happy midlife woman

Meno belly

If I asked you to describe meno belly how would you describe it? 
 

The same as belly fat, just in a woman over 40?  Maybe squishy, soft, muffin top?

I ask because the term meno belly makes me purse my lips and twitch with annoyance.  I’m not sure why it annoys me so much, but it does. There’s something belittling about it, and it is, of course, keeping the commentary about women’s bodies going, stoking women’s anxiety about body image, and used to sell unsound weight-loss diets.

So let's get down it.

(Subcutaneous) belly fat

When most women talk about their increased “belly”, they mean the soft belly you can hold between your fingers.  This is subcutaneous fat, meaning it is just under the skin, and outside of the abdominal muscle wall.  Women usually deposit more fat on their bums and thighs until perimenopause, when we still pop fat on the usual spots but hormones changes prompt a shift to increased visceral fat.  

You can have a changed body shape without gaining any weight, or of course, you can do both.

Visceral fat (abdominal or central) fat

Visceral fat is inside your abdomen and surrounds your stomach, bowel and organs. We all have some visceral fat, it does things like insulate and protect our organs. 

In reality, both subcutaneous and visceral fat are belly fat. It’s just how people use the term that is problematic (there are people being sneaky about this on the Gram in particular).

Ectopic fat

Ectopic means in the wrong place (think ectopic pregnancy). Ectopic fat is when some of the excess visceral fat is stored in tissues other than adipose tissue. These tissues usually only have a smidge of fat, and include the liver, skeletal muscle, heart, and the pancreas. Ectopic fat can interfere with the function of the cells of these organs and you may develop insulin resistance, fatty liver or cardiovascular conditions.

Is visceral fat an issue?

In the last 30 years or so it was discovered that fat (or adipose tissue) wasn’t just somewhere extra energy went to be stored and do nothing else. We now know that fat is actually biologically active and secretes hormones and chemicals. In fact, it is now considered to be part of the endocrine (hormone) system; talk about an upgrade.

Visceral fat makes a bunch of molecules including cytokines which can trigger chronic low-level inflammation, as well as a precursor to angiotensin which causes blood vessels to constrict and blood pressure to rise. Visceral fat is associated with heart disease, high cholesterol, diabetes, stroke, dementia, asthma and some cancers.

What causes increased visceral fat?

One of everything:

  • genetics

  • increasing age (female and male)

  • chronic high cortisol (stress hormones)

  • diet

  • lack of physical activity

  • poor sleep quality and duration

  • alcohol

  • smoking

  • chronic inflammation

  • thyroid issues

  • PCOS

  • perimenopause – when oestrogen drops you have a smaller drop in testosterone which leads to popping more fat in your abdomen and less on hips and bum.

Notice that it wasn’t only the reduction in oestrogen?

Here’s the trick

You can be slim, have a *BMI in the “healthy range” and still have excess visceral fat and even ectopic fat. Genetics and long-term dietary and lifestyle factors all play a part in how much, location and importance of body fat. You can measure your waist to hip ratio, but it’s not 100%. Scans are the most accurate way.

(*The BMI is a flawed measure)

There’s a bazillion diets out there – what one has the magic solution?

None. Zero. Zilch. Zip.

Regardless if people say they have “cracked the code”, have discovered “the secret” or can show you how to be your own "biohacker".

They haven't and they can't. Sorry.

There is mixed evidence about the best approach overall, and most studies are on males – healthy and their 20s, or older and obese. There are very few studies on menopausal women. 

Sure, don’t live of packs of jelly beans and bottles of pinot, but there is no evidence that keto (and whatever name it hides behind), intermittent fasting, vegan, that hideous homeopathic drops diet (you lose weight because you have about 25% of the calories you need to be well long-term) or any other is reliably better than the other.

That leaves you with:

  • Sensible, realistic.
  • Delicious. 
  • Loads of plants, protein with each meal.
  • A Mediterranean-ish style diet.
  • Self-compassion
  • And focusing on overall health and not scammy diets.

 What else can you do?

  • Have a health check with your GP if you're due, or concerned

  • Find some form of movement you enjoy and do that.

  • 40 years and older? If you’re not doing resistance exercises then now’s the time.  It’s great for maintaining muscle mass, and it also reduces visceral fat and reduces inflammation a bit (and other benefits).

  • Review your alcohol intake.

  • Don’t smoke.

  • Be intentional about getting enough sleep (yep, often easier said that done).

 Want more information on nutrition? Grab a copy of my Menopause Nutrition Essentials guide.