The Risks of Abdominal Fat

Medical research has found that where your body stores excess fat can affect your risk of health problems. Studies have shown that fat gained around the abdomen, or "belly fat," is the most dangerous, while fat in the hips, thighs, and buttocks appears to be less so.

A large waist — greater than 40 inches for men or 35 inches for women — has been linked to increased risk of many serious illnesses, including heart disease, high blood pressure, type 2 diabetes, and abnormal cholesterol.

While sit-ups will tone your abdominal muscles, the best way to banish belly fat is to engage in cardiovascular activities, such as walking, swimming, aerobics, and bicycling. Anything that gets your blood pumping will help your body burn off stored fat in the stomach area and elsewhere.

Just as important in the fight against belly fat is reducing calorie intake while still eating a balanced diet. Fruits and vegetables, whole grains, lean proteins, and the like fill you up but don't contain a lot of fat or calories. Avoid fat-laden, fried, and sugary foods. Since excess alcohol intake seems to be linked to abdominal fat deposits, drink alcohol in moderation, if at all.

Some research has suggested that stress is linked to abdominal weight gain. So if you're constantly feeling under the gun, try to eliminate additional stress in your life. In situations where you can't cut out stress, practice relaxation techniques and other stress-management skills.

When it comes to winning the war against abdominal fat, this three-pronged approach — exercise, a healthy diet, and stress management — is your best ally. Your health will reflect your efforts!

Your Scale and You

Unlike other plans that recommend weighing in weekly or less often, we advise you to weigh yourself daily.

"Daily?" you ask. Yes! Studies show that people who weigh themselves daily are more successful at long-term weight loss than those who weigh themselves weekly. Experts speculate that frequent weigh-ins remind you of your goals and help keep you motivated. At the Duke Diet & Fitness Center (DFC), we feel that an essential part of this daily weighing strategy is tracking your weight on a graph. A graph helps you to see the big picture: Rather than focusing on one day's number, you're looking at trends over several days, weeks, or months. There's nothing more motivating than seeing that line move downward over time!

We also like graphs because they can help you to become accustomed to the fact that the number on the scale does fluctuate each day. The line won't always move downward, and that's okay. Weight normally varies from day to day, based on factors like how much water your body is retaining, among others. We find that seeing these normal fluctuations on a graph keeps our clients at the DFC from getting discouraged by them — they look past the little ups and downs and focus on the larger trends.

Another advantage to graphing with daily weigh-ins is that it helps you self-monitor more effectively. If you see your weight beginning to trend in the wrong direction, you can take steps to nip that trend in the bud.

Of course, weighing in daily isn't right for everyone. If you've ever had an eating disorder like anorexia or bulimia or if you find it extremely upsetting to get on the scale, you should talk to your doctor or mental health–care provider. Otherwise, give it a try and see how it works for you!

If daily weighing is a good strategy for you, we encourage you to keep it up — even after you meet your weight goals. Research has shown that people who've lost weight and continue to weigh themselves regularly afterward are better able to keep the weight off. So plan to make your friendship with your scale a lifelong one. Doing so will greatly increase your chances of both short-term and lifelong success.

Metabolic Syndrome

In recent years, health experts have become increasingly interested in a collection of risk factors known as metabolic syndrome. They have found that people with metabolic syndrome are at an elevated risk for developing cholesterol deposits in the walls of the arteries (atherosclerosis), which causes most heart attacks and strokes. Metabolic syndrome also raises the risk of developing type 2 diabetes.

Because these illnesses are among the leading causes of death in the United States, preventing or treating the individual conditions that make up metabolic syndrome could save many lives. People may be diagnosed with metabolic syndrome if they have three or more of the following conditions:

• Increased abdominal fat: a waist circumference greater than 40 inches for men or 35 inches for women
• Elevated blood pressure on several measurements: 130 mm Hg or greater systolic (top number) or 85 mm Hg or greater diastolic (bottom number)
• Elevated level of triglycerides (blood fats): 150 mg/dl or higher after a 12-hour fast
• Low level of HDL (the "good") cholesterol: lower than 50 mg/dl for men or 45 mg/dl for women
• Elevated blood sugar levels: 110 mg/dl or greater after a 12-hour fast

While researchers are still investigating why these factors often occur together, they suspect a gradual resistance to insulin in the body may be to blame. Insulin is a hormone that helps the body's cells use the glucose supplied by food. If the body doesn't use insulin efficiently, cells can't take up as much glucose, so it accumulates in the blood. In response, the body makes more insulin, overloading the blood. As a result of the excess insulin, triglycerides and other fats build up in the blood, increasing the risk of abnormal cholesterol. At the same time, kidneys become strained by the additional load, leading to high blood pressure.

In some cases, the cause of insulin resistance may be genetic or environmental. But most of the time, overweight and inactivity seem to be the culprit. Metabolic syndrome occurs in only 5 percent of adults of normal weight but in 22 percent of those who are overweight and 60 percent of those who are obese. Lifestyle changes such as losing excess weight, exercising, and quitting smoking can help to prevent or treat metabolic syndrome. If you suspect you're at risk, ask your doctor to evaluate you for this serious condition.

Self-Awareness and Mindfulness Meditation

One of the healthy habits we encourage at the Duke Diet & Fitness Center (DFC) is self-awareness or mindfulness — the act of paying attention to what you experience in the moment. Mindfulness can contribute to your overall sense of well-being in many ways, one of the most significant being that it can help to reduce stress.

As part of our self-awareness programming at the DFC, we teach our clients a technique called mindfulness meditation. Developed by Dr. Jon Kabat-Zinn of the University of Massachusetts Medical Center's Stress Reduction Clinic, mindfulness meditation is a method of paying attention to the present moment, without letting your mind drift to the past or future or judging your every thought and feeling.

You can practice mindfulness meditation by carving some time out of your day, finding a quiet place where you can be alone, and then turning your attention to your breath or to some other sensation in your body. As thoughts, emotions, or other sensations arise and compete for your attention, you simply observe and acknowledge them without judging, analyzing, or trying to suppress them. Just give the thought or feeling a little bit of space, and eventually it will pass.

This very simple process can prove quite challenging. Most of us have never tried to train our minds to gain mastery over where our attention is from moment to moment. The solution is to practice.

This week, set aside some time to practice mindful meditation. Make a point to focus on what you are experiencing. Let the feelings flow. See what emerges. After a period of regular meditation practice, you may find that it's easier to be mindful in other situations in your daily life. Next week, we'll show you how to be mindful when you are eating.

Yoga and You

The practice of yoga was developed in India roughly 5,000 years ago to encourage emotional, physical, and spiritual wellness. While it's an ancient art, the popularity of this form of exercise continues to this day. It's easy to see why — yoga not only improves balance, flexibility, and muscle strength, but it also can help to relieve stress.

Yoga is composed of a series of very specific movements, or poses, aimed at building strength and balance. Yoga moves can be done quickly, to build up heat in the body, or slowly and contemplatively to focus on flexibility. Meditation, breathing exercises, and chants may also be featured. There are many styles of yoga. Different styles emphasize different aspects of the practice, and some are more strenuous than others.

If you've never tried yoga, consider signing up for a class. You may want to start with hatha yoga, a style that tends to be slower paced and is good for beginners. Choose an introductory class where the instructor will teach you the poses involved and observe you to make sure you're doing them properly. After a few sessions with a good instructor, you can continue practicing yoga with a group, alone, or along with a yoga videotape.

You'll want to wear comfortable, breathable clothing that allows you to move easily. Yoga is done barefoot, so you don't have to worry about buying any special shoes. You'll need a mat that prevents you from slipping while you do poses, and these can be borrowed or rented at most studios or gyms that offer yoga. If you decide to continue practicing yoga, you may consider buying your own mat.

If you've never done yoga before, let the instructor know it's your first time. Remember, others in your class may have been doing yoga for years, so don't compare yourself to them. In time, you, too, will become comfortable with the poses, and you will begin to experience the benefits.

Lighten Up Family Favorites

Remember Mom's rich brownies? Or Grandpa's five-alarm chili? They're in every family — sacred recipes that get passed down through the generations. The problem is that family favorites often aren't as healthy as they could be. But with a few alterations to the recipe and cooking methods, you can still enjoy the tastes you love while cutting out excess fat and calories. Try the following tips:

Spray, don't pour: Coat pans and baking dishes with cooking-spray butter, margarine, or oil.

Go nonstick: A nonstick pan can reduce the need for fat when you sauté.

Reach for broth: Sauté vegetables in low-sodium vegetable or chicken stock for great flavor minus the fat.

Strip the skin: Cut calories by always removing the skin from poultry and trimming visible fat off meat.

Soak up the flavor: Leaner cuts of meat can be less tender. Use a low-sodium marinade to add flavor and help tenderize.

Switch tactics: Bake, boil, or broil meats and other foods you'd normally fry.

Cut back: Cut the amount of cheese and other fatty ingredients in your favorite recipes by one half, or replace them with low-fat versions.

Get saucy: Try replacing some or all of the fat in baking recipes with applesauce.

Go veggie for a day: Replace meat in dishes with beans or meat substitutes like tofu or vegetarian crumbles.

Slow cook: Use a slow cooker to turn lean meats, vegetables, and beans into delicious soups, stews, and casseroles without adding fat.

Spice things up: Add flavor but not fat to foods with dried and fresh herbs and spices. From the sweet and citrusy flavors of basil and lemongrass to the distinctive flair of cilantro to the richness of curry, a world of flavor awaits your exploration.

Get to know yogurt: Replace the sour cream on your table with low-fat plain yogurt. It makes a great topping for baked potatoes.

And remember, no matter what you're cooking or baking at home, always keep portion control in mind when you sit down to eat it. Moderation is a key to success!

Resisting Temptation at Work

Has this ever happened to you? You're walking past the lunchroom at work and notice a coworker has brought in some chocolate cake. Even though you know you aren't hungry, you stop and dish up a piece. After eating the cake, you realize it wasn't even very good — in fact, it was a little stale! Yuck.
Welcome to the minefield of eating well at work. From vending machines full of junk to free food left in the lunchroom to treats on the receptionist's desk, temptation looms around every corner. And when you consider how many waking hours you spend in the office, it's easy to see why the work environment can pose many hazards to healthy eating.
Try using these techniques for sticking to your plan at work:
Make time for meals. Studies show that when people eat in front of a computer, they eat more and feel less satisfied. Plan some time into your workday to take a break, get up from your desk, sit at a table, and really focus on your food.
Pack your snacks. If trips to the vending machine are tripping you up, bring an assortment of healthy snacks to have on hand when the afternoon munchies strike.
Walk it off. If you're a desk potato, make efforts to add movement into your day. Take the stairs. Park further away. Deliver that memo in person. Take power walks during breaks. Any movement is better than none.
Change course. If you just can't resist the goodies in the lunchroom or vending machine, alter your path so you don't have to walk past them. You won't know what you're "missing."
Think it through. Before helping yourself to junk food or sweets at work, make yourself wait ten minutes. It's likely that the urge will pass.
Let 'em have it. Chances are, during your ten-minute delay your coworkers will polish off the free food before you get there. Problem solved!
This week, pay attention to the food traps at your workplace. Spend some time thinking about how you can face these situations going forward.