Ban The Belly Fat - South Denver

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5/15/2017Ban The Belly FatSusan Buckley, RDN, CDESouth Denver CardiologyBan The Belly Fat Americans spend countless hours andbillions of dollars tryinganything and everythingto attain a flat stomach1

5/15/2017Ban The Belly Fat What is Belly Fat?4 different types of fatFat can accumulate just underneath the skin:subcutaneous fat. Looser fat that lets you “pinch aninch”Retroperitoneal: fat behind the abdominal wallIntramuscular fat within the skeletal musclesVisceral fat – packed between your abdominalorgans (stomach, liver, kidneys, etc). This is intraabdominal or Belly FATBan The Belly Fat2

5/15/2017Ban The Belly Fat Visceral fat affects the abdominal area; itcauses a person to have a thicker waistlineor “pot belly”Having too much fat is always bad, butvisceral fat is far worse than subcutaneousfat for serious health problems – includingheart disease, high blood pressure,stroke, diabetes and even some cancerssuch as breast and colon cancerVisceral Fat Visceral fat is deeper inside, around the vitalorgans (heart, lungs, digestive tract, liver,etc.) in the chest, abdomen and pelvisIt’s so deep inside that you can’t notice itfrom the outsideMany people are sub-conscious about the fatthey can see (subcutaneous fat) – butactually it is the hidden fat – the visceral fat– that does harm3

5/15/2017Belly Fat We all need SOME visceral fatIt provides necessary cushioning aroundorgansWhen a body becomes overweight/obese, itruns out of safe places to store fat andbegins storing it in and around the organsBelly FatFatty liver disease was, untilrecently, very rare in non-alcoholics Now it is common With obesity increasing, fat deposits becomeso full that the fat is deposited into the organslike the liver, and around the heart as well 4

5/15/2017Fatty LiverBelly Fat At one time it was thought that fat cells were simplyinert storage depots for surplus caloriesStudies have established that fat cells can secretecertain hormones and other substances much likeother organs in the bodyHormone leptin, which controls appetite, andadiponectin, which makes the body more sensitive toinsulin and controls blood sugar levels5

5/15/2017Belly Fat Fat is an ACTIVE ORGAN that sends chemicalsignals to other parts of the bodyStudy in the American Chemical Society’s Journal ofProteome Research reported on the discovery of 20new hormones and other substances not previouslyknown to be secreted into the blood by human fatcells. 80 different proteins produced by fat cells.This study also verified that fat secretes dozens ofhormones and chemical messengers – some ofthese are pro-inflammatory chemicalmessengersBelly Fat Belly fat can be thought of as an endocrine organ –an organ that secretes chemicals into thebloodstream that elicit significant changes in theactivity of other organsBelly fat cells produce and secrete several types ofimmune system stimulants called cytokinesThese molecules circulate around the body revvingup certain cells of immunity that are in charge ofinflammationThis can encourage the growth of arterial plaque6

5/15/2017Belly Fat The amount of fat in your cells is determined not justby how much fat enters, but also by how much fatleaves themWhen the amount entering and the amount leavingover a period of time are equal, fat cells don’tenlargeThey properly perform their job of storing fattemporarily as you eat and then releasing it betweenmeals so that you don’t feel hungry before your nextmealBelly Fat Fat cells are not intrinsically evilThey serve a very useful purposeThey allow us to do important tasks such as go towork, exercise, run errands, etc. instead of having toeat all the time to maintain energy levelsBut when insulin levels stay high by eating all thetime or eating very high glycemic foods, our fat cellskeep fat locked up in the cells and won’t release it.7

5/15/2017Belly Fat When insulin level is high, fat cells are lockedin the fat-storing modeWhen insulin is kept low, the switch is turnedoff and fat can be released for use by thebodyTrick is to keep insulin levels LOW!!Belly Fat One of the other tasks insulin performs is theregulation of blood sugarAs more glucose (food/drinks) enters theblood, more insulin is required to control itCarbohydrates cause insulin to spike higherthan either fats or proteinRefined carbs, or rapidly digested carbs,cause the insulin to spike even higher!8

5/15/2017Belly Fat High carbohydrate intake high insulinreleaseHigh refined carbohydrate intake very highinsulin releaseHigher Insulin release higher fat storageFat Cells Once fat cells form, they might shrink duringweight loss, but they do not disappearWeight gained is caused by the creation andexpansion of white fat cells, or adiposetissue.Dieting can shrink fat cells but not eliminatethem9

5/15/2017Belly Fat So, how much is TOO MUCH?Get a measuring tape, wrap it around thewaist, just above your hipbone and checkyour girthDo it while standing upFor best health, waist size should be:Less than 35” for womenLess than 40” for menBelly Fat Having a pear shape with fatter hips andthighs is considered safer than apple shapewith a wider waistline10

5/15/2017Belly Fat Many women notice an increase in belly fatas they get older, even if they aren’t gainingweightLikely due to a decreasing level of estrogen,which appears to influence where fat isdistributed in the bodyBan The Belly Fat So why do we get belly fat?Our bodies are designed to store fat – we’re verygood at itWhen humans werehunters-gatherers, weneeded the ability to storefat so we could then burnit during the winter monthswhen food was scarce11

5/15/2017Ban The Belly Fat Now food is plentiful in our environment allthe time and it’s NOT feast or famineIt’s FEAST ALL THE TIME!Now we’re eating all the time and, as aresult, storing all the timeIf you’re consuming more calories thanyou’re expending, fat will develop12

5/15/2017Ban The Belly FatFat distribution is most influenced by genetics,gender and age Those are factors we cannot change But stress, overeating (especially sugar/carbs) andphysical inactivity can causebelly fat to accumulate outof proportion to the otherareas where fat is deposited Insulin When we eat food, the pancreas releases insulinInsulin’s job is to get the glucose from the food intothe cell where it can do it’s jobWhen insulin levels are constantly elevated, thebody is in “fat storage” modeHigh insulin levels generate a signal that keepsfat packed in fat cells instead of being releasedfor the body to use13

5/15/2017Insulin Our brains respond to high insulin by stimulatingthe appetite centers that send out hunger signals –even if you just ate an hour ago!As a result – instead of burning up the fat we alreadyhave, we end up eating MORE!Explains why losing weight is so difficultFood we eat puts us in perpetual “fat-storage” mode,results in overeating!Insulin 2007 Jay Cutler was the quarterback for the DenverBroncosDuring the season, despite working out with weightsand eating thousands of calories per day, he lostalmost 35 pounds!Diagnosed with Type 1 diabetesWithout any insulin to store energy, he lost a lot ofweightSubsequently regained his lost weight once he wasplaced on insulin14

5/15/2017Insulin Resistance Doctor can measure fasting insulin levelsCorrelates with degree of insulin resistanceLow insulin levels suggest you are sensitive toinsulin: good thing!High insulin levels suggests pancreas is oversecreting insulin to compensate for insulin resistanceAt this point no established “ideal” normal vsabnormal insulin levels. Goal is generally 3-25. Onthe lower end is good.Ban the Belly Fat There is no magic diet for belly fatWhen you lose weight on any diet, belly fatusually goes firstWhat CAN help?15

5/15/2017A Fiber-Rich Diet Research shows that people who eat 10grams of soluble fiber per day, without anyother diet changes, build up less visceral fatover time than others10 grams soluble fiber: 2 small apples, a cupof green peas and ½ cup pinto beans, forexampleA Fiber-Rich Diet Another study from Penn State: (American Journal ofClinical Nutrition) 50 men and women, all obese andhad metabolic syndrome (combination ofabdominal obesity, high blood sugar and high bloodpressure, high triglycerides)For the diet: they all cut calories½ of the participants were told to be sure that alltheir grains were whole grains such as oatmeal,whole-grain cereal, brown rice and barley16

5/15/2017A Fiber-Rich Diet The other ½ were instructed to choose onlyrefined grains, such as white bread, whitepasta and other foods made with white flourAfter 12 weeks, both groups lost about thesame amount of weight –an average of 11pounds (calories count!!)The whole-grain group lost more belly fatand also reduced their CRP by 38%(measures inflammation)A Fiber-Rich Diet Fiber itself has NO calories, yet it helps to fillyou up!SLOWS the absorption of food by the bodyStabilizes blood sugarHelps keep appetite satisfied longerHelps body absorb LESS fat and cholesterolfrom foodsHelps maintain gut/immune health17

5/15/2017A Fiber-Rich Diet Oatmeal, dry, 1/3 cupOat bran, cooked, ¾ cupRaspberries, 1 cupBlueberries, ¾ cupPlums – 2 mediumPeas, frozen ½ cupSweet potato, ½ cupNavy Beans, ½ cupAll bran,1/3 cupFiber One, ½ cupKidney beans, ½ cup 2.7 grams fiber4.0 grams fiber3.3 grams fiber1.4 grams fiber2.4 grams fiber4.3 grams fiber4.0 grams fiber6.5 grams fiber8.6 grams fiber11.0 grams fiber7.9 grams fiberFiber La Tortilla Factory TortillaFlat Out WrapsAlternative Bagel1118 grams8 grams8 grams18

5/15/2017Eliminate Sugary Drinks Soda, juice, sweetened tea, “energy drinks,”Starbucks, etcSugar increases belly fat and fiber reduces it sowhen you juice fruit you remove the fiber, leavingpure sugar!The average American eats 156 pounds of addedsugar each year!The sweet tastes can change the way we perceivefood, think about food, and crave food and can evenenhance our appetite and influence insulin secretion– turning on an “overeating” response100 Extra Calories/Day It doesn’t take much in extra eating anddrinking (or too little exercise) to pack on thefatGetting just 100 calories a day more thanwhat you need a 10-pound weight gain inone year3,500 calories in a pound19

5/15/2017Sweeteners SweetenerGlucoseTable sugarHFCSFructoseAspartameSweet ‘N LowSplenda Relative Sweet Rating0. In the past few hundred years, the human diet hasgone from being almost completely sugar free tobeing laden with sweetenersFood manufacturers add different forms of sugar toEVERYTHINGSugar and HFCS are the two most frequently usedsweeteners in the modern dietAverage person consumes about 44 pounds ofHFCS every year20

5/15/2017Stress Cortisol is the major hormone of stressPromotes overeating, fat storage, belly fatAs belly fat grows, so does blood levels ofcortisol, which only perpetuates stress and makesit worseBelly fat elevates cortisol – triggers a morevoracious appetite, craving for sugar and fat, andweight gainVicious cycle is hard to break – must pay attentionto food intake, exercise AND stress levelsMindful Eating Eat mindfullySLOW downIt takes approximately 15-20 minutes for the signal offullness to reach the brainPortion control can go out the window in that timeTake small bites, chew 15-20 timesSavor the food as you chewSwallow before taking the next bitePause between bites, assess your hunger level21

5/15/2017Can I spot reduce belly fat? Spot reduction is a common misconception involvingfat loss.This is the idea that exercising one body part shouldhelp reduce the fat surrounding that area.This is not true. Reducing body fat levels results inthe removal of fat in the entire body.According to a study cited on, agroup of men performed 5,000 sit-ups over thecourse of a 27-day research project.Testing showed that they lost fat equally over theentire body, rather than just around the abdomen.What To Eat Eat Breakfast!Include lean protein at each mealSlow-release carbsAt least 5 servings (1/2 cup cooked, 1 cupraw) of vegetablesTwo servings of fruitGood fats at EVERY meal22

5/15/2017Eat Breakfast People who skip breakfast (40% of adultsand 60% of children/teens):Are more likely to be overweight or obese– especially around the bellyAre less likely to exercise regularlyHave higher rates of heart diseaseHave higher rates of diabetesAre more likely to die of heart failure23

5/15/2017Lean Protein Breakfast: 2-4 eggs/week if high cholesterol,eggbeaters, cottage cheese, Greek yogurt,whey/plant protein shakeLunch/Dinner: Lean poultry, fish, grass-fedbeef, lean game meats, lean pork, soybeans,beans/legumesKeep red meat (beef, pork, lamb) servings to1-2 per week or lessQuality Carbohydrates Best carbs come from whole foods:vegetables, fruits, whole grains, legumesEat foods in their most unprocessed form:oatmeal instead of oat flour, corn instead ofcornmeal, orange instead of orange juice24

5/15/2017Slow-Release Carbs Carbohydrates that are digested SLOWLYRaise blood sugar SLOWLYCarbohydrates with lots of FIBER – fibertakes longer to break down and digestGlycemic Index/Glycemic Load Glycemic index is a measure of how fast a carbohydratecontaining food raises blood glucoseGlycemic load of food is a number that estimates how much thefood will raise a person's blood glucose level after eating it –based on glycemic indexGlycemic load is defined as the grams of availablecarbohydrate in the food x the food's GI / 100.Low glycemic load foods are absorbed more slowly, ensuringmore stable blood sugarBy reducing post-meal blood glucose levels, low glycemic loadfoods/meals reduce insulin surges25

5/15/2017High-fiber/Low-glycemic breakfast Greek yogurt, berries, whole wheat breadwith almond butterCottage cheese/fruit, Alternative bagel withpeanut butterHigh-fiber tortilla, eggbeaters and veggieswith low-fat cheeseGreek yogurt and Kashi Go-Lean cerealVeggie Omelette26

5/15/2017High-fiber/Low-glycemic lunch/dinner Lunch/Dinner: Lean protein with Vegetables,Beans/Legumes, Sweet potato, peas, beets(in small quantities: brown rice, whole grainpasta, whole-grain bread) High-fiber tortillasAlways include a small serving of healthy fat,as fat helps to slow down digestion andregulate blood sugarFruits Fruits can be high in sugar so 2 servings aday is good for most peopleBerries are lower on the glycemic index thanfruits like bananas and pineapple1 banana 2 fruit servingsBuy organic and eat the skin with lots of fiberKeep dried fruit and juice to a minimum27

5/15/2017Good Fats Nuts/nut butters, seedsOlive, canola, walnut, almond oilAvocadoFlaxseed, groundOlivesHerbs and Spices Herbs and spices can add a lot more thanflavor, color, and variety to your favoritefoodsThey maximize nutrient density because theycontain vitamins, minerals, antioxidants andphytochemicalsThey can increase thermogenesis – youburn more calories after eating spicy foods28

5/15/2017Herbs and Spices The complex flavors they impart decrease the needfor saltCertain herbs and spices such as cinnamon andcoriander allow your body to handle glucose moreeffectivelyChilis and peppers increase fat burningCumin, Sage and Turmeric improve brain functionBasil, cinnamon, thyme and ginger have immuneboosting powersGreen Tea Green tea contains EGCG, which has been shown toincrease metabolic rateOne study found that people who consumed greentea extracts had a 4% increase in thermogenesisand an overall increased energy expenditure of 4.5%Journal of Nutrition study found that exercisers whodrank about 4 cups of green tea per day for 12weeks lost over 8 times more ab fat than those whodrank an ordinary caffeinated beverage – nearly 8%versus less than 1%29

5/15/2017Antioxidants Antioxidants are chemicals found in plantfoods such as fruits, vegetables, coffee andred wineThese chemicals protect you against thedamage done by belly fat because theydeactivate the dangerous by-products ofmetabolism – preventing oxidation of LDLand other fatsWater Of all the nutrients in our diet, water is the mostimportantAlthough you can live for weeks without food, youcan only survive a few days without waterWater is essential to all the life processes that go onin your bodyIt is how you transport oxygen, red blood cells,vitamins/minerals, enzymes and hormonesthroughout your body30

5/15/2017Water Water eliminates waste and toxinsRequired for digestion and absorption, brainfunction, muscle contractions, nervetransmission and controlling bodytemperatureMore than 60% of your body composition ismade up of waterYour brain is composed of 70-80% waterWater Not getting enough water – feel tired and fatigued, stressesyour entire body, including your heart and brainNot getting enough water – could lead to eating too muchStudy presented at the American Chemical Society in Boston in2010 showed that middle aged and older people who drink 2cups of water before eating a meal ate 70 to 90 fewercalories than their non-water-drinking counterpartsDuring the 12-week period, the water drinkers lost 5 poundsmore than the people who didn’t drink water.They kept the weight off as long as they continued to drink31

5/15/2017Water How much water do you need?Your urine should be a light yellow in colorUsually at least 8 glasses of water/dayExercise Large research studies show that about 55% ofadults don’t get any physical activity beyond thebasic activities of daily living33% get none at allThat leaves only about 12% of American adultsengaging in at least moderate level of activityNo wonder we have such a staggeringly high rate ofchronic diseases associated with too much belly fat32

5/15/2017Hazards of Sitting Too Much How many hours do you sit in a day?Driving, at desk, watching TV, working oncomputer?If 6 hours or more, you may be putting yourhealth at riskPeople with sitting jobs have twice the rate ofcardiovascular disease as people withstanding or walking jobsHazards of Sitting Too Much As soon as you sit down, calorie burningdrops to about 1 calorie per minuteThe enzymes in your skeletal muscles thathelp break down fat and keep LDLcholesterol levels low reduce their activity byas much as 90% as soon as you sitAfter 2 hours of sitting, HDL (good)cholesterol levels drop by about 20%33

5/15/2017Exercise Not just for our bodies!Many studies have documented exercise’seffectiveness as a treatment for mild to moderatedepressionExercise has been shown to be as effective asantidepressant medication in some peopleHelps control stressPeople who exercise regularly have lower rates ofinsomnia and anxietyExercise Vigorous exercise trims fat, including visceral fatSlows down the build up of belly fatHow much is enough?Half an hour of vigorous aerobic exercise, done 4times a week minimum, a Duke University studyshowedAdd 3 sessions of strength training per weekVigorous – jogging or walking briskly uphill or on anellipitical or stationary bike34

5/15/2017Exercise Moderate exercise also helpsIt slows down how much belly fat you gainBut to get rid of belly fat, you may need to be morevigorousRake leaves, walk, garden, go to Zumba class, playsoccer with your kids or grandkidsIf you are not active now, it is a good idea to checkwith your healthcare provider before starting a newfitness programExercise Walk! Speed up your walkUniversity of Arkansas found that even whenexercisers burned exactly the same number ofcalories a week, those who did shorter, highintensity workouts had a 20% drop in belly fatafter 3 months while whose who did longerworkouts at a moderate pace had not changeAim for 3 weekly speed sessions lasting about 30minutes. Intensity: can speak only a few short wordsat a time. Can also do intervals35

5/15/2017Exercise Pump some iron!A 12-week Skidmore College study foundthat exercisers who did a higher intensitytotal body resistance routine combined withcardio lost more than twice as much body fat– in particular 4 times as much belly fatcompared with cardio-only exercisersExercise Recommendation is 150 minutes per week ormore30 minutes 5 times a week aerobic2-3 x per week strength training – 20-30 mineach sessionYou don’t have to do it all at once, but youhave to continue your activity at least 10minutes at a time to get maximal benefit36

5/15/2017Exercise Unfortunately, sit-ups and crunches can’teliminate visceral fat directlyYou can’t reduce fat from specific parts ofyour body by exercising that body partOur bodies don’t work that wayYou can tone the muscle, but not burn the fatThese exercises can strengthen your coreIs Sleep Important? Chronic sleep loss increases risk ofdiabetes/heart diseaseAssociated with weight gain in adults andchildrenDecreases leptin, increases ghrelin37

5/15/2017Sleep Getting enough sleep can help reduce belly fatIn one study, people who got 6-7 hours of sleep pernight gained less visceral fat over 5 years, comparedto those who slept 5 or fewer hours per night or morethan 8Canadian researchers found that adults whoaveraged just 5 or 6 hours a night were 35% morelikely to gain 10 pounds and were nearly 60%heavier around the middle than those who slept 7-8hoursSleep Research Columbia University: 6 hours orless a night – 23% more likely to be obesethan people who slept 7-9 hours5 hours or less – 50% more likely4 hours or less – 73% more likely to beobese38

5/15/2017Healthy Sleep Have a standard relaxing bedtime routinekeep it regularDark, cool, quiet bedroomExercise regularly – at least 3 hours beforebedtimeAvoid caffeine, cola, tea – 8 hoursAvoid alcohol – several hoursSleep and sex only – no work, TV!Alcohol and Appetite Stimulated by alcohol Impairs judgment – dis-inhibition of dietary constraintLOWERS blood sugar!Alcoholics – extreme, loss of appetite but when doeat – eat mostly carbsUp to 1 drink per day for womenUp to 2 drinks per day for menWITH Food39

5/15/2017Summary Eat breakfastLow glycemic carbsBalance protein, fat, carbsFiber, fiber, fiber!Drink waterSlow Down Your EatingRev Up Your ExerciseGet some sleepWatch the alcohol40

5/15/2017 5 Fatty Liver Belly Fat At one time it was thought that fat cells were simply inert storage depots for surplus calories Studies have established that fat cells can secrete certain hormones and other substances much like other organs in the body Hormone leptin, which controls appetite, and adiponectin, which makes the body more sensitive to

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