The proven flat belly diet

It’s all about location. Much like in real estate, where fat's located determines its importance: Fat under the skin and fat around abdominal organs behave differently. Fat in and around abdominal organs is active metabolically and acts like an endocrine gland, causing insulin resistance, blood sugar spikes, and interfering with fat metabolism, and is much more of a health issue than fat under our skin.

A bulging abdomen used to be called a beer belly, but sugar belly's more fitting. Studies show that sugar – especially in drinks – increases fat accumulation in the worst possible locations of our anatomy.

Fructose overconsumption – as in drinking 25 percent of daily calories in fructose for 10 weeks – increased triglycerides and cholesterol, caused insulin resistance and belly fat accumulation, a study from the University of California at Davis showed. Another study found that even moderate consumption of sugary drinks (1 daily can of soda for 3 weeks) led to increased belly fat, elevated glucose levels and inflammation markers, and abnormal lipid profiles. A study in the journal Obesity, following 800 people, found sugary drinks were associated with significantly increased belly fat and wider waistlines. And a study assigning overweight people to drink cola, skim milk, diet cola or water for 6 months, with total calories staying constant, found that liver and abdominal fat increased significantly in the regular soda group, while it remaining unchanged in the other groups.

Added sugars are likely culprits of excessive liver and abdominal fat, but are there foods that promote less of it?

Plant-based = smaller belly?

A new study in the American Journal of Clinical Nutrition looks to see if plant based diets affect fat distribution.

The study included almost 600 older people – median age was 62 years. Their diet was assessed by a validated questionnaire, and further, plant based foods were assessed for their healthfulness. For instance, under the healthy plant foods fell fruits, vegetables, nuts, seeds, legumes, whole grain foods, olive oil etc. Less healthy plant based foods included sweets and desserts, refined grains and sweetened drinks. Animal based foods included meats, milk and eggs.

Fat deposits were assessed by MRI, which looked at fat around the abdominal organs, as well as at fat under the skin. The study adjusted its results for age, sex, BMI, education, smoking, alcohol, and exercise as well as for underlying medical conditions.

Overall, people eating higher on the plant-based index – with more plant-based foods and fewer animal products – tended to be thinner, they had slightly lower BMIs, less fat both under the skin and around abdominal organs, and had lower rates of Fatty Liver Disease than those lower on the plant based index.

But for the same level of overweight and obesity, fat distribution wasn’t associated with adherence to plant-based foods overall – only a healthy plant based diet was associated with lower chances of abdominal fat after adjusting for BMI, which is to say, for the same BMI, people on a healthy plant based diet had less fat in the dangerous – abdominal – locations.

These findings are supported by several other studies:

A study in Circulation examined the effect of two weight-loss diets – a low-fat diet, and a Mediterranean diet, rich in unsaturated fat and low in simple carbs –on fat deposits. The 278 participants were followed for 18-months, and besides the weight and waist circumference measurements, total body MRI was used to in order to measure fat quantities around all the internal organs. Although the two groups lost about the same amount of weight, the Mediterranean diet group lost more abdominal fat, more liver fat and more fat around the heart and pancreas. Losing this liver and deep intra-abdominal fat improved participants’ lipid profile and insulin sensitivity.

Another recent study in the Journal of Nutrition examining the diets of 6671 45-65 year olds and correlating them with MRI findings of abdominal fat, found that high fruit and veggie intake are linked with low liver and belly fat.

Ab exercises and workouts

Further research may clarify whether a healthy plant-centered diet helps fight belly fat accumulation ­– its fiber, high antioxidant levels, anti-inflammatory activity and plant proteins may facilitate benefits – or that healthy plant-based eaters minimize consumption of sugary offenders.

Exercise also helps. I’m not talking about abdominal crunches – those are excellent to strengthen your abs, but focusing on abs doesn’t preferentially attack the belly fat under them – all aerobic and strength training reduces the chance of visceral fat, even if you don’t lose weight.

No matter what your genetic disposition, you can affect the distribution of your fat through healthy food choices and keeping active.

Dr. Ayala