The Truth About Belly Fat

What you need to know -- and do -- about belly fat.
By Sonya Collins. WebMD Feature. Reviewed by Laura J. Martin, MD

Belly fat: Did you know that it's not just about your waist size?
It's also about your health. And you can do something about it, starting right now, at any size.
But first, let's be clear: This is not about fat phobia. Your body needs some fat. And it's not about judging yourself or anyone else, or trying to reach some unrealistic ideal.
Instead, it's about getting a handle on your fat -- even the fat you can't see.

Location, Location, Location

That's right: You have fat you can't see. We all do.
People store most of their fat in two ways:
Just under the skin in the thighs, hips, buttocks, and abdomen. That's called subcutaneous (under the skin) fat. It's the fat that you notice.
Deeper inside, around the vital organs (heart, lungs, digestive tract, liver, etc.) in the chest, abdomen, and pelvis. That's called "visceral" fat. It's so deep inside you that you can't notice it from the outside.
Many people are self-conscious about the fat they can see. But actually, it's the hidden fat -- the visceral fat -- that may be a bigger problem, even for thin people.

Like Another Organ

Fat doesn't just sit there. It makes "lots of nasty substances," says Kristen Hairston, MD, assistant professor of endocrinology and metabolism at Wake Forest School of Medicine.
We all have visceral fat -- and it isn't all bad. It provides necessary cushioning around organs.
The problem is when there's too much of it. That's linked to a greater chance of developing high blood pressure, type 2 diabetes, heart disease, dementia, and certain cancers (including breast cancer and colon cancer.)

How Did I Get It?

When obese, a body can run out of safe places to store fat and begin storing it in and around the organs, such as the heart and the liver.
“Fatty liver disease was, until recently, very rare in non-alcoholics. But with obesity increasing, you have people whose fat depots are so full that the fat is deposited into the organs,” says Carol Shively, PhD, professor of pathology-comparative medicine at Wake Forest School of Medicine. “Now there is much interest in fat being deposited around the heart, as well.”
Now that you know more about the fat that we all have, it's time to take action.

How Much Is Too Much?

You could get a CT scan or MRI if you want the most precise way to see where your fat is stored. But that's over the top. There's a much simpler method.
Get a measuring tape, wrap it around your waist, and check your girth. Do it while you're standing up, and make sure the tape measure is level.
For your best health, you want your waist size to be:
Less than 35 inches for women
Less than 40 inches for men
Having a "pear shape," with fatter hips and thighs, is considered safer than the "apple shape," which describes a wider waistline.
“What we’re really pointing to with the apple versus pear is that if you have more abdominal fat, it’s probably an indicator that you have more visceral fat,” Hairston says.

Thin People, Too

Even thin people can have too much visceral fat, though you'd never know it by looking at them.
It's partly about their genes. Some people have a genetic tendency to store visceral fat.
But it's also about physical activity. Visceral fat likes inactivity. For instance, a British study showed that thin people who maintain their weight through diet alone, skipping exercise, are more likely to have unhealthy levels of visceral fat.
So the message is, get active, no matter what size you are.

Controlling Belly Fat: 4 Steps to Take

There are four keys to controlling belly fat: exercise, diet, sleep, and stress management.
Exercise: Vigorous exercise trims fat, including visceral fat. It can also slow down the build-up of visceral fat that tends to happen over the years.
How much exercise does it take? Half an hour of vigorous aerobic exercise, done four times a week, a Duke University study shows.
What counts as "vigorous"? Jogging, if you're already fit, or walking briskly at an incline on a treadmill, if you're not yet ready for jogging. Vigorous workouts on stationary bikes and elliptical or rowing machines are also effective, says Duke researcher Cris Slentz, PhD.
Moderate activity – raising your heart rate for 30 minutes at least three times per week – also helps. It slows down how much visceral fat you gain. But to torch visceral fat, your workouts may need to be more vigorous.
“Rake leaves, walk, garden, go to Zumba, play soccer with your kids. It doesn’t have to be in the gym,” Hairston says.
If you are not active now, it's a good idea to check with your health care provider before starting a new fitness program. They'll probably be thrilled that you want to get started, and will check that you're ready for it.
And forget spot-reducing. There aren't any moves that specifically target visceral fat.
Diet: There is no magic diet for belly fat. But when you lose weight, on any diet, belly fat usually goes first.

Controlling Belly Fat: 4 Steps to Take continued...

A fiber-rich diet may also help. Hairston’s research shows that people who eat 10 grams of soluble fiber per day, without any other diet changes, build up less visceral fat over time than others. That’s two small apples, a cup of green peas, and a half-cup of pinto beans, for example.
“Even if you kept everything else the same but switched to a higher-fiber bread, you might be able to better maintain your weight over time,” Hairston says.
Sleep: Getting the right amount of sleep helps. In one study, people who got six to seven hours of sleep per night gained less visceral fat over 5 years, compared to those who slept five or fewer hours per night, or eight or more hours per night. Sleep may not have been the only thing that mattered -- but it was part of the picture.
Stress: Stress happens. It's what you do with it that matters.
You probably already know that people tend not to make the best food choices when they're stressed. And when you've got chronic stress, that can be a problem.
Shively recommends getting social support (turn to your friends and family), meditating, and exercising as ways to handle stress. Signing up for a workshop or some counseling sessions can also help you tame your stress.
Short on time? “If you could only afford the time to do one of these things, exercise probably has the most immediate benefits, because it hits both obesity and stress response,” Shively says.

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