Why are women more prone to belly fat? How it’s a risk for heart disease, diabetes and cancer
As women age, their metabolism slows and they don't burn as many calories
The skinny jeans don’t fit. The pretty dress has to be packed away.
You just measured your waistline and now want to throw the measuring tape out of the window.
Sob.
The truth is, the problem goes beyond outfits not fitting, what people say, or cosmetic concerns about how you look. We hate to sound the alarm, but it can actually be a health concern. The deeper belly fat that accumulates around abdominal organs is active, and has been linked to several diseases, including heart disease and cancer. Moreover, it appears to be a problem that women face as they grow older, as compared to men.
The trouble with belly fat
Belly fat isn’t just the flab below the skin. Unfortunately, it goes a lot deeper than a pair of jeans not fitting you.
The fat below the skin is called the subcutaneous fat. That’s the love handles, as it is fondly called. Yet, this layer isn’t the problem. However, it’s the hidden fat, or rather the visceral body fat that causes the problems. This is far deeper. “This fat is accumulated around internal organs such as the liver and intestines,” says Nadine Aoun, a senior dietician at Medcare Women & Children Hospital. “This is kept deep within the abdomen. Around 10 per cent of the total fat that is stored in the body, is composed of it.”
However, the cells found in the visceral fat are physiologically active, explains Aoun. This visceral fat is essentially an endocrine organ that secretes hormones and several chemicals that have a profound impact on other tissues, she says. For instance, one substance is the retinol-binding protein RBP4, that was discovered in a 16-year study of nurses, published in an American journal for the National Library of Medicine, in 2013. This protein increased the risk of developing coronary heart disease.
The dangerous cells
As Aoun explains, fat cells produce substances such as cytokines and interleukin-6, which also increase the risk of heart disease. Moreover, they negatively impact blood pressure and the blood’s capacity to clot. “A high level of visceral fat in the body increases LDL (low density lipoprotein) or bad cholesterol while decreasing HDL (high density protein), or good cholesterol,” she says.
According to the American Heart Association News site, a leading study showed, “Women with bigger waists relative to their hips face a higher risk of heart attacks than men with a similar body shape….
“The study, published in the Journal of the American Heart Association, suggests that a waist-to-hip ratio measurement may be a better indicator of heart attack risk than body mass index for both men and women.”
For this study, researchers looked for gender-based link between weight, fat distribution, and heart disease risk in nearly half a million men and women.
"We found that women with bigger waists and waist-to-hip ratios face a greater risk of experiencing a heart attack than men who have a similar 'apple shape'," said the study's lead author Sanne Peters, a researcher at the George Institute for Global Health, at the University of Oxford, in the UK, as quoted in the report published on www.heart.org.
Women with a waist size greater than 35 inches and men with a waist larger than 40 inches are at higher risk for heart disease and Type 2 diabetes, according to the American National Heart, Lung, and Blood Institute.
The report said, “The study also suggests that measuring waistline size and comparing it to hip size might be a better way to predict heart disease risk than the widely used body mass index (BMI), which calculates body fat based on height and weight.
"BMI is a measure of general obesity, and it does not discriminate between fat around the hips or the waist," Peters is quoted. "Yet, compared to fat around the hips, fat around the waist is more metabolically active, is closely related to insulin resistance, and may be more strongly associated with the risk of heart disease, stroke and diabetes.
"Measures of body fat distribution, including waist circumference, waist-to-hip ratio and waist-to-height ratio, may be more suitable as indicators for cardiovascular disease risk," she said.
Diabetes, heart disease and cancer
There are numerous studies that have explored the harmful impacts of belly fat on women, in particular. The Million Women Study, which was undertaken in Britain, proved the connection between the development of coronary heart disease and an increase in waist circumference over the course of 20 years. The probability of women developing heart disease were doubled, among women with expansive midsections.
Moreover, there is a risk of cancer. According to a 2013 study published in the European Journal of Cardiology, there were significantly higher chances of women with visceral fat, getting colorectal cancer. In 2017, Dutch researchers explored the links between total body fat and abdominal fat to the risk of breast cancer. According to the research, when women in the study lost weight, there were changes in the levels of estrogen, leptin and inflammatory proteins. This pointed towards a reduction in the risk of breast cancer.
This presence of visceral fat also increases the risk of Type 2 diabetes owing to insulin resistance, adds Mitun De Sarkar, a clinical dietitian and founder of Dubai-based wellness clinic Simply Healthy. The culprit is again the secretion of RBP4, which shows resistance to insulin. Insulin resistance occurs when the cells in your muscles don’t respond well to insulin and cannot easily take more glucose from the blood. As per the Cleveland Clinic site, once this happens, the pancreas make more insulin to overcome the increasing blood glucose levels. However, when the cells become entirely too resistant to insulin, it leads to an increase in glucose levels, which can lead to Type 2 diabetes.
Sarkar adds that this development of fat also sees a host of other problems, including sleep apnea, liver disease, gallbladder problems, reproductive issues during pregnancy.
Are women more prone to belly fat then men?
It’s frustrating to not gain weight and still have that belly fat. Is it just a women’s problem?
According to research published in 2021 by the American Harvard Medical School, as women go through the middle-age spread, their proportion of fat to body weight tends to increase — more than it does in men. The fat storage features in the upper body, moving from the hips and thighs. Even if you don’t actually gain weight, the waistline increases as the visceral fat pushes against the abdominal wall. There are several reasons for this, including hormonal changes.
Aoun attributes this to decreased levels of estrogen in women. “Since estrogen has an impact on the location of fat in the body, this is probably the result of a decreased estrogen level,” she says. Belly fat is difficult to eliminate because it is classified as active fat, she explains.
Unlike some fatty tissue that merely sits ‘dormant’, belly fat releases hormones that can affect your health — and your ability to shed weight, particularly around the waist and abdomen. As women age, their metabolism slows and they don't burn as many calories
In the years that lead up to menopause, the changes in estrogen cause a shift in the body shape. This typically begins between 45 to 55, and lasts around seven years. Prior to this, women usually store more of their fat in the thighs and hips. Around menopause, there’s a change in the fat storage locations in women.
“Unlike some fatty tissue that merely sits ‘dormant’, belly fat releases hormones that can affect your health — and your ability to shed weight, particularly around the waist and abdomen. As women age, their metabolism slows and they don't burn as many calories,” adds Aoun. Moreover, menopausal stages can also induce insulin resistance and increased abdominal fat, which is difficult to lose with diet and exercise alone.
In a 2021 study, Gail Greendale, a professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles, USA, and her colleagues tracked how the bodies of 380 middle-aged women in Boston and Los Angeles changed over 12 years. She also included the time before, during and after their transitions to menopause. While the results differed according to ethnicities, the overall outcome was that around menopause, the women started storing fat more like men. This meant, less around the thighs and hips and more around their midsections. Men also store fat in their midsections as they age, but it is a far slower and a steadier change, the research concluded.
There could be several reasons behind this growth of belly fat. “A sedentary lifestyle and the foods you eat can all contribute to an increase in abdominal fat. This can include eating a lot of sugar and carbohydrates while not consuming enough fiber and protein. Genes can also influence an individual's likelihood of being overweight or obese,” explains Aoun.
How do we overcome this ‘nasty’ belly fat?
Those sit-ups and stomach crunches are not enough.
You need to observe your entire lifestyle, which includes rigorous exercise and a healthy diet, explain the experts in consensus. So, keep a watch on your waist measurements, and opt for a diet full of fiber, green vegetables and reduce your sugar intake and carbohydrates. "Lifestyle changes, including a balanced diet, regular exercise, and stress management, are crucial in mitigating health risks," says Sarkar. "Prioritise overall wellness to prevent and manage the health problems associated with abdominal fat storage."
Lifestyle changes, including a balanced diet, regular exercise, and stress management, are crucial in mitigating health risks. Prioritise overall wellness to prevent and manage the health problems associated with abdominal fat storage
You need to include a diet full of proteins, whole grains, low-fat dairy and vegetables. Manage your sleep patterns. Unhealthy sleeping habits can contribute to obesity as well, and address your stress. Stress leads to the release of cortisol, which triggers more storage of visceral fat.”