Are you happy with your midsection?

Updated: May 2

If you are like me, checking it in the mirror and constantly pinching to estimate the size of "the damage", read on. So, the stomach does not look flat, no six-pack is visible, and not all clothes look good on you. Let us fix it. But before you start doing hundreds of crunches, we need to check something else first.

Is this fat subcutaneous or visceral?

Most of the fat occupies the subcutaneous layer just under the skin. The most uncomplicated check is to pinch yourself. Suppose you can lift the fat with your fingers and measure its thickness using a calliper. In that case, you are dealing with subcutaneous fat. However, there is another type of body fat. It is called visceral fat, which surrounds internal organs. This fat is a sign of increased risk of developing diabetes and heart-related diseases. People with lots of subcutaneous fat often have lots of visceral fat. Please ask your doctor to get an abdominal ultrasound test done to determine if you are at risk of having visceral fat. If this is the case, your first step would be to lose weight and get into a healthy BMI range. Calculate your BMI by dividing your body weight in kg by the square of your height in meters. Keep this ratio under 25.

Is this fat white or brown?

Brown fat keeps us warm during cold exposure; it is packed with energy-generating mitochondria and has a protective property. White fat is different in many ways. Its primary function is energy storage, it contains small numbers of mitochondria, and the cells have large fat droplets. How to make your fat brown? One of the consistently researched tools is exposure to a cold environment. Start your day with two minutes under a cold shower. Low your room ambient temperature during the day, and ensure your bedroom temperature is below 18-19 oC. Explore the Wim Hoff technique for the cold water immersion.

Is it genetic?

It is a million dollars question. The FTO gene, a major genetic risk factor for obesity, codes for fat mass and obesity-associated protein. Start with getting your DNA genetic test done using Ancestry or 23andme websites. The test is a saliva swab that you place in an envelope and mail back to the laboratory. Once you have raw data of all your DNA sequences, use online services like FoundMyFitness by Dr Rhonda Patrick or Promethease to obtain your comprehensive genes report. The read is not always pleasant. Please do not despair as many conditions are epigenetic, meaning you can still correct their course by adjusting your lifestyle.

This is what my genetic report says about my FTO gene: "rs1421085 (C;C) genotype is associated with a 1.7-fold increased risk of obesity as a result of the body shifting from energy-burning adipocytes (brown adipose tissue) to energy-storing adipocytes (white adipose tissue). Consequently, adipocytes store more lipids, and the individual gains weight. This genotype is also associated with reduced thermogenesis (the burning of fat to produce heat) in response to cold exposure. Therefore, less fat is burned in adipose tissue during cold exposure."

Do you have healthy thyroids?

Any underlying health condition could impair your ability to lose fat. However, maintaining a healthy thyroid hormone is an essential tool for body metabolism regulation. The interrelationships between body fat and thyroid status are complex. In summary, this hormone is responsible for generating nutritional signals by producing leptin and peptides regulating appetite. It also regulates cholesterol and carbohydrate metabolism, modulates hepatic insulin sensitivity and influences the body's ability to generate brown fat. Check your thyroid hormones at your next annual blood test.

What is your stress level?

Uncontrollable stress changes our eating habits. We tend to overeat, seeking comfort in food during stressful times, and forget to eat mindfully. When we are under pressure, palatable foods become both increasingly rewarding and particularly difficult to resist. From an energy balance perspective, recurrent instances of using food to cope with stress are likely to lead to excessive increases in weight and fat deposition in your abdominal section.

What is your nutrition like?

The specific food eaten matters. Consumption of fat and simple carbohydrates at the same time will promote insulin secretion. Insulin will shovel all consumed fat into the fat storage cells. At the same time, your body will only use glucose for the daily energy expenditure. To use the consumed fat as your primary energy source and initiate spending of the existing fat deposits, you have to shift to ketosis. When you consume fewer carbohydrates, the insulin level is reduced, and lipid metabolism is shifted from synthesis and storage toward breakdown and oxidation, consequently inducing nutritional ketosis. Doing so mimics metabolic starvation in the body and utilizes ketone bodies as alternative energy sources. The ketogenic diet has been researched well and proven to assist with body fat loss. Until recently, saturated fat was demonized. These days more and more research papers are getting published confirming that this type of dietary fat does not promote cardiovascular disease. You can try a milder approach and follow the Mediterranean diet high in monounsaturated and omega-3 polyunsaturated fats. Another strategy could be to increase protein consumption and cut out all refined sugars, grains, beer, and fruit from your diet.

What do you do to strengthen your core?

Despite popular belief in the benefits of traditional abdominal crunches, it has proven to be one of the least effective exercises for improving your abdominal muscles. The American Council on Exercise conducted a sponsored study in 2001, revealing the best and worst abdominal exercises. Overall, the top three were abdominal bicycle crunch, captain's chair and crunch on a Swiss exercise ball.

Generally, no abdominal exercises will help you lose belly fat. However, they can improve your muscles definition and contribute to the daily energy expenditure. I have found one exciting study describing the benefit of abdominal hollowing.

To perform this exercise:

  • get onto your hands and knees with hands under your shoulders and knees under your hips.

  • tuck your chin in so that you are straight from your head to your hips.

  • concentrate on your navel area, and pull that region in and up. You can even do it sitting, standing, or while moving.

The bottom line

Check your health markers first, then start moving and keep your calories balance in check. Look at nutrition optimization and incorporate core strengthening exercises into your fitness routine. Rome was not built in a day. Be kind to yourself.

Scientific references

Endogenous ways to stimulate brown adipose tissue in humans

The importance of gene-environment interactions in human obesity

Thyroid and Obesity: An Intriguing Relationship

Thyroid Hormone Regulation of Metabolism

Stress and Eating Behaviours

Chronic Stress and Energy Homeostasis

Stress-Related Eating, Mindfulness, and Obesity

Impact of a Ketogenic Diet on Metabolic Parameters in Patients with Obesity or Overweight and with or without Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials.

Saturated Fats and Health: A Reassessment and Proposal for Food-Based Recommendations: JACC State-of-the-Art-Review

Is abdominal hollowing exercise using real-time ultrasound imaging feedback helpful for selective strengthening of the transversus abdominal muscle?

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