Where you store you fat is important. Belly fat is more dangerous than fat in other places, since it carries a higher risk of heart disease, stroke, diabetes and certain cancers compared with fat stored in hips and thighs. And more than 50 % of men and 70% of women between ages of 50 and 79 have waists that fit the definition of "abdominal obesity."

There are two kinds of "belly fat" - subcutaneous (this you can pinch), and fat inside the abdomen (visceral fat), which surrounds the abdominal organs, and is located in the omentum. Subcutaneous fat is not particularly dangerous, but visceral fat IS dangerous; there is a correlation between a large waist and a higher risk of death. Visceral fat (belly fat) actually secretes hormones and lipids (like triglycerides) that are harmful to the body.

Obviously, excess calories are the cause of belly fat (omental fat), but in my experience one of the greatest causes is alcohol, especially beer. When I first started doing liposuction, I became excited about reducing the size of the belly, especially in men. But then I realized this fat is INSIDE the abdomen, not just under the skin (subcutaneous). And I quickly realized that the cause in most of these men was beer drinking. Alcohol gives you empty calories.

So how do you lose belly fat. It is not as difficult as you might think. With diet (calorie restriction) and exercise, belly fat is often the first to go. But exercise alone will not do it. You can do 1000 abdominal crunches a day, and it will not reduce belly fat - it will only tone the abdominal muscles. Pick a physical activity you enjoy and will do regularly, and stick to it. Then use a prudent diet - more vegetables, fruits and whole grains. Cut back on sugars, including beverages, as well as saturated fats and refined grains like those found in pastries. Cut down the alcohol. Remember, this is a "life-style change", and not just a temporary thing that you can go back to when you lose weight.

Women have the advantage of losing subcutaneous fat easier, since most women have subcutaneous fat and not visceral (belly) fat. I found the quickest way for my patients was liposuction, with the caveat that a lifestyle change had to accompany the surgery.

A Johns Hopkins study suggests that a low-carbohydrate diet may be the best way to lose belly fat. And to get a dramatic improvement in your metabolic profile, you don't need to lose all the weight. Even a 5 -10 percent weight loss lowers dangerous levels of insulin and estrogen.

Only an MRI or CAT scan can show how much belly fat you have, but your waist size is a good indicator. Danger zone for women is a waist 35 inches or larger; for men, it's 40 inches or larger. Just watch how your pants fit. 

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