Fat around the middle...?

Q.  My 50 year old friend has intractable weight gain particularly round her tummy.  I’m 45 and have good and bad tummy days, which can vary from flat to fat in a day.  Exercise doesn’t shift it. Is it the same cause? A.  'These are different but both common problems,’ says women’s health expert Dr Marilyn Glenville, author of Fat Around the Middle (www.marilynglenville.com).  ‘Leading up to menopause, extra pounds often settle round the middle because your body tries to compensate for declining oestrogen.  Some oestrogen is manufactured in the fat cells there, which offsets the loss from the ovaries.’

A little extra weight is fine but too much can cause a health problem. Your waist should measure less than 80 per cent of your hip measurement, (a ratio of 0.8).  If your hips are 40 inches, say, your waist should be under 32.  A higher ratio increases your risk of breast and other cancers, heart disease, hypertension, type 2 diabetes, strokes and Alzheimer’s disease.

The key to weight loss is a low carb diet, plus exercise. The standard thinking is to reduce fat intake with skimmed milk and low/no fat foods.  But research shows people on low carb diets lose much more weight, and have better lipid profiles (cholesterol and triglycerides), than those on low fat diets.

Cut out refined carbs, particularly white bread, white pasta/rice, cakes and biscuits.  Eat lots of vegetables, which contain carbs, with small amounts of brown rice and oats (wheat can make bloating worse).

Exercise is vital.  Your metabolism (the speed at which your body functions) declines with age mainly due to muscle loss.  From 40 to 50, women can lose five pounds of muscle.  This matters because the more muscle you have, the more fat you burn because muscle is metabolically active even when you are still.

Do regular cardiovascular exercise such as brisk walking, dancing, jogging or tennis plus resistance exercise, eg weight training, press-ups, using resistance bands, gardening and vigorous household chores.

Flat to fat tummies are probably due to intermittent bloating; excess fat is more consistent. Check with your doctor for any underlying problem (eg gluten and/or lactose intolerance).  Other usual causes are wind, overeating or eating too quickly, constipation, food intolerance, candida (yeast) overgrowth and also water retention (especially around your period).

The first stage of digestion happens in your mouth so chew well and eat slowly. It takes 20 minutes for your brain to register you are full so eating too much too fast can cause bloating and weight gain.  Constipation can cause bloating and flatulence.

Keep a food diary and note trigger foods, often beans, chickpeas, lentils and kidney beans, broccoli, Brussels sprouts, cauliflower, cabbage, onion and leeks, also sugary foods and fizzy drinks.  Limit fruit to three portions daily away from main meals, and avoid fruit juice.

Check for candida.  This yeast overgrowth (also known as thrush) feeds on sugar, causing fermentation, bloating, discomfort and fatigue.  Your doctor may be helpful or you can take a home saliva test for candida antibodies (£140.40 from www.naturalhealthpractice.com). Candida can be controlled by dietary changes, principally cutting out all sugar until it is better, and natural remedies.  (Natural Solutions to IBS by Marilyn Glenville, published in February by Macmillan, covers this;  pre-order here.)

Consider supplements.  Digestive enzymes are key to breaking down food and absorbing nutrients but they decline as we age.  Try Extrazyme 13, £21.95 for 90 capsules (take one capsule just before or with a main meal) - buy here.  Probiotics help many people (myself included);  try NHP Advanced Probiotic Support, £29.98 for 60 capsules - buy here - both from Victoria Health.  Live natural yogurt and probiotic drinks (eg Actimel) may also help.

REDNESS REMEDY

Rosacea is notoriously intractable but a reader with this distressing skin condition recommends Medik8 Red Alert Serum, £28 for 15 ml, ‘which is so good I use it night and morning’.  (Find it at www.dianenivern.com - buy here.)  The product was specifically designed to treat areas of redness on the face.  This reader does take good care of her skin, with facials every six weeks with a facialist experienced in rosacea.  She also recommends the SkinCeuticals Serum 10 AOX+, formulated for sensitive skin, £67 for 30 ml (www.skinceuticals.co.uk).  She reports that her redness and spots are greatly improved and she now feels she can go out without foundation.  ‘Before I wouldn’t go out of the door without foundation or tinted moisturiser.’  Medik8 products are available from qualified and trained retailers only: for stockists call 05603-141956.

DON'T GET S.A.D....

If you have the January blues, which affects about 17 per cent of us, or more severe Seasonal Affective Disorder (SAD), affecting up to seven per cent, consider using a light box daily.  The neat new LED LitePod, £120, is Kindle-sized so easily transportable and powerful, £120 from www.sad.co.uk.  You can rent a light box from www.healthyhouse.co.uk - buy here.  NB do check cautions, such as eye conditions including glaucoma.