Fat around the Middle – How to Lose that Bulge for Good

As we get older it can feel harder to stay in shape, Dr Marilyn Glenville is the author of an excellent book called 'Fat Around the Middle' and she advocates a specific programme including supplements to crack the problem, I invited her to share her tips.
Janey Lee Grace www.imperfectlynatural.com

If you have a tendency to gather fat around your middle, apple rather than pear shaped, you will know how difficult it is to lose it.  Your arms and legs may be acceptable looking, but the middle bit, from your bust to your groin - seems to defy all attempts to diet and exercise. Perhaps your clothes feel uncomfortable, your waistband is too tight, you’ve got a gaping blouse and a “muffin top” layer of fat pouring over the waistband of your jeans or worst of all – you’ve been asked when your next baby is due.

What you may not know is how dangerous the fat around your middle really is (more so than fat on your thighs or bottom), increasing your risk of diabetes, heart disease, stroke, high blood pressure and cancer (especially breast cancer).  Because of where the fat sits on your body, normal diets, even rigorous exercise regimes rarely work.  

Ballooning waistlines

Research from the Department of Health in 2005, has shown that Britons now have the fattest stomachs in history.  Between 1993 and 2004, women’s waistlines ballooned by an average of 1.6in (4.1cm) to 34.1in (86.6cm) and men by an average 1.5in (3.8cm) to 38.4in (97.5cm).  Figures published in 2004 showed that between 1951 and 2005, women’s waists have increased by 6.5in (16.5cm).

But compare the other changes in height, bust and hips:

 

 1951 2004 Difference
Height 5ft 3in (1.6m) 5ft 4.5in (1.64m) 1.5in (3.8cm)
Bust 37in (94.0cm) 38.5in (97.8cm) 1.5in (3.8cm)
Hips 39in (99.1cm) 40.5in (102.9cm) 1.5in (3.8cm)
Waist 27.5 (69.9cm) 34in (86.4cm) 6.5in (16.5cm)
Source:  National Sizing Survey

So we have become generally taller and larger but there is an enormous difference between the 1.5in gain in height, bust and hips and the 6.5in gained on the waist.   There is no doubt that we have lost the traditional hourglass figure (synonymous with a pear shape) and women have become more apple shaped with all its health risks.  

So by following the recommendations below, you will not only rid of fat around your middle, but you will also be doing the best you possibly can to prevent health problems in the future. Short term, you get to look better.  Long term? You live longer. It’s as simple as that.

How?
The aim is to change your body’s underlying biochemistry so that it gets the message that it is OK to let go of the fat it is choosing to store around the middle of your body.

What’s the cause?
The main reason some people gather more fat around their middle than others is specifically because of the action of the stress hormone cortisol.

Millions of years ago, our bodies were designed to react quickly to danger.  Like wild animals we were on constant alert so we could run or fight if threatened. When your brain thinks your life is in danger it stimulates the release of adrenaline and cortisol

This fight or flight response is incredibly clever and thoroughly efficient. It provides instant energy for 5-10 minutes allowing you to react swiftly to dangerous situations.

These days, many of us live under chronic stress.   But our bodies can’t distinguish between late trains, missed appointments, spiralling debt, infuriating work colleagues, family disputes and the truly life-threatening stress it gears up to challenge. So it reacts exactly the same as it’s always done. 

The problem with many modern lifestyles is that stress (our ‘perceived threat’) is almost continuous and comes without the natural release that either fighting or fleeing might provide. Unless you do something physical (as your body is expecting you to) all that extra energy, in the form of fat and glucose, has nowhere to go. It must be simply re-deposited as fat.

Food cravings you can’t control
After a stressful event cortisol levels in the blood often remain high for a while, effectively increasing your appetite because your body thinks you should refuel after all this fighting or fleeing. This means people under constant stress quite often feel constantly hungry. Worse, their body urges them to stock up on the foods it thinks will be most useful after all that ‘activity’ – carbohydrates (like sugar) and fats. 

It’s just the sort high-sugar, high-fat comfort and convenience food many people crave.

The fat around the middle connection
If you don’t fight or flee when your body expects you to, the fat and glucose swimming around your system get deposited as fat – around the middle of your body. And if you eat something sugary or fatty as a consequence of the post-stress appetite surge, any weight you gain as a result, will be around your middle too.

The reason fat targets the middle is because it is close to the liver where it can most quickly be converted back into energy if needed.  There it provides the body with protection ready for the next stress attack.

Your body is only trying to help. To continue providing the energy it thinks you need, it tries to keep a convenient fat store ready for constant use and creates cravings and increases appetite to ensure good supplies of necessary fuel.

Do you have a problem?
For the purposes of measuring fat around the middle, BMI (body mass index) isn’t the best test. The best test is the difference in size between your hips and your waist (your ‘hip to waist ratio’). This is the true measure of fat around the middle and the best indicator of whether or not you are going to be vulnerable to all the health risks associated with it.

Just get a tape measure and compare your waist measurement (at the narrowest point) with your hip measurement (at the widest point). Divide your hip figure by your waist figure to get what is known as your waist–hip ratio.

 For example: 86cm (34in) waist divided by 94cm (37in) hip = 0.9

If your calculation gives a figure greater than 0.8 you are officially apple shaped and you need to take action. For men the danger zone is above 0.95.

Menopausal?
If you are going into the menopause, your body will be extremely reluctant to let go of the fat around your middle. This is because fat is a manufacturing plant for oestrogen which will help protect your bones from osteoporosis.  It’s a very clever system, designed to protect you, but it helps explain why mere diet and exercise alone will rarely shift that stubborn fat. The combined effect of female hormonal changes, slower metabolism and stress with high cortisol levels create a bigger likelihood of fat around the middle. 

Why tummy fat is bad for you
Not all fat in the body behaves the same.  Fat around the middle of the body literally has a mind of its own and it actually operates just like an endocrine (hormone-secreting) organ, producing its own array of hormones.  This fat around the middle manufactures an array of chemical messengers including blood clotting agents, substances which contract blood vessels and raise blood pressure (vasoconstrictors), inflammatory agents, hormones (like oestrogen) and molecules which control hunger.

This “toxic fat” is far more metabolically active than fat elsewhere and it increases the risk of heart disease, high blood pressure, stroke, cancer and diabetes. 

So what can you do to get rid of the fat around your middle?
Follow this four pronged approach for three months to see a significant change in your body shape and as a consequence, it will dramatically improve your long term health.

1) eat healthily
2) take supplements
3) address stress
4) take exercise

Eating healthily – NOT dieting!
There is a chance that your pattern of eating is subconsciously telling your body that it is under stress.  If you restrict your diet or cut calories your body inevitably thinks there is a famine out there and that causes stress.  It will slow down your metabolism to hold on to your precious fat stores. Furthermore, if your blood sugar levels fluctuate (as they do for most women), your body will be releasing adrenaline which is the same hormone it releases when you are under stress. Once more it encourages your body to store fat.

The solution is to find a way of eating that tells your body all is well –and reassure it that is not under stress.

The 3-month eating plan
Aim to stick to the eating plan 80% of the time and allow yourself a 20% off for good behaviour (and human fallibilities!) and don’t talk about ‘good’ and ‘bad’ foods (it induces guilt). Instead try to think of foods as junk (unhealthy) and healthy foods.

Try to stick to these simple rules:
1) Stop dieting
Stop dieting (yes, really!) and don’t count calories, otherwise your body will think there’s a famine and raises stress levels (which contribute to fat storage)

2) Eat little and often
Try to keep your blood sugar levels and energy levels stable by eating something every three hours. Just eat breakfast, lunch and dinner plus a snack mid morning and one mid afternoon, with no longer than three hours between. Oh, and try not to eat carbohydrates after 6pm.

This will stop those roller-coaster highs and cravings for sweet foods.  Because your blood sugar isn’t allowed to drop, your body will no longer have to ask you for a quick fix. As the blood sugar steadies, so will the mood swings. As your cortisol levels reduce you will automatically start to happier and calmer inside.

3) Don’t skip breakfast
If you miss breakfast completely your body immediately registers famine and hangs on tight to your ample stores of fat.

4) Eliminate all sugar and refined carbohydrates
Avoid any foods that make your blood sugar rise quickly because as blood sugar drops again your body releases adrenaline and cortisol to stabilise it once more.  Swap to whole grain alternatives.

5) Add protein to each meal
Protein slows down the rate the stomach processes food and slows the passage of the carbohydrates with it. As soon as you add a protein (be it animal or vegetable) to a carbohydrate you change it into a slower releasing carbohydrate, which is a very good thing.

6) Eat essential fats
A lifelong dependency on low fat diets might mean you’re consuming less saturated fat, but most people today have unwittingly made themselves deficient in the good fats – essential fatty acids, found in oily fish, nuts and seeds. As the name implies these essential fatty acids are essential.

Essential fats are so important as that they help you in a number of ways:

* They slow down the rate at which the stomach empties, so making carbohydrates even more slow-releasing
* They boost your metabolism
* They make you less insulin resistant
* They reduce inflammation

7) Don’t eat on the run
It gives your body the message that time is scarce, you are under pressure and stressed. Furthermore, your digestive system will be less efficient. Make a point of sitting down and eating your food as calmly as possible.

8) Watch what you drink
Cut out all caffeine and sugary drinks and significantly reduce alcohol intake (cut it out completely for a month if you can).

9) Change the way you think about food
If you’re really serious about changing your body shape you need to think about food and eating as a way of life so that healthy, enjoyable eating becomes a habit, something you do everyday without even thinking about it, just like cleaning your teeth.

Supplements
Because your body has been under this constant stress for so long it will usually need a bit of extra help to get its functioning back to normal, and to reassure it completely that it’s not under constant attack.  You can get this extra help in the form of supplements and herbs.

When you are continually stressed, the body becomes increasingly nutritionally deficient.  Also a number of chemical reactions are involved in turning glucose into energy instead of fat.  Certain vitamins and minerals help this to happen.  If you are deficient in these nutrients, the body will find it harder to let go of that weight around the middle.

Chromium
One of the most important minerals for losing that apple shape is chromium.  This mineral is needed for the metabolism of sugar. It helps insulin take glucose into the cells. Without chromium, insulin is less effective at controlling blood sugar levels and glucose levels rise.

Magnesium
Known as ‘nature’s tranquilliser, magnesium calms the adrenal glands and helps balance blood sugar by contributing to the production and action of insulin.

Zinc
Zinc is an extremely important mineral, as it is needed for the production of stress hormones, insulin and sex hormones. Research has shown that supplementing with zinc helps control cortisol. 

Vitamin C
We know that vitamin C is involved with glucose metabolism and that according to the Centre for Disease Control and Prevention in the US, people with diabetes have significantly lower concentrations of vitamin C, up to 30% lower. Vitamin C is crucial for adrenal gland function.  The more cortisol is made, the more vitamin C is used.

B vitamins
The B vitamins are known as the ‘stress’ vitamins and are important to take when working on nourishing and calming the adrenal function.   B vitamins also have an effect on blood sugar balance because they are needed for glucose metabolism. 

Co-enzyme Q10
This vitamin-like substance is important for energy production and normal carbohydrate metabolism.  Co-enzyme Q10 helps shift fat around the middle because it releases energy by burning that fat. 

Co-enzyme Q10 also has a role in controlling blood sugar levels and helps to lower glucose and insulin, so improving insulin resistance. 

Alpha Lipoic acid
Alpha lipoic acid is a powerful antioxidant that is made by the body and is a co-factor in vital energy-producing reactions.  Its role is to release energy by burning glucose.  The more glucose is burned, the less insulin the body has to release and so the body stores less fat.  Alpha lipoic helps makes tissues more sensitive to insulin so that insulin can do its job of moving glucose into the cells and not storing it as fat.

Amino Acids
Amino acids are the building blocks of protein and a number are vital to losing fat around the middle because they can help to make cells more sensitive to insulin while others are important to help cushion the body against the effect of the stress hormones.  The most important ones are: N-acetyl cysteine, carnitine, tyrosine, arginine, glutamine, leucine, isoleucine and valine. 

Siberian Ginseng
The herb of choice for the adrenal glands is Siberian ginseng. Siberian ginseng is classed as an adaptogen, which means that it works according to the body’s need – providing energy when required, and helping to combat stress and fatigue when pressure.  It helps to encourage the normal functioning of the adrenals and acts as a tonic to these glands.

(To avoid having to purchase single supplements for all of the above, I have formulated two supplements for The Natural Health Practice that contains all of the above.  They are called NutriPlus and AminoPlus and are available from www.naturalhealthpractice.com or 0845 8800915),

Exercise
Exercise or physical activity has never been more important. If you have fat around the middle of your body caused, in part, by the activity of your stress hormones, exercise MUST become one of your priorities. By simply making time for exercise in your life, you can control the potentially damaging fight or flight response.

Build muscle
Muscle is metabolically active. This means it requires fuel in the form of calories just to maintain it even when you are sitting doing nothing.  So the more muscle you have, the more calories you use up, and, if you don’t overeat, the more fat you will burn.  

This is one of the infuriating reasons why men tend to find it easier to lose weight than women - they generally have more muscle than women.

Weight gain with age
It is sad, but true that we all tend to gain weight as we get older. One of the main reasons is that we lose muscle.  After the age of 40, women can start to lose about 230g (½lb) of muscle a year. So over ten years between 40 and 50, most of us will have lost 5lbs of muscle.   As muscle mass decreases, our metabolism become increasingly sluggish. Let’s face it; we all also tend to get less active as we get older so this inactivity will only add to the problem. With less muscle and less activity weight is likely to pile on as fat.

What kind of exercise is best?
In order to lose that fat around the middle, you need to do a combination of cardiovascular (getting you puffed) and resistance training (with weights or bands to build muscles). The aim is to use exercise to help burn off fat AND to build muscle which helps you burn off even more fat faster. 

Stress
One of the most surprising ways to slim the fat around your middle, is to cut back on the stress in your life, because that will help reduce cortisol levels, and – when combined with diet, exercise and supplements – will train your body to stop storing fat around your middle.

How to reduce stress
1) prioritise
2) delegate
3) put yourself first
4) learn some relaxation techniques
5) put things in perspective
6) take time to eat
7) take time to go to the toilet (yes! Really)
8) take regular exercise
9) spend time with your friends
10) have a cuddle
11) laugh
12) get enough sleep

Go for it!
Changing the way you eat, adding supplements and an exercise regime AND trying to cut back on the stress in your life isn’t going to seem easy for the first few weeks. But please persevere. In less than a month you will start to notice a few changes.  The fat at the top of your belly often goes first, then lower down, then across your back. And before you know it, your clothes will start to feel lose.

Dr Marilyn Glenville PhD
Dr Marilyn Glenville PhD is the UK’s leading nutritionist specialising in women’s  health. Dr Glenville is the former President of the Food and Health Forum at the Royal Society of Medicine, a registered nutritionist, psychologist, author and popular broadcaster who obtained her doctorate from Cambridge University. She is a popular international speaker and as a respected author on women's healthcare she gives regular talks on radio and frequently appears on television and in the press.

For over twenty five years Dr Glenville has studied and practised Nutritional Medicine specialising in the natural approach to female hormone problems.
With her special interest in the female hormone cycle, Dr Glenville works with women who suffer menstrual problems such as heavy periods, painful periods, PMS, fibroids, PCOS and endometriosis, and who wish to work on a nutritional approach to these problems. Dr Glenville also helps couples who are having difficulty conceiving or having recurrent miscarriages.
Dr Glenville is the author of 9 internationally bestselling books (see below) many of which have become the standard reference books for practitioners and have sold over 500,000 copies which have been translated into over 20 languages.
The titles include:

Fat Around the Middle
Overcoming PMS the Natural Way   The Natural Health Bible For Women
The New Natural Alternatives to HRT  Healthy Eating for the Menopause. Osteoporosis – the Silent Epidemic Getting Pregnant faster.      Natural Solutions to Infertility.
The Nutritional Health Handbook for Women.
Dr Glenville won the Best Nutrition Health Writer of the year award in 2009 and has been awarded a place in the 2010 edition of ‘Who’s Who’ of famous people.
Dr Glenville works in a gynaecology clinic in London and also in Tunbridge Wells.
For more in depth information look on Marilyn’s website www.marilynglenville.com.
If you are interested in a consultation you can contact Dr Glenville’s clinic on 0870 5329244 or by email: health@marilynglenville.com 
                                                                                                                                                                       

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