There are two main types of fat storage. Subcutaneous fat is stored right under your skin, and visceral fat, the so-called “belly fat,” is stored deep in your body, packed between abdominal organs like the stomach, liver, kidney, and intestines.

Visceral fat is downright deadly. One reason is that fat cells inside the abdomen secrete high levels of an inflammatory molecule called interleukin-6, according to researchers at Washington University in St. Louis. And higher levels of inflammation are linked to nearly every chronic health problem, including insulin resistance (prediabetes) and type 2 diabetes, high blood pressure, heart disease, cancer, chronic obstructive pulmonary disease, and Alzheimer’s disease.

Do you have excess belly fat? To find out, put a tape measure around the largest part of your waist. You have excess belly fat if you’re a woman with a waist measuring 35” or more, or a man with a waist measuring 40” or more.

Extra belly fat, extra risk

Scientific research shows that if you have excess belly fat—just that one risk factor—you might be at extra risk for a host of ailments:

Atherosclerosis. The thickened arterial linings of atherosclerosis are a risk factor for heart attack and stroke. For every 20 percent increase in abdominal fat among menopausal women, there is a corresponding 2 percent increase in the thickness of the arterial lining, according to a study published in Menopause.

Heart failure. In a study published in Circulation, every additional ten centimeter (3.9 inch) increase in waist circumference was linked to a 29 percent higher risk of heart failure.

Cancer. In a study of nearly 6,000 older women, those with more belly fat had a 68 percent higher risk of lung cancer and a 34 percent higher risk of gastrointestinal cancers.

Cognitive decline. A study in the British Journal of Nutrition showed that older people with more belly fat had a greater level of cognitive decline.

Dementia. If you have excess belly fat in your 40s, you’re 2.3 times more likely to have dementia in your 70s, according to a study published in Neurology.

Chronic obstructive pulmonary disease (COPD). In a 10-year study, researchers found that people with excess belly fat had a 72 percent increased risk of developing COPD.

Asthma. People with more belly fat are 1.4 times more likely to develop asthma, according to the European Lung Foundation.

Depression. Researchers at Rush University Medical Center in Chicago found that women with more belly fat were more likely to be depressed—and depression also increases the risk for cardiovascular disease and diabetes.

Osteoporosis. Women with more belly fat had decreased bone mineral density, according to researchers at Harvard Medical School.

Migraine. In people ages 20 to 55, more belly fat was linked to a significantly greater risk of migraine headaches, say researchers from Drexel University College of Medicine.

Premature death. In a 14-year study from the Mayo Clinic, normal-weight individuals with excess belly fat had double the risk of dying from any cause.

Bottom line: If you want good health and long life, lose excess belly fat.

Hormonal imbalances

Belly fat tends to accumulate because of imbalances in several hormones:

  • Insulin, which ushers blood sugar out of the bloodstream and into the cells.
  • Estrogen. Menopause and its falling levels of estrogen trigger the accumulation of belly fat.
  • Ghrelin and leptin. These hormones control appetite and satiety (feeling full after eating).
  • Cortisol, a hormone generated during times of stress.

It takes healthy eating, regular exercise, stress management, and sufficient sleep to rebalance those hormones.

Dietary changes

Dietary changes will get you to about 70 percent of your goal. (See sidebar for the other 30 percent.)

Cut refined carbohydrates. Cut back on (or eliminate) sugary processed foods and refined carbohydrates such as white bread and white pasta.

Cut vegetable oils. Eliminate pro-­inflammatory, hormone-disrupting vegetable oils, including soybean, canola, sunflower, corn, cottonseed, vegetable, safflower, and peanut oils. (These may also be lurking in packaged foods.) Instead, favor anti-inflammatory olive and avocado oils. Use olive oil on salads and avocado oil (which has a high burning point) for cooking.

Emphasize protein, vegetables, and good fats. Keep carbohydrates to a minimum and focus on complex carbs (like vegetables) over simple carbs (like white bread). This approach will balance blood sugar and hormonal production and regulate appetite.

Eat three meals a day and limit between-meal snacking. Include dairy if you’re not sensitive to it. For those who prefer less or no meat, protein-rich beans are a good alternative.

Drink plenty of water and other non-caloric beverages, such as coffee or tea. Limit diet soda to no more than one serving per day.

When you eat out, choose a protein­-centered entrée such as steak, chicken, or fish, and ask for it grilled, which helps you avoid unwanted oils.

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