What does your waistline say about your health? Find out why belly fat is more common after menopause, what dangers it poses — and what to do about it.
By Mayo Clinic Staff
An expanding waistline is sometimes considered the price of getting older. For women, this can be especially true after menopause, when body fat tends to shift to the abdomen.
Yet an increase in belly fat can do more than make it hard to zip up your jeans. Research shows that belly fat also carries serious health risks. The good news? The threats posed by belly fat can be cut down to size.
Your weight is largely determined by how you balance the calories you eat with the energy you burn. If you eat too much and exercise too little, you're likely to pack on excess pounds — including belly fat.
However, aging also plays a role. Muscle mass typically diminishes with age, while fat increases. Loss of muscle mass also decreases the rate at which your body uses calories, which can make it more challenging to maintain a healthy weight.
Many women also notice an increase in belly fat as they get older — even if they aren't gaining weight. This is likely due to a decreasing level of estrogen, which appears to influence where fat is distributed in the body.
The tendency to gain or carry weight around the waist — have an "apple" rather than a "pear" shape — might have a genetic component as well.
The trouble with belly fat is that it's not limited to the extra layer of padding located just below the skin (subcutaneous fat). It also includes visceral fat — which lies deep inside your abdomen, surrounding your internal organs.
Although subcutaneous fat poses cosmetic concerns, visceral fat is linked with far more dangerous health problems, including:
- Cardiovascular disease
- Type 2 diabetes
- Colorectal cancer
Research also has associated belly fat with an increased risk of premature death — regardless of overall weight. In fact, some studies have found that even when women were considered a normal weight based on standard body mass index (BMI) measurements, a large waistline increased the risk of dying of cardiovascular disease.
So how do you know if you have too much belly fat? Simply measure your waist:
- Place a tape measure around your bare stomach, just above your hipbone.
- Pull the tape measure until it fits snugly around you, but doesn't push into your skin.
- Make sure the tape measure is level all the way around.
- Relax, exhale and measure your waist, resisting the urge to suck in your stomach.
For women, a waist measurement of 35 inches (89 centimeters) or more indicates an unhealthy concentration of belly fat and a greater risk of problems such as heart disease, high blood pressure and type 2 diabetes. For men, a waist measurement of 40 inches (102 centimeters) or more is considered cause for concern.
You can tone abdominal muscles with crunches or other targeted abdominal exercises, but just doing these exercises won't get rid of belly fat. However, visceral fat does respond to the same diet and exercise strategies that can help you shed excess pounds and lower your total body fat. To battle the bulge:
- Eat a healthy diet. Emphasize plant-based foods, such as fruits, vegetables and whole grains, and choose lean sources of protein and low-fat dairy products. Limit saturated fat, found in meat and high-fat dairy products, such as cheese and butter. Choose moderate amounts of monounsaturated and polyunsaturated fats — found in fish, nuts and certain vegetable oils — instead.
- Keep portion sizes in check. Even when you're making healthy choices, calories add up. At home, slim down your portion sizes. In restaurants, share meals — or eat half your meal and take the rest home for another day.
- Include physical activity in your daily routine. For most healthy adults, the Department of Health and Human Services recommends moderate aerobic activity, such as brisk walking, for at least 150 minutes a week or vigorous aerobic activity, such as jogging, for at least 75 minutes a week. In addition, strength training exercises are recommended at least twice a week. If you want to lose weight or meet specific fitness goals, you might need to exercise more.
To lose excess fat and keep it from coming back, aim for slow and steady weight loss — up to 2 pounds (1 kilogram) a week. Consult your doctor for help getting started and staying on track.
Jun. 08, 2013
- Ferrara CM, et al. Differences in adipose tissue metabolism between postmenopausal and perimenopausal women. Journal of Clinical Endocrinology and Metabolism. 2002;87:4166.
- Snijder MB, et al. What aspects of body fat are particularly hazardous and how do we measure them? International Journal of Epidemiology. 2006;35:83.
- Understanding adult obesity. Weight-Control Information Network. http://www.win.niddk.nih.gov/publications/understanding.htm. Accessed Feb. 26, 2013.
- Jacobs EJ, et al. Waist circumference and all-cause mortality in a large US cohort. Archives of Internal Medicine. 2010;170:1293.
- Zhang C, et al. Abdominal obesity and risk of all-cause, cardiovascular, and cancer mortality: Sixteen years of follow-up in US women. Circulation. 2008;117:1658.
- Overweight, obesity and weight loss. U.S. Department of Health and Human Services. http://www.womenshealth.gov/publications/our-publications/fact-sheet/overweight-weight-loss.html. Accessed Feb. 26, 2013.
- Better health and you: Tips for adults. Weight-Control Information Network. http://win.niddk.nih.gov/publications/better_health.htm#loseweight. Accessed Feb. 27, 2013.
- 2008 Physical Activity Guidelines for Americans. U.S. Department of Health and Human Services. http://www.health.gov/paguidelines/guidelines/. Accessed Feb. 26, 2013.
- Assessing your weight and health risk. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/risk.htm. Accessed Feb. 26, 2013.
- Dietary Guidelines for Americans, 2010. U.S. Department of Health and Human Services. http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm. Accessed April 3, 2013.
- Coutinho T, et al. Central obesity and survival in subjects with coronary artery disease: A systematic review of the literature and collaborative analysis with individual subject data. Journal of the American College of Cardiology. 2011;57:1877.
- Coutinho T, et al. Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: Role of "normal weight central obesity." Journal of the American College of Cardiology. 2013;61:553.
- Slentz CA, et al. The effects of aerobic versus resistance training on visceral and liver fat stores, liver enzymes and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT: A randomized trial. American Journal of Physiology. Endocrinology and Metabolism. 2011;301:E1033.
- Nicklas BJ, et al. Effect of exercise intensity on abdominal fat loss during calorie restriction in overweight and obese postmenopausal women: A randomized, controlled trial. The American Journal of Clinical Nutrition. 2009;98:1043.
- Arsenault BJ, et al. Physical inactivity, abdominal obesity and risk of coronary heart disease in apparently healthy men and women. International Journal of Obesity. 2010:34:340.
- Kostek MA, et al. Subcutaneous fat alterations resulting from an upper-body resistance training program. Medicine & Science in Sports and Exercise. 2007;39:1177.
- Wilmore JH, et al. Physiology of Sport and Exercise. 4th ed. Champaign, Ill.: Human Kinetics; 2008:492.
- Santosa S, et al. Adipocyte fatty acid storage factors enhance subcutaneous fat storage in postmenopausal women. Diabetes. 2013;62:775.
- The Menopause Guidebook. 7th ed. Mayfield Heights, Ohio: The North American Menopause Society, 2012. http://www.menopause.org/publications/consumer-publications/-em-menopause-guidebook-em-7th-edition. Accessed Feb. 27, 2013.
- American Cancer Society. http://www.cancer.org/cancer/cancercauses/dietandphysicalactivity/bodyweightandcancerrisk/body-weight-and-cancer-risk-effects. Accessed April 3, 2013.
- Laskowski ER (expert opinion). Mayo Clinic, Rochester, Minn. April 3, 2013.
- Jensen MD (expert opinion). Mayo Clinic, Rochester, Minn. May 13, 2013.