Soundtrack: Olivia Newton-John “Physical”

Kanye West “The New Workout Plan”

An expanding waistline is sometimes considered the price of getting older. For women, this can be especially true after menopause, when body fat tends to shift to the abdomen. Yet belly fat is about much more than just how you fit into your clothes. Research shows that belly fat also carries serious health risks. In my work with women across the United States I have seen the causes and the effects of belly fat. I am compelled to address this topic head-on.

The trouble with belly fat is that it’s not limited to the extra layer of padding located just below the skin (subcutaneous fat). It also includes visceral fat — which lies deep inside your abdomen, surrounding your internal organs. Although subcutaneous fat poses cosmetic concerns, visceral fat is linked with far more dangerous health problems, including:

• Cardiovascular disease
• Type 2 diabetes
• Colorectal cancer

Research also has associated belly fat with an increased risk of premature death — regardless of overall weight. In fact, some studies have found that even when women were considered a normal weight based on standard body mass index (BMI) measurements, a large waistline increased the risk of dying of cardiovascular disease.

Belly fat doesn’t just lay idle at your beltline. Researchers describe it as an active “organ” in your body — one that churns out hormones and inflammatory substances.

“Abdominal fat is thought to break down easily into fatty acids, which flow directly into the liver and into muscle,” says Lewis Kuller, MD, DPH, professor and past chair of epidemiology at the University of Pittsburgh School of Public Health.

When these excess fatty acids drain into the liver, they trigger a chain reaction of changes — increasing the production of LDL ‘bad’ cholesterol and triglycerides. During this time insulin can also become less effective in controlling blood sugar, so insulin resistance sets in, he explains.

Blood sugars start to get out of balance. Fats and clots get into the bloodstream, and that sets the stage for diabetes, heart disease, and more.

And research shows that abdominal fat triggers a change in angiotensin, a hormone that controls blood vessel constriction — increasing the risk of high blood pressure, stroke, and heart attack, Kuller explains.

Indeed, belly fat is a key indicator of “metabolic syndrome,” a cluster of abnormalities that include high levels of blood sugar, blood pressure, and triglycerides, as well as low levels of “good” HDL cholesterol. This combination of risks has an impact on mortality from heart disease. In addition to all of this, there is another very common effect of belly fat that uniquely impacts women.

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Uterine Fibroids are benign tumors of muscle and connective tissue that grow in and/or around the wall of a woman’s uterus. There is one major cause for the development and growth of fibroids and that is estrogen dominance, the state of having too much estrogen in one’s system relative to progesterone.

From the onset of puberty to menopause, a woman’s body is designed to have estrogen and progesterone work together to fuel and regulate her monthly cycle.

The bulk of estrogen is released into a woman’s blood circulation during the first half of her monthly cycle. Estrogen works to build the lining of a woman’s uterus to prepare it for implantation of a fertilized egg should fertilization occur.

The bulk of progesterone is released into a woman’s blood stream during the second half of a healthy monthly cycle. During this time, progesterone acts to maintain the rich lining of the uterus that estrogen helped to build up during the first two weeks of her cycle.

If a fertilized egg successfully implants into the uterine wall i.e. if a woman becomes pregnant, her body must continue to produce a large amount of progesterone on a continuous basis to maintain a thick and well vascularized uterine wall throughout the course of pregnancy. This job of continuous progesterone production is handled nicely by a healthy placenta.

If there is no implantation/pregnancy, a woman’s body stops producing large amounts of progesterone, which results in sloughing off and elimination of the thickened uterine lining, also known as a woman’s monthly flow.

This cycle repeats itself about once every month until a woman experiences menopause, with estrogen dominating the first half of each cycle, and progesterone dominating the second half.

Sadly, many women and even teenage girls in industrialized countries have too much estrogen and/or too little progesterone in their systems.

There are many reasons why estrogen dominance is a problem, but the relevant answer for this post is that having estrogen dominance causes a woman’s uterine lining to thicken far more than is healthy during her monthly cycles. This repeated, excessive thickening can result in localized growths in the muscle and connective tissue that line the uterus. We call these growths uterine fibroids.

All of these physiological facts have convinced me that addressing estrogen dominance is essential to shrinking and preventing uterine fibroids.

What causes estrogen dominance?

Exposure to Xenoestrogens is one significant factor in estrogen dominance. Xenoestrogens are estrogens that are produced outside of the body. Here is a list of significant sources of xenoestrogens:

• birth control pills
• hormone replacement drugs
• condom spermicides
• conventional personal care products, particularly cosmetics
• Plastic cookware
• Growth hormones found in factory-farmed animal products
• Pesticides and herbicides
• Foaming agents in soaps and detergents

Estrogen is produced in three different areas of the body: ovaries (testicles in men), adrenal glands, and fat cells. That’s right. Estrogen is produced by fat cells. The more fat cells a woman has, the greater chance she has of experiencing estrogen dominance.

It is estimated that three in every four American women have fibroids, with one in four women seeking medical care for the condition. African American women are three to nine times more likely to develop fibroids. Uterine fibroids can be hard to combat given the fact that women are diagnosed with the disease at various stages and when they are in various physical conditions. While the fibroids may develop slowly in some women, others may develop more aggressively. Right now, hysterectomy is the most common treatment for uterine fibroids, accounting for 200,000, or 30 percent, of all hysterectomies in the United States.

I believe that a woman having her uterus is a good thing. Fibroids and the hysterectomies that are resulting from them are a silent epidemic in this country, especially among Black women. When we look at the three areas of the body where estrogen is produced, there is something that jumps out. Fat cells and overly active adrenal glands can both be addressed with the same prescription: EXERCISE.

Adrenal glands are activated by stress. When we feel unsafe in any way then the body’s “fight or flight” response kicks in and the adrenal glands produce adrenaline to make it easier to fight or flee. When we exercise, in addition to improving the way our body looks, we also get some direct sress-relieving benefits:

• It pumps up your endorphins. Physical activity helps to bump up the production of your brain’s feel-good neurotransmitters, called endorphins. Although this function is often referred to as a runner’s high, a rousing game of tennis or a nature hike also can contribute to this same feeling.
• It’s meditation in motion. After a fast-paced game of racquetball or several laps in the pool, you’ll often find that you’ve forgotten the day’s irritations and concentrated only on your body’s movements. As you begin to regularly shed your daily tensions through movement and physical activity, you may find that this focus on a single task, and the resulting energy and optimism, can help you remain calm and clear in everything that you do.
• It improves your mood. Regular exercise can increase self-confidence and lower the symptoms associated with mild depression and anxiety. Exercise also can improve your sleep, which is often disrupted by stress, depression and anxiety. All this can ease your stress levels and give you a sense of command over your body and your life.

If you’re experiencing extreme symptoms from fibroids then there is a very good chance that you’re also experiencing a high level of stress as well as carrying too much belly fat, in addition to exposure to Xenoestrogens. Everyone can immediately address a large part of what is causing their fibroids by exercising. And I don’t mean just walking around the block, even though every little bit helps. I mean exercise like your life depends on it, because it does. Swim, run, do yoga, lift weights, dance, whatever works for you. Just get moving.

Belly fat is the enemy.