Why getting rid of belly fat is key to a longer, healthier life

CNN

2 days ago

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Hiding deep inside the body, a dangerous type of fat wraps itself around vital organs such as the kidneys, liver and heart — triggering inflammation that can lead to insulin resistance and chronic diseases which cut life short.
Called visceral fat, it can make bellies expand — but not for everyone. Even people who are thin can carry too much visceral fat around their organs, a phenomenon known as 'skinny fat.'
'Visceral fat is a marker for everything — insulin resistance, elevated cardiovascular risk, fatty liver and type 2 diabetes — all very bad outcomes that limit a long and healthy life,' said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.
Excessive deep belly fat is even linked to long-term cognitive health, said preventive neurologist Dr. Kellyann Niotis, who researches Alzheimer's disease and Parkinson's disease risk reduction at the Institute for Neurodegenerative Diseases in Boca Raton, Florida.
'Visceral fat is metabolically unhealthy and secretes a lot of inflammatory chemicals that can cause brain atrophy and impact cognition,' Niotis told CNN in a prior interview.
As the size of a person's belly grows, studies show the memory center of the brain shrinks and hallmark signs of Alzheimer's disease can appear — namely beta-amyloid plaques and tau tangles. This accelerated march toward dementia can begin as early as the 40s and 50s, well before any cognitive decline is apparent, according to researchers.
If visceral fat is about 10% of your body's total fat mass, that's normal and healthy, according to the Cleveland Clinic. So how do you know if that tummy starting to obscure your view of your feet is out of control? One way to tell is to measure your waistline.
Non-pregnant women with a waist size greater than 35 inches (88.9 centimeters) and men with a waist greater than 40 inches (101.6 centimeters) are at higher risk from visceral fat, according to the US Centers for Disease Control and Prevention.
You can measure your waistline yourself: Without sucking in your tummy, wrap a tape measure over your waist at the top of your hip bone (typically across the belly button). Exhale normally and measure, making sure that the tape is parallel to the floor and snug, but not tight, across the skin. (No cheating by sucking in your stomach — this is your health at risk.)
Another key sign is lean muscle mass. If you have more body fat than muscle mass, you're more likely to have visceral fat throughout the body, even the muscles, Freeman said.
You can measure lean muscle mass with a yearly DEXA scan, a large noninvasive X-ray machine that measures bone density, internal visceral fat and muscle mass. There are also over-the-counter biometric scales that track percentages of body and visceral fat and lean muscle mass.
Then there is common sense, Freeman said. Poor exercise and eating habits are a red flag for belly fat, now and in the future.
'Human beings were designed to be fit and strong and active,' he said. 'Eating unprocessed foods and not doing cardio and strength training are good signs that if you don't have excess now, you may soon — even if you don't look 'fat.''
Want to make a change? Visceral fat is reversible with lifestyle changes, Freeman said.
'The real holy grail, the elixir of youth, the key to staying young and aging gracefully is to remain strong and fit,' he said.
Always check with your doctor before beginning any new exercise program. Then start with cardio to get the heart pumping, Freeman said. A good method is to briskly walk for at least 30 minutes a day —'but when I say briskly, I mean fast enough to lose your breath and not be able to hold a conversation. Keep that up for a half hour at a minimum.'
The critical next step is to add resistance, otherwise known as strength training, he added.
'When I tell people to go walking or biking or swimming or jogging, I usually recommend that they do resistance concurrently,' Freeman said. 'Carry some weights with them, or put on a weighted backpack, put resistance on the bike or bike uphill, and put fins on their hands when they swim so that there's resistance in the water. Do whatever they need to try to combine the cardio with strength training.'
Some of the most effective resistance exercises for building lean muscle and losing fat require multiple joints in the body to work together, according to the nonprofit American Council on Exercise.
Dead lifts, lunges, planks, presses, pull-ups and push-ups require many muscles that elevate oxygen use and the release of hormones such as adrenaline that increase blood flow to muscles and boost overall heart rate — both key goals.
As you build lean muscle mass, try to add weight, increase sets and repetition, and reduce the breaks you take between exercises. If you're unsure how to do that without injuring yourself, seek out the advice of a physical trainer, the council suggests.
'If you're doing all the right things and you're not building muscle mass, talk to your doctor to rule out issues such as low testosterone that may be hindering your progress,' Dr. Richard Isaacson, director of research at the Institute for Neurodegenerative Diseases, told CNN previously.
Plant-based diets are excellent ways to improve nutrition and lose belly fat, experts say.
'Get rid of the standard American diet, filled with all the processed foods and added fats, sugars and the like and switch to a predominantly whole foods diet,' Freeman said.
The Mediterranean diet — which is more of a lifestyle than a diet — has won top honors since 2019 for its focus on eating fruits, vegetables, grains, olive oil, nuts and seeds, while emphasizing the importance of meals with family and friends and daily exercise. The diet also slashes consumption of sweets and recommends small amounts of dairy and meat, especially red meat. Fish, however, is a staple, especially fatty fish such as sardines.
Older people who followed a lower-calorie Mediterranean diet and minimally exercised up to six days a week gained muscle and lost a significant amount of body fat by the end of a year and kept much of it off for three years, according to an October 2023 study.
A May 2024 study found the Mediterranean dietary pattern cut the risk of death for women by about 25% for more than 25 years, with reductions in both cancer and cardiovascular mortality.
Changing when you eat may also help. Try a pattern of eating called intermittent fasting or time-restricted eating, Freeman said. However, he added, it doesn't work for everyone.
'People who are struggling with weight loss have to get their bodies out of its routine, and that's very hard to do,' Freeman said. 'Some people, not everyone, respond by some degree to time-restricted eating.
'You eat breakfast at 11 o'clock, you eat dinner by five o'clock — so six hours a day you're eating, and 18 hours a day you're not. Combine that with strength and cardio training and change the type of fuel to whole foods. You put all those together, and magic things start to happen.'