Three Reliable Strategies for Reducing Abdominal (Belly) Fat

Three Reliable Strategies for Reducing Abdominal (Belly) Fat

By Gary Pepper, M.D. and Sam Jeans, MSc

Without a doubt, abdominal (belly) fat is the focus of much of our negative emotion as we get older. Studies have shown that estrogen plays a major role in body fat distribution, hence why women experience a much greater change in visceral fat with age particularly after menopause (400% vs 200% in men between the ages of 30 and 70).

“If women gain weight after menopause, it’s more likely to be in their bellies,”Michael Jensen, M.D., professor of medicine at Mayo Clinic.

Multiple studies, including this one published in the Journal of Menopausal Medicine, have also found that estrogen replacement therapy (ERT) can reduce some of this weight gain. However, estrogen replacement is not without its risks and is unsuitable for many.

Namely, ERT can increase the risk of blood clots leading to strokes and embolisms and cause headaches, swelling, or edema. ERT is also often linked to an increased risk of breast and ovarian cancer, but studies reviewed by have shown that the risk is only significant after using ERT 10 years or more (in the case of estrogen-only therapy). Combination HRT poses a much greater risk.

As such, ERT is certainly not a ‘silver bullet’ for treating menopause-related abdominal weight gain.

Three Reliable Strategies For Reducing Abdominal Fat

The good news is that it’s possible for virtually anyone to reduce abdominal fat. The bad news is, there’s no real shortcuts and you can’t cheat your way to a trim waist!

For most people, it comes down to those two worrisome words: diet and exercise.

Does Spot Reduction for Abdominal Fat Work?

But wait, is there an easier way? It might seem logical to start an intense abdominal workout regime to tackle excess belly fat. This is known as spot reduction.

The concept of spot reduction is not new, but studies including this one published in the Journal of Strength and Conditioning Research generally show that spot training is ineffective. In fact, the concept of spot training has been almost entirely debunked.

Moreover, spot training doesn’t rate as a great use of exercise time either – you’re likely better off spending that time on other types of holistic core or full body workouts.

However, this isn’t to rule out the benefit of strength and conditioning training with a focus on the abdomen and core, as strengthening this part of the body will boost your metabolism and help you fight age-related weight gain. The studies just show that you can’t ‘target’ one part of the body with one specific exercise.

Strategy 1: Core Exercises Without the Sit-ups

Spot training doesn’t work in the way many imagine it to work, but core training is an excellent way to lose weight in general. Core training will strengthen the abdominal muscles, which will increase muscle tone in the area and also help deal with over-stretched skin.

In recent years, sit-ups have fallen out of favor as they put immense strain on the back. Harvard Health suggests that they would be replaced with planking, which is excellent for the core and easier on the back.

Mountain climbers and burpees are also great alternatives to sit-ups and both can be modified to reduce joint strain and impact.

  • Exercise the core and legs to support muscle mass and increase metabolism.
  • Core exercises also build stability and balance, which become increasingly important with age.
  • Skip the crunches and sit-ups in favor of mountain climbers, burpees, and planks.

Strategy 2: HIIT For Cardio

High-intensity interval training (HIIT) is a recurring theme in any article aimed at helping people lose abdominal fat. In a nutshell, HIIT involves short bursts of intense exercise followed by rest periods, with the average session lasting around 15 minutes at the most.

HIIT burns calories quicker and more efficiently than steady-state cardio (e.g. a treadmill). It’s also easier to slot into your day and you can spend the rest of your workout time on strength training.

Those who aren’t used to intense exercise should seek advice before starting a HIIT training regime, though studies have shown that even lower intensity sessions are excellent for burning calories and improving cardiovascular health.

  • High-intensity interval training is a quick and efficient way to burn calories.
  • Almost any exercise can be used in a HIIT training regime, so you can pick your favorite one.
  • For seniors, HIIT is still generally safe and the benefits are proven even when the intensity is reduced to what one can handle.

Strategy 3: Make Long-Term Dietary Changes

You may often hear that diet is more important than exercise when it comes to losing weight, and this is generally true. As the old adage goes; “you are what you eat”!

In our previous article, we explored how different types of food affect the metabolism (i.e. the thermic effect of food). Protein uses more energy to digest than fat or carbs, so switching to a protein-rich diet that incorporates more raw, unprocessed foods is ideal for burning abdominal fat.

There are various diets proposed for dealing with hormonal changes relating to age or menopause, and perhaps the most promising is the Mediterranean diet. The people of Mediterranean countries in Southern Europe enjoy some of the lowest rates of cardiovascular and heart disease, as well as lower rates of degenerative diseases (like Alzheimer’s), diabetes, and even some cancers.

Harvard Health has created a diet review of the Mediterranean diet here. In essence, it involves consuming less red meat and more fish, more raw foods and healthy fats (e.g. from olive oil), and drinking practically mostly water.

Avocados, seeds, nuts, and oily fish all feature prolifically, as well as heaps of dark leafy greens. Oh, and you can still eat cheese and drink wine in limited quantities (this is a Mediterranean diet, after all!).

  • Cut processed foods from the diet wherever possible.
  • Bump up consumption of raw and unprocessed foods (but make sure you don’t overcompensate with high-fat options like nuts).
  • Don’t forget to avoid sugary drinks. Choose water instead.

Summary: Abdominal Fat and How to Lose It

It’s important to understand that abdominal fat is NOT the same as generalized body fat (subcutaneous fat).

For those with an hourglass body shape and thin waist, this is perhaps good news.

For those suffering from the beer belly or middle-age spread, this is probably not good news! And let’s face it, more people fall into this category.

Abdominal fat is worse than any other fat and a bulging waistline is a cause for action, even if the rest of you is relatively slim. Whilst it can be stubborn, abdominal fat is not unshiftable and with dedication and perseverance, it’s possible to shift even the most problematic fat.


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Four Reasons Our Metabolism Changes with Age

Four Reasons Our Metabolism Changes with Age

Aging Metabolism

By Gary Pepper, M.D., and Sam Jeans MSc

It’s tempting to think that our bodies simply ‘slow down’ as we age, which makes it harder to keep weight off, but a study of 6,600 people aged between one week old to 95-years-old revealed that it’s not as simple as one might assume.

In our prior post, we defined what metabolism really is (a mixture of at least 3 different processes), so we can now move on to discussing how these processes change as we age.

A 2021 study, published in Science, found that our total daily energy expenditure is 50% faster in our first year of life than during adulthood. After our first birthday, our daily energy expenditure begins to taper off by some 3% each year until around the age of 20.

But here’s the surprise; instead of our total daily expenditure slowing gradually from say, the age of 30 onwards, it tends to remain very stable until the age of 50 or 60. After then, it decreases only slightly, by around 0.7% per year.

“Some people think of their teens and 20s as the age when their calorie-burning potential hits its peak…But the study shows that, pound for pound, infants have the highest metabolic rates of all.” – Dr. Katzmarzyk, Professor and Associate Executive Director for Population and Public Health Sciences at the Pennington Biomedical Research Center.

In essence, what this study shows is that the metabolism – and total energy expenditure – slows over time because of a mixture of factors, and not just because of age only. In other words, many people gain weight as they age for reasons other than what is often simply described as “the body slows down as you age”.

If you’re struggling more with your weight as you age, there are probably a few different things going on.

Problems and Solutions for Age-Related Weight Gain

1: Your Diet Has Changed

Diets can change in either direction with age, they might vastly improve as we realize the benefits of a healthy diet, or they might slip deeper and deeper into bad habits and indulgence!

What we do know is that a high-fat, low-protein diet lowers the thermic effect of food, which means that more excess calories end up deposited as fat.

A 2016 study from Purdue University found that a high-protein diet can boost the metabolism, boosting energy expenditure by around 100 calories per day. That’s 100 calories you’re losing for free, without moving, simply by eating high protein foods. For how long the increase in calorie burning by high protein diet lasts, is not clear, however.

Grabbing a shelf full of protein supplements in your 50s, 60s, or 70s is probably not required.

The following is a list of natural high-protein foodstuffs to consider:

  • Nuts
  • Beans, peas, and legumes
  • Seeds
  • Eggs
  • Soy
  • Unprocessed dairy
  • Oats and grains
  • Dark leafy vegetables

2: You’re Moving Less

Next up, it’s all too easy to start moving less with age. Rather than low-level exercise, it’s usually the more vigorous activities that start getting neglected with age.

Exercise demands remain quite consistent throughout life, and it’s generally now recommended that older adults up to the age of around 50 to 60 commit to a similar exercise regime as those aged much younger. The older we become however, limitations on exercise duration and intensity are imposed by illness and degenerative conditions such as arthritis, heart and lung disease and whatever injuries have occurred over the years.

Web MD recommends a considerable 150 minutes of moderate cardio spread over 3 days or more, which is what the CDC recommends for all adults who are medically able.

A strong body of research has also found that more rigorous exercise like high-intensity interval training can protect seniors from an array of diseases whilst bolstering their metabolism. It is strongly advised, particularly in older individuals, that before stepping up your exercise regime to always consult a physician prior to starting.

3: You’ve Lost Muscle Mass

Muscle loss (sarcopenia) reduces BMR whilst simultaneously reducing the number of calories burnt during exercise. Harvard Health cites that muscle loss can hit 3% to 5% per year after the age of 30. A higher percentage of lean muscle tissue boosts the level of calories burnt during exercise and at rest, so fighting against muscle loss is a potent way to maintain a steady metabolism.

It’s possible to fight against muscle loss by engaging in strength and resistance training in addition to your standard exercise regime. Follow a strength or resistance training plan approved by a professional, aimed at your age group and skill level and always take things slowly at the start.

4: Your Hormone Levels Have Changed

The hormone levels of both men and women progressively change with age.

Whilst men obviously do not experience anything like the level of hormone change that comes with female menopause, they may still experience somewhat of a “male menopause” which involves the loss of testosterone often beginning during the 50’s. Obesity in men is also associated with lower testosterone levels, creating a vicious cycle of increasing obesity causing lower testosterone which then inhibits the ability to lose weight, and so on.

Medical News Today primarily recommends lifestyle changes to support hormone levels, including increasing exercise and decreasing consumption of processed and fatty foods. Limiting alcohol consumption is also recommended not only to reduce caloric intake but alcohol may also suppress male hormone (testosterone) production.

Some herbs and supplements are also suggested to support metabolic hormones – Ginseng, Maca, and Ashwagandha are amongst those that show the most promising preliminary evidence, though large-scale studies are still lacking.

Summary: How Getting Older Affects Your Metabolism

Age does affect the metabolism, but it’s not as simple as your body just “slowing down” as you get older – and we are not powerless to stop it!

We have greater control over our metabolism than generally assumed and making just a handful of small changes might be all it takes to beat the “middle-aged spread”.

Considering all 3 components of the metabolism – BMR, TEF, and TEE – helps target strategies aimed at improving each, such as switching to a high-protein diet to increase calorie burning during eating, increasing exercise, and also supporting hormone function, and increasing lean muscle mass to boost BMR.

A combined, holistic approach provides a much better outcome than focusing on just one part of the metabolism in isolation of the others.

Disclaimer: This and all articles at are for educational purposes only and are not intended as medical advice or treatment. By choosing to view this article you agree to the Terms of Use of Metabolink, Inc which can be found at


What is Metabolism and How Does it Change with Age?

What is Metabolism and How Does it Change with Age?

What is metabolismWhat is Metabolism and How Does It Change with Age?

By Gary M. Pepper, M.D. and Sam Jeans, MSc

Our bodies undergo many transitions as we age, some good and some not so good!

In the latter category of “not so good”, many people tend to struggle more with their weight as they get older. Obesity rates are higher in older populations, and in the United States, more than 30% of both men and women over 60 are obese.

Obesity in older age brings about much of the same risks as it does at any age, including an increased risk of heart disease, diabetes, high blood pressure, stroke, and mobility problems, and the risks climb ever higher with each year that goes by!

Unraveling what happens to our metabolism as we age helps provide strategies for staying healthy and reducing the risks of putting on excess weight. The popular consensus is that, as we age, our bodies ‘slow down’, which makes it tougher to keep weight off, but does that really tell the whole story?

Metabolism Defined

At its most fundamental, metabolism encompasses every chemical process required to sustain life. It’s easy to confuse the entire concept of metabolism with just the basal metabolic rate (BMR) alone, but this is just one component of metabolism.

Many people use the terms interchangeably, whereas, in fact, there are three main components to metabolism:

1: The Basal Metabolic Rate (BMR)

The body is in constant motion, so even when we’re totally sedentary, sleeping, or otherwise at rest, we require energy and nutrients to function correctly.

So long as the heart pumps, the lungs breathe and the body and its organs go about their business growing and repairing cells, we are utilizing energy in one form or another, and this is our basal metabolic rate (BMR).

The BMR varies depending on the following factors:

  • Body Size and Muscle: Larger bodies have greater energy demands and higher BMRs.
  • Lean Muscle Tissue: Whilst it’s true that larger bodies have greater energy demands, BMR also increases relative to the proportion of the body that is made up of lean muscle. Muscle burns more energy than most other tissues.
  • Body Fat Percentage: Fat burns energy at a much lesser rate than most cells. A high body fat percentage relative to lean muscle tissue results in a lower BMR, even if the body itself is physically larger.
  • Age: Age does affect the BMR for a few different reasons, which we will discuss shortly.
  • Growth: Younger children have generally higher BMRs due to body growth, and they also need more energy to maintain their body temperatures.
  • Gender: Men likely have higher BMRs than women on average as they’re larger and have higher percentages of lean muscle tissue.
  • Genetics: Genetics do play a role in BMR, but there is debate surrounding quite how drastic the influence of genetics is compared to other factors.
  • Hormones: Hormone levels, particularly those governed by the thyroid gland, also influence BMR. Hypothyroidism (sluggish thyroid function) is associated with a lower BMR whereas hyperthyroidism (excessive thyroid function) is associated with elevated BMR. Metabolism-related hormones are also influenced by diet, for example, iodine deficiency may result in an underactive thyroid that lowers BMR.
  • Activity Level: Whilst physical activity burns energy directly as a result of exercise, it also raises BMR by stimulating the growth and repair of new cells, such as muscle cells.
  • Infection: Infections stimulate an immune response that requires energy, thus boosting BMR.
  • Environment/Temperature: Colder environments may increase BMR slightly as our bodies work harder to maintain a stable core temperature. Conversely, hotter environments may increase BMR as our bodies work harder to cool down.


2: Thermic Effect of Food (TEF)

The consumption of food itself requires energy and some foods are much easier to digest than others.

It takes considerable effort for our bodies to move food through the digestive system, and our body also needs to absorb and transport nutrients from that food, which further requires energy.

A concept that tends to pop up in various diet plans is ‘calorie negative food’ – that is food that burns more calories to digest than they provide as food. Sadly, there is no evidence that we can ‘eat ourselves thin’ by consuming calorie-negative food!

TEF varies considerably depending on the food consumed and its macronutrients content:

  • Fat has a thermic effect of some 0 to 5%, which means that for every 100 calories of fat consumed, the body burns just 0 to 5 calories
  • Carbohydrates have a thermic effect of around 5 to 10%, so for every 100 calories of carbs consumed, the body burns just 5 to 10 calories.
  • Protein has a much higher thermic effect of around 20 to 30%, so for every 100 calories of protein consumed, the body burns 30 calories (Source: Healthline).

Overall, TEF accounts for around 5 to 10% of our daily energy demands. This is increased when we consume a high-protein and low-fat diet.

3: Thermic Effect of Exercise (TEE)

Thirdly, our body requires energy to sustain movement and exercise. This is highly variable and obviously depends on physical activity levels – the more we move, the more energy we require to breathe, fuel our muscles, and repair cells.

Common estimates suggest that physical exercise uses between 15% and 30% of average daily energy expenditure. Engaging in intense or protracted physical exercise ( such as running a marathon) will increase that figure.

The total accumulative energy required for these 3 metabolic components – BMR, TEF, and TEE, makes up our total daily energy expenditure.

In Part 2 of this article, we will cover how aging affects our metabolism and what we can do about it. Check back at for the publication date.

Disclaimer: This and all articles at are for educational purposes only and are not intended as medical advice or treatment. By choosing to view this article you agree to the Terms of Use of Metabolink, Inc which can be found at


Medical Specialists Remain Resistant to Treatment for Hypothyroidism Preferred by Patients








by Gary Pepper, M.D.

According to government estimates, 4.6% of the US population aged 12 or more has hypothyroidism (low thyroid function). Based on treatment guidelines published in 2012 by the American Association of Clinical Endocrinologists (AACE), only synthetic thyroid hormone (levothyroxine, Synthroid, Levoxyl) is an appropriate therapy for this condition. According to these guidelines, the biologic product Armour Thyroid, is unfit for this treatment purpose. Armour Thyroid, an extract of porcine thyroid, has been available as a treatment for hypothyroidism for about 100 years. It was first used in the U.S. to treat hypothyroidism in 1892, a year after it was introduced into the United Kingdom. The impact of the AACE guidelines is more than symbolic (more…)

What is Behind the Epidemic of Obesity and Type 2 Diabetes in Children and Teens in the U.S.?

by Gary Pepper, M.D. and Andrew Levine, Pre-med

If you ask the average person to define diabetes, a typical response might be “it’s when you have unhealthy eating habits and an overabundance of sugar in your blood.”  Although that is not far from the truth, a more accurate definition is that diabetes is a disorder in the way our body uses insulin to process digested food for energy and storage. A good part of what we eat is broken down into glucose, the principle form of sugar in the blood. Diabetes occurs when there is not enough insulin to push the glucose into our cells. This deprives the body of the energy it needs because glucose is metabolized as fuel by all the organs in the body. Therefore in diabetes despite an elevated amount of sugar in the blood,  the cells are actually starving for energy.  We sometimes conceive of glucose in the blood as the enemy , but without it we would die. (more…)

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