Too many patients, as documented in an on-line study of 12,000 individuals conducted by the American Thyroid Association published in June 2018, (https://doi.org/10.1089/thy.2017.0681) , complain of persistent symptoms of hypothyroidism despite what their doctors believe is successful treatment with levothyroxine (brands include Synthroid, Unithroid, Tirosent, Levoxl). We believe something needs to be done to resolve this conflict between patients and their doctors.
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 Breastcancer.org 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.
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.
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.
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.
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.
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.
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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