You heard the expression “beer belly”. It is an unflattering term for increased abdominal girth, especially in males. It is quite often that this picture is found in middle-aged men who consume more beer than what is good for them, but they may also mill around the hot dog stands at the ball game instead of being physically active. Any leftover calories are stored as belly fat, which protrudes their stomach as if they were pregnant.
There is a big difference between belly fat and body fat. Belly fat is metabolically much more active. Body fat is more sessile. So, it is the belly fat we need to do something about as this has been shown to be associated with heart attacks, strokes and diabetes.
Originally it was thought that excessive weight would best be measured with the body mass index (BMI). But subsequently it was shown that athletes with well-developed muscles could have BMI’s that were in the overweight (between 25.0 and 30.0) or even obese category (more than 30.0). Also, some people with heavy bones can have excessive BMI values despite them being normal based on other measurements. The new measurement is the old fashioned abdominal girth to hip ratio.
You measure the abdominal girth, the hip girth and divide the abdominal girth by the hip girth. Normally this should be 80% (=0.8) or less for women and 90% (=0.9) or less for men. But a person with a beer belly will have ratios of 1.2 or 1.5. This is where it shows that there is a problem. If you take blood tests of that person you would also find elevated triglycerides, lowered HDL cholesterol (the protective cholesterol) and elevated LDL cholesterol (the bad cholesterol). But it does not stop there. We know from studies that often the insulin level is elevated in the sense of hyperinsulinism. In fact that person has often the metabolic syndrome, which is a characteristic change of the metabolism in an obese person. The blood is thicker with clotting factors floating around, there are inflammatory kinins that circulate and these factors work together on causing hardening of the arteries.
Why is a beer belly dangerous?
There are not only cardiovascular risk on the long-term causing heart attacks and strokes down the road. There is a danger of fat deposits in the liver, called fatty liver disease.
In time this can turn into liver cirrhosis and in some cases develop into liver cancer. Because belly fat causes inflammation in the system including in the lining of the blood vessels, this can in time also affect the immune system, weakening it and eventually allowing cancer to develop. Common cancers that are associated with obesity are breast cancer, ovarian cancer and uterine cancer in women, prostate cancer in men and pancreas and colon cancer in both sexes.
In men beer bellies produce a lot of estrogen, the female hormone. This is so because fat tissue contains the enzyme aromatase that metabolizes male hormones into estrogen. Estrogen in men is only good in traces, but when it is massively produced it will counter testosterone production and will cause heart attacks and strokes.
What can be done about a beer belly?
We need to understand how beer bellies develop. One of the sources of fat from beer bellies is the consumption of foods that contain a lot of fructose. Food manufacturers have been diligent in mixing high fructose corn syrup into sugary drinks and into a myriad of processed foods.
Sugar itself can only be processed and stored until the glycogen stores in the liver and the muscles are filled. The liver metabolizes a surplus of sugar into triglycerides and LDL cholesterol. This is also the case for any fructose that comes from metabolized sucrose (table sugar) and from the high fructose corn syrup popular with the food processing industry. One problem is that fructose can only be processed by the liver, while glucose gests directly taken up by cells with the help of insulin.
The surplus of fructose is mostly used to metabolize into triglycerides and LDL cholesterol before it is stored as fat in fat cells. Unfortunately a lot of the fat will end up between your guts, in the liver as fatty liver and in the beer belly, a metabolically more active form of fat.
The sad part is that in the 1960’s I have seen the German economic wonder (“Wirtschaftswunder”) where many mid fifty to mid sixty business men died as a result of obesity and subsequent heart attacks and strokes. At that time it was thought that Germans having been starved during World War II lived it up in the late fifties and 1960’s to the point where they ate what they could get hold of: cakes, fatty cheeses, whipped cream, fatty foods like pork roasts and beef. They also consumed loads of bread, buns, pasta and sugar. Margarine also became popular with its hydrogenated fatty acids that also contained free radicals. The end result was that they gained weight, did not exercise and developed their beer bellies.
Since the 1980’s when low fat/high carbs became popular to replace saturated fatty acids that were supposed to be responsible for heart attacks, strokes and obesity, obesity continued to steadily increase. Sure, the hydrogenated fatty acids did not help and should be cut out. But the bigger problem was the consumption of high fructose corn syrup and over-consuming high glycemic-index carbohydrates.
Here is the solution of what to do get rid of the beer belly.
- Remove sugar and high fructose corn syrup from your diet.
- The second effective step is to cut out as many empty starches that you can cut out like white rice, bread, sweets, cookies, cakes, ice cream and pasta. The reason for this is that these starchy foods get metabolized in the gut into sugar, which causes an insulin response. The extra insulin is responsible for developing inflammation in the arteries, which eventually leads to heart attacks and strokes.
- Exercise on a regular basis. This will produce HDL cholesterol, the protective cholesterol, which balances LDL cholesterol.
- Perhaps the most important step is to rebalance your food intake. With this I mean that you replace high glycemic-index carbs with low glycemic-index carbs. This means you will eat a lot of salads, steamed vegetables, and fruit. This gives you a lot of extra fiber, which your system needs to slow down the rate of sugar absorption, helps you to lower LDL cholesterol and helps you to detoxify your body in the gut where toxins are bound to fiber.
- If you are heavily into alcoholic drinks there is another source of refined carbohydrates that gets metabolized into LDL cholesterol, triglycerides and can cause fatty liver disease and liver cirrhosis. A moderate consumption of alcohol (one drink for women per day and two drinks for men per day) lowers the risk of heart attacks and strokes, while excessive alcohol intake increases the risk.
- Bioidentical hormone replacement may be something you have not heard about. But if you are a woman above the age of 40 or a man above the age of 50 chances are that your natural hormone production from your testicles or adrenal glands (in a man) or from the ovaries or adrenal glands (in a woman) are no longer keeping up with the demand of regular life. Part of the aging process is that is that the production of our sex hormones slows down shortly before menopause in women and shortly before andropause in men. This will not only manifest itself in hot flashes and sleep disturbance in women or in erectile dysfunction and grumpiness in men; it will eventually lead to a lack of energy metabolism in the heart, the brain and other organ systems that have sex hormone receptors. A lack of hormones translates into yet another cause of heart attacks, strokes and certain cancers. This is an area where conventional medicine disagrees with anti-aging medicine. But it is my experience from years in general practice that heart attacks, strokes, colorectal cancer and pancreatic cancer in both sexes, cancer of the breasts, uterus and ovaries in women and prostate cancer in men are indeed more common when natural hormone production has declined.
On the other hand, when bioidentical hormone replacement is given, the metabolism of all cells will return to normal and the likelihood of not developing all these illnesses at an earlier time is diminishing as well. It is not a panacea for eternal life, but it will add significant longevity without premature disabilities, which is what we all need.
Although weight gain around the waistline is common these days and increased mortality due to heart attacks, strokes and cancer is common, we do not have to accept this as the new norm. We need to assess our food intake habits, cut out the items that contribute to the beer belly and ask ourselves what other change in lifestyle we need to do to improve our body shape and our energy metabolism. Life is too precious to just throw away years of fruitful living in our golden retirement years. Work on these factors in midlife or even in younger years and you will enjoy disease-free aging.