Why We Gain Belly Fat and How to Fight It

Belly fat comes in two types, subcutaneous (right under the skin) and visceral (intraabdominal fat); the latter is the most dangerous type and the one that increases dramatically around menopause.

• Subcutaneous fat: is that fat that you can pinch around your midsection. It is caused by an over consumption of calories. While this fat can be distressing, especially to women, it is not as dangerous to our health even though it can lead to extended wear and tear on joints.

• Visceral fat: is the intraabdominal fat that wraps around our internal organs, making us look pregnant, and presents like a beer belly in men. We cannot pinch this fat. This type of fat is very dangerous and has been tied to type 2 diabetes, heart disease, nonalcoholic fatty liver disease, etc. This type of fat actually spews inflammatory cytokines.

Within 2 years of your period stopping, most women will notice a dramatic increase in visceral fat. Fat accumulation shifts from hips and thighs to the abdomen. The phenomenon is almost universal, and occurs even in those at normal weight.

Why do we get more belly fat around menopause? It has to do with hormonal changes, not just in our sexual hormones but also in hunger/satiety hormones as well as our stress hormones. It is not driven by calories in, calories out but more by the quality of the food we are eating.

• Estrogen prompts the liver to produce a hormone called steroid hormone-binding globulin (SHBG). As estrogen decreases as we go through perimenopause and menopause, our SHBG also decreases. SHBG binds our sex hormones and keeps them inactive. As SHBG drops, the activity of some of our hormones can increase. Androgens (male hormones like testosterone) will increase the body’s preference to drive fat to abdomen.

• Estrogen also improves insulin sensitivity, ensuring that we don’t need as much insulin to get glucose (blood sugar) into our cells for energy. When estrogen decreases, there is no check on insulin, resulting in excess insulin which prompts the accumulation of abdominal fat.

There is no magic potion or quick fix to reverse this process but there are certain things you can do to decrease visceral fat and improve quality of life and metabolic health, based on a number of research studies looking at menopausal women.

1) Get Enough Fiber. Minimum 25 grams, but 35 is optimal. Good sources of fiber: berries; legumes (peas, peanuts, legumes); flax meal & chia seeds; nuts & seeds; oatmeal; and fruit and veggies. The bulk of your nutrition should come from food; if you have allergies, you can turn to supplementation as needed.

2) Avoid Added Sugars. No more than 25 grams of added sugars per day. (We are not talking about the natural sugars in fruit; those are good because they are paired with fiber and slow absorption of the glucose into your system.) Added sugars come in processed foods, an include high fructose corn syrup (HCFS), agave, honey, as well as all other sugars. Fructose is biggest cause of fatty liver disease and visceral fat; table sugar is half glucose/half fructose.

a. Why fructose is bad for you is that the liver has to process all fructose and gets easily overwhelmed by our high-fructose diet, forcing it to convert fructose to fat for storage before it can be burned.

b. Sugary drinks are the WORST thing for your diet. Replace sugary sodas, juices, and coffee drinks with just water and you will see the biggest improvement in your health.

3) Eat a Diet Rich in Probiotics. Some good probiotics include: Greek or natural plain yogurt (if you don’t have dairy intolerance), kimchi, miso, kefir, pickles, kombucha, and other fermented products. Consider a probiotic supplement if don’t get enough of these types of foods. Choose a probiotic that has at least 1 billion; Garden of Life has a good one for women with 80 billion.

4) Do Aerobic Exercise. Cardiovascular exercise lowers your fasting insulin which is good because insulin drives fat to the abdomen. While resistance training is also important, it is aerobic exercise that does the most against visceral fat. You should aim to work at 60-75% of your max heart rate; often that can look like 30 mins of cardio, 5 days/week.

5) Get Enough Protein. How much? It depends. Most women are not getting enough protein throughout the day. The recommended range is for 1-1.5 grams for every kilogram of lean body mass for women, which usually works out to around the 70-100 grams range. (If you are vegan/vegetarian you may need to supplement.) The key is to divide that number out at meals and snacks throughout the day, not just at dinner. We can only process about 30 grams of protein at a time, so if we have too much protein at any one point, it will just get converted to fat.

6) Intermittent Fasting. Will help decrease visceral fat. Intermittent fasting can involve different ranges of eating windows. Some suggest a daily fast of 16 hours, with an eating window of 8 hours. (If you are diabetic or have a history with eating disorders or disordered eating, you shouldn’t try intermittent fasting.) You should also focus on eating healthy foods in your eating window because if you just eat junk, your health will still suffer.

**Content provided for educational and informational purposes only. It is derived from information from a YouTube video by Dr. Marie Claire Haver, OBGYN & Nutritionist, and founder of the Galveston Diet. It is not to be considered medical advice.**