Diabetes and belly fat

As frustrating as it is to carry around that spare tire or suffer from “muffin top” syndrome, you might find some comfort in the fact that a slimmer, trimmer middle is something that everyone strives for, even celebrities (OK, I realize that’s little consolation). But my point is that, whether your goal is to lose weight to improve your health, to look better, or to feel better — or all three — it can be a challenge. Fortunately, there are steps that you can take to whittle your waist somewhat and, perhaps most importantly, lower your risk for a host of health problems.


Blasting Away Belly Fat: Here’s How
Losing weight can be a challenge, and it seems to be harder for some than others. Plus, depending on how much you want to lose, you may be in it for the long haul. Keep in mind that everyone is different, and what may work for one person may not be the best option for someone else. There really is no magic bullet…yet. And if there were, all of us would have heard of it by now. That being said, last week I mentioned that liposuction (not exactly a feasible option for many people due to the cost) is not a contender for losing visceral fat. So what does work? Here are some possible options:

Move it. Yes, you do need to exercise. There’s no way around it. For some people, exercise doesn’t result in actual weight loss (meaning, the scale may not budge), but it can and does shrink visceral fat.

Even if you haven’t gained weight, you may notice that fat redistributes itself and tends to settle around your middle. This is especially true of women who have gone through menopause. A study done at Duke University showed that men and women who did no exercise for six months increased their visceral fat by 9%; those who exercised regularly decreased their visceral fat by 7%.

Make physical activity a routine part of your day. Aim to do at least 30 minutes of exercise most days of the week, and take advantage of opportunities throughout your day to be active. This means climbing stairs, weeding the garden, walking around the mall and even standing while you chat on the phone. Also, plan to do both aerobic exercise (such as walking, bicycling, or dancing) along with strength-training (using hand weights, resistance bands, or exercise machines). By the way, spot exercises, such as abdominal crunches, will tighten your muscles but won’t shrink visceral fat.

Slash saturated and trans fat. Eating less of these types of fat can help lower your LDL cholesterol, and cutting back on them may also help you lose some of your visceral fat, as well. Some studies indicate that trans fat, in particular contributes to an increase in abdominal fat, so it’s best to avoid it as much as you can. Also, getting more than 30% of calories from fat each day may lead to excess visceral fat, so cutting back on all fats isn’t a bad idea.

Eat more soluble fiber. Researchers at Wake Forest Baptist Medical Center in North Carolina, who studied more than 1100 people, have discovered that for every 10-gram increase in soluble fiber, one can reduce visceral fat by about 4% over five years. (These same researchers found that moderate exercise lowered visceral fat by 7% over the same time period). Where do you find soluble fiber? Apples, citrus fruits, oatmeal, beans, broccoli, and carrots are good sources.

Go for the (whole) grain. Grains seem to get a bad rap among some people with diabetes. However, if you’ve been avoiding them, you may want to reconsider. A study out of Tufts University, looking at data of more than 2800 people from the Framingham Heart Study, found that those eating whole grains had less subcutaneous fat and less visceral fat compared to those who ate more refined grain products.

Sip on green tea. Several studies indicate that drinking green tea may help to whittle your waist. Green tea contains catechins, caffeine, and theanine, substances that may promote fat loss.

Stop smoking. It’s no big surprise by now that smoking is just plain bad for you. If you do smoke, now’s the time to make a plan to quit for good. Besides the well-known health risks linked with smoking, such as heart disease, lung disease, and cancer, smoking can lead to a build-up of abdominal fat and cause insulin resistance.

Get your ZZZs…but not too many. Researchers at Wake Forest University School of Medicine found that people under the age of 40 who get six to eight hours of sleep each night have less visceral fat than those who get less than 6 hours. But getting more than 8 hours of sleep may be associated with increased visceral fat, too. Not too little, not too much is the motto.

Ditch the high-fructose corn syrup. You’re probably doing this already. But if you’re having a hard time giving up regular soda, for example, you might think twice knowing that, at least in rats, high-fructose corn syrup contributes to abdominal fat gain.

Chill out. Those Wake Forest University researchers have been busy: Studying monkeys, they found that those who were “socially stressed,” meaning that they were considered to be subordinate to other monkeys in the study, developed more abdominal fat. Having high levels of the stress hormone cortisol appears to move fat from subcutaneous areas to the abdominal area. Bottom line: if you’re overly stressed, find ways to help better manage it, even if it doesn’t go away completely!

Focusing on Food and Fitness

Thirty-three obese, postmenopausal women participated. On average, they were about 57 years old and had had diabetes for at least one year.

The women were in for a major change when they enrolled in the 14-week study. None had dieted or exercised regularly in a year.

The women were divided into three groups. Some women were given a low-calorie diet high in healthy monounsaturated fats like olive oil.

The dieting women also got nutritional consultation, a week’s worth of menu ideas, and a weekly meeting for motivation and support.

Another group was given a supervised aerobic exercise program consisting of walking 50 minutes three times a week, occasionally doing other activities for variety. The third group followed both programs.

Before and after the study the women got MRI scans to see how much visceral fat they had.

Diet alone did not reduce visceral fat. Only exercise alone or exercise plus dieting reduced visceral fat.

The researchers say their study demonstrates the importance of exercise in reducing visceral fat in the treatment of women with type 2 diabetes.

The study appears in the March issue of The Journal of Clinical Endocrinology & Metabolism.

Sixty-nine percent of American adults are overweight, and over 35 percent are obese1. These conditions aren’t just aesthetically unpleasing. Obesity increases your risk for numerous conditions including heart disease, stroke, Type 2 diabetes, high blood pressure, and cancer2.

Sadly, about 3.4 million adults die each year3 from being overweight or obese. Globally, obesity now kills about the same as tobacco and more than all wars, terrorism, and violence. Nearly all people who are overweight already have “pre-diabetes” and have significant risks of disease and death. They just don’t know it.

When you begin to put on weight, especially lethal belly fat, your biology shifts out of balance, veering into the unstable and unhealthy territory of disease —which in turn makes you fatter. A vicious, deadly cycle ensues unless you take control of your weight.

Insulin: The Key Player in Belly Fat

Numerous hormones contribute to belly fat, but none proves more powerful than insulin, your fat storage hormone. High levels of insulin tell your body to gain weight around the belly, and you become more apple-shaped over time. Insulin also drives inflammation and oxidative stress, creating myriad downstream effects.

Eventually you become insulin resistant, which leads your body to generate belly fat and hold on to that spare tire for dear life. Fatigue after meals, sugar cravings, blood sugar swings or hypoglycemia, high triglycerides, low HDL, low sex drive, and problems with blood clotting are also common among people who are overweight.

Simply put, less insulin equals less belly fat, since insulin makes you hungry and stores belly fat. The best thing you can do to prevent diabesity and all its problems is to lose weight.

The Number One Thing You Can Do to Reduce Belly Fat

High insulin levels don’t just exist in a vacuum. They influence other hormones like leptin, your satiety hormone. When insulin blocks leptin, your body thinks it is starving even after a Big Mac, fries, and a large soda. Ever wonder how you can still be hungry right after a big meal? It is the insulin surge and the leptin resistance.

More than any other food, sugar becomes responsible for hijacking your brain chemistry and your metabolism to create insulin resistance and all its repercussions.

Calorie for calorie, sugar is different from other calories that come from protein, fat, or non-starchy carbs such as greens. Sugar scrambles all your normal appetite controls. So you consume more and more, driving your metabolism to convert it into lethal belly fat. We are all overdosed at an average of twenty-two to thirty teaspoons of sugar4 a day per person in America.

Fructose, the most metabolically damaging sugar, just makes things worse. It goes right to your liver, where it starts manufacturing fat, which triggers more insulin resistance and causes chronically elevated blood insulin levels, driving your body to store everything you eat as – you guessed it – dangerous belly fat.

You also get a fatty liver, which generates more inflammation. Chronic inflammation causes more weight gain and diabesity. Anything that causes inflammation will worsen insulin resistance.

Another problem with fructose is that it doesn’t send informational feedback to the brain, signaling that a load of calories just hit the body. Nor does it reduce ghrelin, the appetite hormone that is usually reduced when you eat real food.

We are programmed to store belly fat in response to sugar so that we can survive the winter when food is scarce. Genes do play a role, but they are a minor contributor to the massive obesity and diabetes pandemic we are facing globally. Shut down the insulin surges—and thereby arrest belly fat storage and cravings.

Why Belly Fat is Not Your Biggest Challenge

The biggest challenge you’re facing with being overweight or obese is not your waistline or your weight. It’s not your belly. It’s your brain. Changing the way you think about food so you get your mind working with your body, not against it, is critical to weight loss and healing.

If you want to lose pounds, you need to first lose the ideas that keep you stuck in an endless cycle of yo-yo dieting. You need to let go of the beliefs and perspectives that sabotage your goal of permanent weight loss and vibrant health. Thinking the way you’ve always thought and doing things you’ve always done will only lead to more of the same.

Numerous factors contribute to belly fat, but over my decades practicing medicine I’ve found when patients focus on these seven strategies they normalize insulin, lose that stubborn belly fat, and finally gain abundant health.

  1. Eat real food. When we eat real food, which contains many nutrients, we are more satisfied, eat less, and lose belly fat. Getting adequate vitamins and minerals helps you burn calories more efficiently, helps regulate appetite, lowers inflammation, boosts detoxification, aids digestion, regulates stress hormones, and helps your cells become more insulin sensitive. Along with lots of green vegetables, include protein in every meal since studies show it keeps you fuller longer5 so you lose more weight.
  2. Manage stress levels. Chronic stress causes your brain to shrink and your belly to grow. Chronically elevated levels of your stress hormone cortisol cause increased blood sugar and cholesterol, depression, dementia, and promotes the accumulation of belly fat that we so commonly see in patients with insulin resistance or diabetes. You crave sugar and carbs and seek comfort food. Read this blog to understand how stress impacts you and effective strategies you can take to reduce stress levels.
  3. Address food sensitivities. We often crave the very foods we are allergic to. Getting off them is not easy, but after two to three days without them, you will have renewed energy, relief from cravings and symptoms, and begin to shed belly fat. Gluten and dairy are two big food sensitivities, but many others can create roadblocks that make losing belly fat nearly impossible. This blog further describes how food sensitivities can make you fat and how to intelligently eliminate them.
  4. Get 7– 8 hours of sleep. Not getting enough sleep drives sugar and carb cravings by affecting your appetite hormones. One study found even a partial night’s poor sleep6 could contribute to insulin resistance. Poor sleep also adversely impacts fat-regulating hormones like leptin and ghrelin. You need to prepare for sleep. This blog provides 19 strategies to optimize sleep.
  5. Optimize your nutrient levels:
    Take a high-quality multivitamin that contains blood sugar-balancing nutrients.
    Optimize omega-3 fat. Omega-3 fatty acids are important for controlling insulin function.
    Optimize your vitamin D Low levels of this critical vitamin impair appetite control.
    Consider taking natural supplements for cravings control. L-glutamine and PGX (a super fiber) are among the natural dietary supplements that can help reduce cravings.
  6. Monitor alcohol. A nice glass of red wine with a meal, a cold beer on a hot day, or a shot of tequila at a party are some of the sweet pleasures of life. But as a daily habit, alcohol can do more harm than you realize, especially if you have diabesity or struggle with weight loss. Consider this: If you drink two glasses of wine a day, you will consume about 72,000 extra calories a year, which could mean an extra 20 pounds a year. And these liquid calories go right to your belly. Stop for six weeks. See how you feel. Then, if you want, enjoy one to three glasses of wine or alcohol a week. (A “glass” is 5 ounces of wine, 1.5 ounces of distilled spirits, or 12 ounces of beer.)
  7. Exercise regularly. Aside from changing your diet, exercise is probably the single best medication for diabesity. Walk at least 30 minutes every day. For some, 30-60 minutes of more vigorous aerobic exercise four to six times a week may be necessary. Studies show interval training7 and weight resistance8 can improve fat loss.

What one strategy would you add to permanently banish belly fat and become lean and healthy? Share yours below or on my Facebook fan page. If you would like to learn how you can rid yourself of food addiction, sugar cravings and banish that belly fat for good, join us for The 10-Day Detox Diet Challenge.

1CDC Centers for Disease Control and Prevention, Faststats – Obesity and Overweight.
2NIH National Heart, Lung and Blood Institute, What Are the Health Risks of Overweight and Obesity?
3WHO World Health Organization, Obesity and overweight, Fact sheet N°311, Updated January 2015
4Amercian Heart Association, By Any Other Name It’s Still Sweetener, Updated: June 16, 2014
5Am J Clin Nutr. 2006 Feb;83(2):211-20., Effect of a high-protein breakfast on the postprandial ghrelin response., Blom WA1, Lluch A, Stafleu A, Vinoy S, Holst JJ, Schaafsma G, Hendriks HF.
6J Clin Endocrinol Metab. 2010 Jun;95(6):2963-8. doi: 10.1210/jc.2009-2430. Epub 2010 Apr 6., A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy,Donga E1, van Dijk M, van Dijk JG, Biermasz NR, Lammers GJ, van Kralingen KW, Corssmit EP, Romijn JA
7J Obes. 2011; 2011: 868305.,Published online Nov 24, 2010. doi: 10.1155/2011/868305, High-Intensity Intermittent Exercise and Fat Loss, Stephen H. Boutcher*
8J Appl Physiol (1985). 2012 Dec 15;113(12):1831-7. doi: 10.1152/japplphysiol.01370.2011. Epub 2012 Sep 27., Effects of aerobic and/or resistance training on body mass and fat mass in overweight or obese adults., Willis LH1, Slentz CA, Bateman LA, Shields AT, Piner LW, Bales CW, Houmard JA, Kraus WE.

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