Dr. Shyam P Lohani

Having excess weight or general obesity is a cause of concern for its link to various illnesses so does the excess fat in the abdominal area or abdominal obesity. Because too much fat in the midsection may put us at greater risk for certain medical conditions than excess fat in our thighs or buttocks. Abdominal obesity is a condition when excess fat is present in the abdominal area. The abdomen is the part of the body between the chest and pelvis. Abdominal obesity is known as belly fat, central obesity, and truncal obesity.

Types
Two types of belly fat are visceral fat that surrounds vital organs and subcutaneous that sits under the skin. Subcutaneous fat that lurks beneath the skin as stuffing on the thighs, buttocks, or upper arms may be cosmetically challenging, but it is otherwise harmless. However, the visceral fat that accumulates around abdominal organs is found to be metabolically active and has been strongly associated with a host of serious risks of diseases, including heart disease, cancer, and dementia.

Abdominal obesity impairs the responsiveness to insulin, raising blood sugar and insulin levels. Excess body fat contributes to major causes of death and disability, including heart disease, high blood pressure, stroke, type 2 diabetes, asthma, osteoarthritis, fatty liver, breast cancer, colon cancer, depression, and dementia. Health complications arising from visceral fat are usually more harmful than subcutaneous fat.

A study has demonstrated a direct link between the development of coronary heart disease and an increase in waist circumference over a 20-year period. The chances of developing heart disease were doubled among women with the largest waists even when other coronary risk factors were taken into account.

Cancer risk is also raised by belly fat. The chances of the development of colorectal cancer were nearly doubled among postmenopausal women with increased visceral fat. Breast cancer risk increases as well. A study published recently linked both total body fat and abdominal fat to a raised risk of breast cancer. When the women in the study lost weight indicated a reduction in breast cancer risk. Perhaps most important with regard to the toll on individuals, families, communities and the health care system is the link between abdominal obesity and the risk of developing dementia decades later. People can make many lifestyle and dietary changes to lose belly fat and in turn, reduce the chances of many illnesses associated with it.

Abdominal obesity can be calculated by measuring waist circumference and waist size compared to hip size, also known as the waist-to-hip ratio. In order to measure waist circumference, wrap a tape measure around the widest part of the stomach, specifically across the belly button and above the hips. The risk of heart disease and diabetes rises with the increased measurement and is based on gender. In general, if the waist measures 35 or more inches for women or 40 or more inches for men, chances are that we are harboring a potentially dangerous amount of abdominal fat.

To calculate the waist to hip ratio, the first step is to measure the abdominal circumference. Then, measure the hips around the widest part and divide waist size by hip size to get the waist to hip ratio. A chance of suffering a heart attack or stroke increases as the number rises above 0.9 for men and 0.85 for women. Common causes of excess belly fat include a poor diet, too much alcohol, lack of exercise, stress, genetics, poor sleep, and smoking. An especially sugary diet such as cakes and candy, and drinks such as soda and fruit juice, can cause weight gain, slow metabolism, and reduce our ability to burn fat. Low-protein, high-carb diets may also affect weight. Protein helps a person feel fuller for a longer period of time and people who do not include protein in their meal may tend to eat more food overall.

Prevention
The steps that may help people lose unwanted belly fat are by improving their diet, reducing alcohol consumption, carrying out moderate levels of physical activity, getting enough sunlight, reducing stress, getting sufficient sleep, and quitting smoking.

A sedentary lifestyle can lead to weight gain along with many other serious health problems. Therefore, it becomes imperative for people trying to lose weight to include a good amount of exercise in their daily routine. Aerobic exercises and strength training have been proved to be helpful for people to tackle their belly fat. Stress-relieving activities include mindfulness, yoga, and meditation. Smoking is implicated as a risk factor for belly fat, as well as many other serious health conditions. Quitting smoking can significantly decrease the risk of excess belly fat and improve overall health parameters.

No pill or tonic has been scientifically shown to dissolve or decrease abdominal fat. We have to work at it. And that means avoiding or drastically limiting certain substances from our meals, controlling overall caloric intake, and engaging in exercise that burns calories besides avoiding stress, limiting alcohol intake, and quitting smoking. It is up to us to take small steps to create lifelong changes are to eat a healthy diet, exercise, decrease stress, and improve our sense of well-being.

(Dr. Lohani is the clinical director at the Nepal Drug and Poison Information Centre. lohanis@gmail.com)