Belly fat in women: Taking — and keeping — it off

An expanding waistline is sometimes considered a price of getting older. For women, this can be especially true as body fat tends to shift to the abdomen after menopause.

That extra belly fat does more than just make it hard to zip up a favorite pair of jeans, though. Research shows that belly fat carries serious health risks. But the threats posed by belly fat can be lowered.

What's behind belly fat

How much a person weighs depends in large part on four things:

• Calories taken in each day.
• Calories burned off each day.
• Age.
• Genetics.

People who regularly eat and drink more calories than they burn each day are more likely to gain extra weight, including belly fat.

Getting older also makes a difference. People lose muscle as they age. And the problem is worse for those who are not physically active. Loss of muscle mass decreases how quickly the body uses calories. That can make it more challenging to maintain a healthy weight.

Many women notice an increase in belly fat as they get older even if they don't gain weight. This is likely due to a lower level of estrogen because estrogen seems to have an effect on where fat is located in the body.

Genes can contribute to an individual's chances of being overweight or obese too. It also plays a role in where the body stores fat.

Belly fat is more than skin deep

The trouble with belly fat is that it's not limited to the layer of padding just below the skin. That's called subcutaneous fat. Belly fat also includes visceral fat. And that lies deep inside the abdomen and surrounds the internal organs.

Regardless of a person's overall weight, having a large amount of belly fat raises the risk of:

• High blood pressure.
• An unhealthy amount of fat in the blood.
• Sleep apnea.
• Heart disease.
• High blood sugar and diabetes.
• Certain cancers.
• Stroke.
• Fatty liver.
• Early death from any cause.

Measuring your middle

To see if your belly fat is a concern, measure your waist:

• Stand and place a tape measure around your bare stomach, just above your hipbone.
• Pull the tape measure until it fits snugly, but it doesn't push into the skin. Make sure the tape measure is level all the way around.
• Relax, exhale and measure your waist. Don't suck in your stomach as you measure.

For women, a waist measurement of more than 35 inches (89 centimeters) signals an unhealthy amount of belly fat and a greater risk of health problems. In general, though, the greater the waist measurement, the higher the health risks.

Trimming the fat

You can strengthen and tone abdominal muscles with crunches or other exercises focused on your belly. But doing those exercises alone won't get rid of belly fat. The good news is that visceral fat responds to the same diet and exercise strategies that can help get rid of other extra pounds and lower total body fat. Try these tips:

• Eat a healthy diet. A healthy diet involves:
• Focusing on plant-based foods, such as fruits, vegetables and whole grains.
• Choosing lean sources of protein, such as fish and low-fat dairy products.
• Limiting processed meats, as well as the saturated fat that's found in meat and high-fat dairy products, such as cheese and butter.
• Choosing moderate amounts of monounsaturated and polyunsaturated fats. They are found in fish, nuts and certain vegetable oils.
• Choose portion sizes wisely. Even when you're making healthy choices, calories add up. At home, cut down your portion sizes. In restaurants, share meals. Or eat half a meal and take the rest home.
• Replace sugary drinks. Drink water or other beverages without sugar instead.
• Get active. For most healthy adults, the Department of Health and Human Services recommends moderate aerobic activity, such as brisk walking, for at least 150 minutes a week or vigorous aerobic activity, such as jogging, for at least 75 minutes a week. Strength training exercises are recommended at least twice a week. If you want to lose weight or meet specific fitness goals, you might need to exercise more. There is some evidence that high-intensity interval training (HIIT) can help reduce belly fat, as can strength training.

Losing belly fat takes effort and patience. To lose extra fat and keep it from coming back, aim for slow and steady weight loss. Ask your health care provider for help getting started and staying on track.