CHUBBY TUMMY OR SYNDROME X?
There is a fine line between just having a chubby tummy and the point at which it causes health problems. Scientists studying the frightening preponderance of problems associated with apple-shaped fat distribution have given it a name: metabolic syndrome. It is also known as syndrome X or insulin resistance.
The big worry is that fat situated around the middle can kick off a domino effect which cascades all through the body, affecting many different areas. The problem which we tend to think of as a cosmetic one can very rapidly snowball into wide-ranging and catastrophic problems such as heart disease, diabetes, stroke, high blood pressure and even cancer.
HOW DOES THE DOMINO EFFECT START?
Cortisol has much to answer for. High cortisol levels mean high levels of blood sugar (glucose) because your body has to make enough fuel to deal with imminent attack. When the blood sugar increases, your body has to respond by releasing insulin from the pancreas to help move the glucose out of your blood and into the cells to provide them with energy. But if you don't need that energy (see the page " Stress- is it making you fat" for more details on the affects of cortisol) the default is to store the glucose as fat.
If the stress continues, cortisol levels remain high, so the body make further attempts to increase blood sugar levels by triggering the breakdown of sugar stores in the liver and muscles. This is what gives you a craving for sugar and caffeine (as your body is urging you to refuel).
Out comes more insulin to deal with the extra blood glucose. And so it goes on and that's all fine - for a while. But over time, the body simply cannot respond to insulin in the same way it used to. If you push yourself to the limit too often you could easily become intolerant to insulin - or insulin resistant.
Insulin resistance is the start of the problem and it is the hub of a wheel out of which radiate a number of frightening spokes - DIABETES, HEART DISEASE, CANCER, HIGH BLOOD PRESSURE, HEART DISEASE, STROKES, ALZHEIMER'S DISEASE.
TUMMY FAT IS TOXIC FAT
Scientists always assumed that fat was just a useful form of energy storage. Getting enough to eat was the focus of survival and fat cells could be easily plundered in times of famine or attack. In the last few years, however, they have discovered that fat actually has a mind of its own, acting just like an endocrine (hormone-secreting) organ, producing its own array of hormones.
Fat also known as adipose tissue, manufactures an array of chemical messengers including blood-clotting agents, substances which contract blood vessels and raise blood pressure, inflammatory agents, hormones and molecules which control hunger. Fat cells are also able to produce an immune response in the body, which causes inflammation. Fat cells also secrete oestrogen and two other compounds - tumour necrosis factor alpha and resistin - both of which interfere with the function of insulin.
Unfortunately, not all fat in the body behaves in the same way and it is the fat around the middle of the body (or visceral fat) that has a mind of its own. This fat is far more metabolically active that fat elsewhere and has been called "Toxic fat" because it increases the risk of heart disease, high blood pressure, stroke, cancer and diabetes. The pear-shaped fat around the hips and thighs does nor appear to operate in the same way and is relatively inactive and inert.
Fat cells around the waist have been found to be the most highly active of all. They pump out substances which might be quite useful in small amounts, but when too much of this type of fat is active, the body's delicate balance can be upset. This can affect the way in which insulin is used and also raise blood pressure and increase the amount of cholesterol in the body.
Abdominal fat cells can quickly break down stored fats, in case extra is needed when you are under "attack". It then dumps the resulting fatty acids into the bloodstream which can cause high levels of fat and sugar in the blood. Whilst this may be useful if your life is in danger, when it is not (as is most often the case)it increases the risk of diabetes (in the case of blood sugar) and heart disease (in the case of fat).
THE MENOPAUSE
As we grow older we tend to gain weight. We generally become less active, but we also naturally lose muscle and this makes it harder to burn fat. Whilst this is a problem experienced by men and women alike, women have the added complication of the hormonal changes of menopause.
The peri-menopause can start up to ten to fifteen years before the menopause. Many women will have no symptoms at all, except an expanding waistline and possibly their periods become more irregular as the function of the ovaries starts to decline. However, although we associate the menopause with the archetypal image of the 'matronly' woman with the large belly, it does not have to be that way.
The menopause creates something of a Catch-22 situation. As your ovaries produce less and less oestrogen, your body strives to compensate by manufacturing it elsewhere to protect your bones from osteoporosis. We know that larger and fatter women produce more oestrogen, which reduces their risk of osteoporosis, but the higher oestrogen levels do increase their risk of breast cancer.
For many women, the menopause itself is a source of stress. In our Western culture, it is seen as a negative state, a time of loss. No more periods mean you are no longer fertile. The chances are you'll also be experiencing the empty nest syndrome with children leaving home. You may be wondering what your role is now, or caring for sick elderly parents and wondering when it's all going to end. It all adds to the stress.
In more traditional cultures, the menopause is seen as a positive time, women gain status, they become 'wise women', extended families living together mean they do not have to shoulder the entire responsibility of looking after elderly relatives and children do not move far away.
Unfortunately, cortisol, which as you know is produced when you are under stress, increases the activity of an enzyme called aromatase causing the body to convert more male hormones to oestrogen. This in turn causes the weight to pile on around the middle of your body and therefore increases your risk of breast cancer.
So the combines effect of female hormonal changes, slower metabolism and stress with high cortisol levels come together to create a bigger likelihood of fat around the middle.
It is therefore important to follow the recommendations outlined below to avoid the detrimental effects of the shape changes.
Also see my pages on'MANAGING THE MENOPAUSE'.
(Source: Fat around the middle - Marilyn Glenville)
FAT AROUND THE MIDDLE