Reading: Belly Fat: 7 Myths & 3 Surprising Truths

Belly fat is an unfortunate reality for many postmenopausal women: Even those genetically predisposed to store fat in their hips and thighs often struggle with an expanding midsection once they hit 50 or 55. “Postmenopausal women burn less fat than they did in their premenopausal years,” says ob-gyn JoAnn Pinkerton, MD, executive director of the North American Menopause Society. “Cells not only store more fat but are less willing to part with it.”

And it’s not just that metabolism slows down at this time of life — there’s also a natural shift in where fat accumulates in the body.

Abdominal fat is not just a matter of aesthetics: The kind of fat that collects around the midsection can be dangerous. Increased belly fat has been linked to many of the chronic diseases associated with aging, including heart disease, cancer, type 2 diabetes — even dementia. Still, think twice before falling for claims that certain diets, supplements, super foods, or spot exercises will magically melt away belly fat.

Here, some myths — and surprising truths — about battling this midlife scourge.

Myth #1: As long as I continue my premenopause exercise routine and maintain my healthy diet, I will keep belly fat in check.

If only.

Postmenopausal women just don’t burn as many calories as before menopause. “Even women who are eating healthily and exercising have to make some changes after menopause,” says Wendy Kohrt, PhD, professor of medicine and chair of women’s health research at University of Colorado, Denver. “Though how declining estrogen affects women is variable – in the same way that premenstrual symptoms are – on average, menopause is associated with a change in energy needs and a decrease in metabolic rate, meaning that if women don’t change anything else (in terms of eating or activity habits), they are likely to start gaining weight.”

Dr. Kohrt, who has studied postmenopausal women extensively, has found that after menopause, resting metabolic rate declines by the equivalent of 50 to 60 calories per day. “That doesn’t sound like very much,” says Dr. Korht, “but if the amount of energy a woman is burning when she is just sitting around decreases by 50 calories a day – and there are roughly 4000 calories in a pound – that is roughly equivalent to gaining a pound of fat every 80 days or so if she doesn’t make compensatory changes.”

To add insult to injury, not only do older women need to exercise more to burn the same number of calories, but their motivation to exercise declines right along with their metabolic rates.

To maintain a healthy weight after menopause – and get rid of belly fat — you have to step up your exercise game. And cut calories. “You can do this by either eating less or by eating foods with fewer calories,” suggests Dr. Sandra Arévalo, a spokesperson for the Academy of Nutrition and Dietetics.

Myth #2: My genes dictate whether I will develop belly fat.

While genes determine if you are apple- or pear-shaped, after menopause, it’s all about hormones.

Dr. Kohrt found that when premenopausal women were put on a drug that suppressed their ovarian function, bringing estrogen down to postmenopausal levels, resting metabolic rate declined, physical activity decreased, and abdominal fat levels went up. “We found an alarming increase,” she says.

Yet, when researchers added back the estrogen, those effects were reversed to premenopausal levels.

Indeed, a recent study published in the Journal of Clinical Endocrinology & Metabolism found that women who underwent menopausal hormonal therapy had significantly lower levels of body fat than women who didn’t.

But estrogen is not the only hormone to dictate whether you can pinch an inch.

Recent research points to another possible culprit. Scientists know that FSH, or follicle-stimulating hormone, which tells the follicles to produce more estrogen, rises at menopause when the ovaries start to fail. Studies in mice suggest FSH might also be responsible for the increase in belly fat that occurs at this time of life. In fact, when researchers block this hormone in mice, they become more physically active, burn more calories — and yes, lose abdominal fat.

Myth #3: BMI is the most important number to determine your health risk

False. The circumference of your waist is a much better indicator than body mass index (a measure of body fat based on height and weight), says Dr. Kohrt. In fact, the Million Women Study, based in Britain, found that even when other coronary risk factors were taken into account, women with larger waists had a significantly higher risk of developing heart disease than women with smaller waists.

Other studies have found that women with excess belly fat also have almost double the chance of getting colorectal cancer, while women whose waists were nearly as big as their hips were three to four times as likely to be diagnosed with breast cancer.

According to the National Heart, Lung, and Blood Institute, women whose waists measure 35 inches or higher are at increased risk for heart disease and type 2 diabetes even if their weight – and BMI – fall into the normal range. This is likely because the type of fat that accumulates around the midsection is more harmful than the flab that pads the buttocks, hips, and thighs.

Myth #4: All belly fat is created equal

It turns out that there are different types of fat, even in the abdomen, some of which is more metabolically active, and thus more dangerous. The subcutaneous fat that accumulates just beneath the skin, creating the stubborn “love handles” or “muffin top” that older women struggle with, is relatively harmless.

But the deeper, visceral fat, which tends to collect around the abdominal organs, and even the heart, has been linked to increased risk of heart attack, cancer, and dementia.

Recent studies suggest that visceral fat is comprised of a relatively newly-discovered type of fat cell, which comes from bone marrow stem cells, is more prevalent in women, and increases with age. These bone marrow-derived fat cells tend to accumulate in the abdomen and produce inflammation, says Dr. Kohrt, which could explain why they threaten health.

Myth #5: Eating fat makes your belly fat

“Eating fat does not make you fat,” says Sara Gottfried, MD, New York Times bestselling author of The Hormone Cure and The Hormone Reset Diet. “Eating excess carbs makes you fat by raising insulin, the fat storage hormone.” Insulin, a hormone produced by the pancreas, helps the body turn sugar into energy; it stores some of the glucose it takes from the bloodstream as fat, for later use. “When insulin levels are out of balance and abnormally elevated, it triggers your body to store the calories you eat as fat,” says Dr. Gottfried. “This fat gets deposited in your liver and around your waistline.”

Nearly 60 million Americans are affected by a condition known as insulin resistance, in which the body stops recognizing the signals sent out by insulin, causing blood sugar levels to rise. “As glucose builds up in the blood, the body responds by producing even more insulin, and that leads to more fat storage. It also leads to other downstream problems like high blood pressure, heart disease, prediabetes, diabetes, and dementia.”

One strategy to prevent insulin resistance – and keep belly fat in check – is to choose foods with a lower glycemic index, like plain yogurt, legumes, and non-starchy vegetables, suggests Dr. Pinkerton. Low GI foods are more slowly digested, absorbed, and metabolized by the body and less likely to cause spikes in blood sugar. Avoid high GI foods, like white bread, cookies, and sugary beverages, she says.

Myth #6: Ab Crunches will eliminate belly fat

“You can’t spot reduce,” says Dr. Kohrt “You can’t do sit-ups and think you will be burning fat from your belly region, just like you can’t do leg presses and expect to lose fat in your legs.”

Some studies have suggested that exercise might be able to prevent or decrease visceral fat, she says. Preliminary findings in her own research suggest that aerobic or endurance exercise can best minimize abdominal weight gain. Other recent studies indicate that high-intensity exercise in short bursts can be effective in reducing belly fat as well.

Because women begin losing muscle after menopause (which partly explains why they don’t burn as many calories as they used to), it’s also important to choose types of exercise that maintain or increase muscle mass, like resistance training and yoga, adds Dr. Arévalo.

Myth #7: Certain foods will blast belly fat

Specific foods or drinks – like apple cider vinegar or green tea — don’t melt away fat by themselves, says Dr. Pinkerton. However, combining these with other healthy choices may help burn fat.

Choose foods that are rich in fiber, she says, including lots of dark leafy vegetables and fruit, which are less caloric and make you feel full, so that you eat less overall. Avoid fat- and sugar-laden foods and soft drinks, and limit alcohol consumption, which has been linked in studies to excess belly fat. And eat lean proteins — like chicken, turkey, fish, beans, tofu, and egg whites — which are “a woman’s best friend during menopause,” according to Dr. Pinkerton.

Indeed, some studies suggest that eating more protein can help reduce belly fat; it also reduces cravings and boosts metabolism.

Truth #1: Insufficient sleep can lead to increased abdominal fat

Lack of sleep wreaks havoc on the appetite hormones, leptin — which Dr. Gottfried refers to as the “put-down-your-fork hormone” — and ghrelin, which makes the body think that it’s hungry.

Sleep deprivation causes a decrease in leptin and an increase in ghrelin. Too little leptin, which tells your body it’s full, makes your brain think you don’t have enough energy, spurring you to keep eating; too much ghrelin has the same effect.

Unfortunately, declining estrogen levels — not to mention hot flashes — can disrupt sleep after menopause. Not only does lack of sleep mess with our appetite hormones, but being tired makes us crave extra energy — and sugary foods.

Try to get at least seven hours of sleep each night.

Truth #2: Reducing stress can help fight belly fat

Excess stress – and the consequent elevated cortisol levels – interferes with sleep, raises blood glucose levels and promotes insulin resistance. When your body is unable to properly regulate insulin levels, “it turns your waist into a magnet for fat,” according to Dr. Gottfried. “Because visceral fat has four times the cortisol receptors of fat elsewhere, you keep taking on more fat,” she explains in her book The Hormone Reset Diet. Not to mention that women are more likely to overeat in response to stress.

Yoga offers the dual benefit of reducing stress and helping to build lean muscle mass so you will burn calories more efficiently.

Truth #3: Simple adjustments in posture can reduce the appearance of belly fat

If all else fails, stand up straight. “I often tell women who are really upset by belly fat to stand in front of the full-length mirror in my office, take a deep breath, put their shoulders back, straighten their backs and stand tall,” says Dr. Arévalo. “And they are surprised to see how half of their belly fat disappears.”