Safia is fed up. She is trying to keep up a healthy exercise programme but she still seems to be putting on weight around her midriff. She is just entering her forties and it is getting to be a fight to button her jeans.

Keeping it off

Sagarika is three years past her menopause. She is alarmed at how rapidly her waistline is increasing. She wants effective steps to keep that fat off her belly.

Heredity, hormonal changes or aging cause many women to have an increase in abdominal fat, as they grow older. Menopause tips the scale even more. Unfortunately, gaining fat over the abdomen has bad health implications. Abdominal fat is worse than fat over other body areas like the hips, arms and legs.

Why abdominal fat is dangerous

As you age, your metabolism tends to slow down. As less fat is burned off, more of it slowly gets deposited in the wrong places. Women tend to have an increase in fat deposits as compared to men. Menopause adds its own twist to this — the fat gets deposited over the abdomen. This shift in body fat distribution can be insidious at first but can escalate alarmingly if proper measures are not taken.

Though being overweight has negative health implications, abdominal weight gain is particularly unhealthy. Too much abdominal fat increases the risk of:

Heart disease

Breast cancer

Diabetes

Metabolic syndrome

Gallbladder problems

High blood pressure

Colorectal cancer

Indians particularly suffer from an increased propensity for metabolic syndrome, which is due to insulin resistance. An increasing waistline is therefore a treacherous health risk.

Is it just ‘love handles’?

The fat that is deposited abdominally is not restricted to ‘love handles’. It is not just the rolls of fat that you can grab on the front and sides of your abdomen. The treacherous fat is the fat that lies inside the abdomen. This type of fat is called visceral fat and lies inside the abdomen, surrounding the abdominal organs. Fat located between the skin and the abdominal wall, is more visible but also less likely to be a health risk.

Some women experience a widening waist even without gaining any weight. Even in women of normal weight, too much fat concentrated in the midsection is unhealthy.

Get that measuring tape out

Don’t put it off. Check your waist size now. To measure your waist, run a tape measure around your midsection at about the level of your umbilicus. Breathe normally and don’t hold your tummy in. Hold the tape lightly against the skin, taking care not to press your skin in.

In a woman of healthy weight, a waist measurement of 85 centimetres or more indicates an unhealthy concentration of abdominal fat. Maintaining your waist size at half your height in centimetres is an excellent health measure.

Battling the bulge

Brisk walking is the secret weapon in the battle of the bulge. Walk 30-45 minutes, at least 5 days a week. Healthy eating is your second weapon. Increase portions of complex carbohydrates such as fruits and vegetables, and reduce simple carbohydrates like rice and sugar. Drastically reduce your portion size.

Exercises for toning abdominal muscles

Abdominal hollowing

Get down on all fours. Let your tummy hang down as you take a deep breath. Let your breath out, and at the end of your exhalation, pull your navel inward and upward toward your spine. Hold for 10 seconds and then rest for 10 seconds. Work up to 10-15 repetitions. During each effort, your spine position should not change and you should breathe freely. You can also do this standing up.

Pelvic tilts and pelvic lifts

Lie on your back on the floor with your knees bent. Flatten your back against the floor by tightening your abdominal muscles and bending your pelvis up slightly. Hold for five to 10 seconds. Repeat five times and work up to 10 to 20 repetitions.

For pelvic lifts, lie on your back with your knees bent and your arms relaxed by your sides. Tighten your lower abdomen and lift your buttocks up off the floor, with your feet pressing down on the floor. Hold for five to 10 seconds. Repeat five times and work up to 10 to 20 repetitions.

(The author is a Chennai-based obstetrician and gynaecologist with a special interest in women’s health issues.)

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