DPP4 in Obesity Promotes Adipose Inflammation and Insulin Resistance” Nature (2018). nature.com/articles/doi:10.1038/nature26138 Journal information: Nature Provided by Columbia University Medical Center Citation: Belly fat promotes diabetes under orders from liver (2018, March 21) retrieved 2 February 2020 from https://medicalxpress.com/news/2018-03-belly-fat-diabetes-liver.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

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