Trim your tummy: Middle management

Fat around the midriff is not only unsightly, but potentially deadly – and it’s notoriously hard to shift. Rob Sharp meets two doctors who think they’e found the answer
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Indy Lifestyle Online

Pot-bellies, paunches, muffin tops and love handles. Comical descriptions of belly fat belie the profundity of its health risks. A September 2009 study published in The International Journal of Clinical Practice linked abdominal obesity to elevated risks of diabetes, hypertension, lipid disorders and cardio-vascular disease. Given how notoriously difficult such fat is to shed, maybe those approaching middle age should pre-emptively hoist their trousers by way of surrender.

Thankfully our youthful washboards might not be lost forever. US husband and wife Mary Dan and Michael Eades, who are both doctors and are also bestselling authors, think they have found a solution – which they’ve tried and tested themselves – in their book Losing Your Middle-Aged Middle, released in the UK last month. The pair regularly lecture on obesity across America and often appear on US national TV. And despite the pearly gleam to their teeth – they are pictured grinning on their nutrition website – they are reassuringly human when it comes to expanding waistlines.

Motivation for the volume came when the pair were due to appear as hosts for a pilot on a new healthy eating show. “We showed up for this item and felt pretty slim but the producer and director had other ideas,” says Michael, who speaks with a soft, Midwestern twang. “I was given a cinch to hold in my belly even though I didn’t feel it was sticking out all that much. The pilot was a hit and the show was commissioned. Suddenly we had six weeks before the show was due to be broadcast on network TV. That was the time during which we needed to lose weight. Once we’d figured out how to do it, and accomplished it, |it became the genesis of a longer project we wanted to pursue.”

The main cause for the expanding middle-aged waistline, according to the pair, is the storage of excess fat deep within the abdominal cavity, in and around our vital organs, such as our livers. This accumulation is not only unattractive, but potentially deadly. “When its accumulation reaches a critical mass,” write the Eades, “it begins to behave more like a tumour than a storage reservoir, infiltrating the organs and muscles – most importantly the liver – and wresting metabolic control from them.” When fat is stored in our visceral tissue it acts like, and is treated like, a foreign body. We generate immune cells, or macrophages, in response. When these get to dangerously high volumes they can cause damage to blood vessels and lead to a heightened tendency for blood clot formation. In addition, fat stored inside the liver can prompt liver disease; according to the British Liver Trust, this is on the rise in Britain and is now the fifth-largest cause of death in the UK.

“Middle body fat is different and requires a different tool to treat it,” says Mary Dan, somewhere on the line dividing medical advice from salesmanship. “By using our methods you can do it more quickly than other ways, reduce your inflammatory burden and decrease your girth.”

We all have experience of gut-shifting travails. The traditional way to blubber-bust is by exercising more and eating less. However, as the pair point out, the average 68kg person carries enough fat to provide the energy to walk 1,000 miles without eating; exercise is tough to sustain. Their approach is to tweak the list of things we eat rather than hitting the gym and crash dieting.

While in many ways their thoughts on ramping up meat, fish and eggs at the expense of carbohydrate mimics diets currently on the market, their details are rather radical. The Eades recommend increasing meat in the diet for its amino acid content as opposed to protein, as well as (controversially) increasing saturated fat intake, which they say gives us strong bones instead of heart disease (it helps us absorb calcium), as well as improving nerve signalling and giving us healthy lungs. They plump for intelligent exercise techniques: drop the sit-ups, they say, which tend to thicken the abdominal muscle and thus worsen a paunch, and instead opt for a “special exercise” which combines the pulling in of one’s belly with exhalation – it can be done anywhere, and tautens muscle (incidentally, the two doctors recommend measuring abdominal diameter as opposed to BMI as a measure of obesity; it is better at telling the difference between muscle and fat).

Whether or not this works, most experts would agree that all-round exercise is one of the best ways to tackle excess fat around the middle of the body. Exercise reduces insulin levels, thereby discouraging the storage of fat. And we all know where that fat ends up.