by Scott Kahan, MD; and Adriana Williams, MD
While we have some control over our weight such as changing what we eat and how much we exercise, other factors are outside of our direct control such as genetics, environment and social determinants of health. Where we gain weight is even less so in our direct control.
Typically, carrying more weight and storing too much fat increases health risks. And where we gain weight has an even greater impact on the risks for developing long-term health conditions including:
Fat accumulation is most common either in the midsection or the hips, thighs and buttocks. It is also important whether fat accumulates just under the skin (subcutaneous fat) or around the inner organs like the heart, liver and kidneys (visceral fat). Visceral fat has a greater impact on long-term health risks because these cells are more likely to make hormones and other chemicals that increase inflammation, blood clotting and overactive immune responses.
The areas of the body where fat clusters are primarily driven by the below factors:
In addition to the factors above, there are certain medical conditions and medications that can potentially impact where fat accumulates. For example, a medical condition such as lipedema may cause fat to accumulate in your lower body.
There are many ways to measure body composition, including expensive body scans, but in most cases, simple measurements are sufficient. Measuring waist-to-hip ratio is a quick way to estimate visceral abdominal fat vs subcutaneous lower body fat. Studies done by the Annals of Internal Medicine and Frontiers in Public Health have shown that people with higher waist-to-hip ratios are at greater risk for long-term health issues such as diabetes and heart disease. According to the World Health Organization, a high waist-to-hip ratio for men is 1.0 or greater and for women is 0.86 or greater.
First, let’s appreciate our bodies, regardless of weight, shape or size. From eyes and noses to skin and hair, to brains and fingerprints and personalities, we all look, feel and experience the world differently. We are each unique and have different shapes and sizes. Work hard to maximize your body’s health and abilities, but catch yourself before shaming its shape or size (or anyone else’s for that matter).
While we have little control over many of the factors discussed above, there are several things we can do to improve our health risks:
Minimize Sugary Foods
Foods that tend to spike insulin levels may increase the accumulation of visceral fat. Therefore, minimizing sugary foods and “junk foods” can lead to less visceral fat. In contrast, whole grains, complex carbs and lower-carb foods generally digest slower and don’t spike insulin levels as much.
Avoid Trans Fats and Saturated Fats
Additionally, trans fats and saturated fats may also increase the risk for belly fat. Unsaturated and polyunsaturated fats that are found in fish, nuts, seeds and vegetables can help reduce insulin resistance and visceral fat.
Being active, regardless of weight, is one of the healthiest things we can do for ourselves. Physical activity improves insulin resistance, decreases visceral fat and reduces long-term health risks. Any kind of physical activity is beneficial. For some, exercising in the gym is preferred; for others, taking walks with friends or while listening to a podcast is more fun.
Both stress and sleep also impact visceral fat. Getting restorative sleep is especially important given that insufficient sleep impacts stress levels and metabolism. In one long-term study, those who slept too little (five or fewer hours per night) accumulated nearly three times as much visceral fat compared to people who slept 6-7 hours per night.
It’s important to pay attention to where your weight is clustering in your body because it could be affecting your health. If you are concerned about where your weight is clustering, be sure to consult with a healthcare provider about what you can do.
About the Authors:
Scott Kahan, MD, MPH, is a physician trained in clinical medicine and public health. Dr. Kahan is the Director of the National Center for Weight and Wellness in Washington, D.C. and Chair of the Clinical Committee for The Obesity Society. He serves on the Board of Directors for the OAC, the American Board of Obesity Medicine, The Obesity Society and the Obesity Treatment Foundation.
Adriana Williams, MD, is a Clinical Coordinator at the National Center for Weight & Wellness in Washington, D.C. She served as a Medical Assistant for the Institute of Neurological Recovery and was a medical student at Medical University Lublin.
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