June 30, 2015


Better than a six pack this summer

As it warms up and clothing becomes minimal, many of us are thinking even more than usual about our abdomen. I believe a big part of why we feel a well-toned abdomen is attractive is because it’s such a challenge. At a time when more than a third of Americans have a large reservoir of fat here, visible abdominal muscles seem to convey extremely hard work, good genes, self-restraint … or an eating disorder.

If you’re someone whose abdomen isn’t what you’d like it to be, first figure out why you want it to be different. Is it about how you look to others? Is it about your health? Is it both?

Even without a washboard for a belly, you can be vibrantly healthy. In fact, an abdomen that is overly hard – due to tightness of the abdominal muscles – is not ideal. Numerous traditional Asian arts of healing and fitness, such as qi gong, kung fu, shiatsu, and tai chi, emphasize building a strong yet soft abdomen for optimal health and sensitivity. When the belly is rigid, we tend to breathe more shallowly, rather than deeply into the abdomen; we may experience digestive irregularity or constipation; we may have lower back pain; and women may have more painful periods.

The issue of abdominal sensitivity is way outside most Westerners’ box, but Eastern traditions consider this region to be like a pond that registers – as “ripples on the surface” – subtleties in our thoughts and emotions and otherwise imperceptible signals from the people and environment around us. The next time you’re in a tense conversation, keep a portion of your attention on your belly and see what you notice. Perpetually tight abdominal muscles, or the habit of continuously sucking in your stomach, makes this form of perception difficult. If our attention were more down in our belly than up in our head, we’d be more sensitive, peaceful, and grounded.

So, although I don't advocate developing a rigid abdomen, I do think building a strong abdomen is great idea, and I believe it's important not to accumulate excessive fat in this area. Abdominal obesity, also known as central obesity, visceral obesity, or visceral adiposity, is the accumulation of fat around the belly. This is often referred to as the “apple shape” – as opposed to the “pear shape” that comes from fat deposited more in the hips and buttocks. The apple/pear distinction was created to help people understand that one body shape – the apple – is associated with a number of health risks. In my opinion, it’s not been that helpful, because most people with abdominal obesity aren’t shaped like apples, and many of them probably think they’re pears.

Pictures depicting people with an apple superimposed over them seem to imply that the torso should be spherical in order to conform to the apple shape. But the central part of central obesity refers to fat that is mainly deposited around the center of the entire body – meaning about the level of the navel.

The key is to compare the waist circumference to the hip circumference. The waist measurement is taken at what would be the narrowest place on a lean person – or about one inch above the belly button. The hip measurement is taken at the widest place at the buttocks/hips – roughly at the level of the top of the pubic bone (just above the genitals). Technically, this should be measured in centimeters, using a non-stretchy measuring tape, being sure to keep it even (parallel to the floor) when measuring. After you take your measurement (or better yet, have someone else do it for you), the waist number is divided by the hip number. The result – known as the waist-to-hip ratio (WHR) – is one useful measure of general health.

In women, a number around 0.7 is ideal and men should shoot for a WHR of about 0.85. A higher number is what gives the so-called apple shape. Even a WHR that’s elevated by just a few tenths may put you at greater risk of developing cardiovascular disease, high blood pressure, reduced fertility, asthma, Alzheimer’s disease, and diabetes. The pear shape, by the way – which should actually reduce the WHR – has no such negative health correlations (although, if a pear-shaped person is obese, the obesity itself still carries increased risks).

Here’s something interesting . . . if you think the men you know are dogs because they drool when they see an hourglass-shaped woman, it may actually be more biological rather than a simple matter of social conditioning. A low WHR in a woman generally correlates with healthy estrogen levels and fertility. So, men may be unconsciously responding to signals of the reproductive health of the women they’re attracted to. But even if you don’t care about attracting women, being super fertile, or having a washboard stomach, consider this: Life insurance companies may be some of the best judges of death risk – their money rides it, after all. And nowadays they always include a WHR measurement in their physical exam for insurance coverage.

If you're determined to have your dream abdomen this summer, or you just want an abdomen that's healthy, here are some things to keep in mind:

1)  You can’t focus weight loss on your abdomen. Sorry. Lots of abdominal exercises won’t do it. If you have a flabby belly, you need to lose weight. If comes off your whole body pretty evenly. You can use abdominal exercises to strengthen your core, which is a fine idea, but compared to almost any other exercise, they are a terrible way to burn calories. Instead, stick to these basics of weight loss: Do aerobic exercise – especially interval training, do strength training and build muscle, eat more fiber (vegetables and/or beans at every meal), cut out sweeteners and flour, get at least 7 hours of sleep a night, stop eating before you feel full, stay conscious during the eating process, never allow yourself to feelguilty about what and how you're eating (even if you believe it's not good for you, eat slowly, and always savor your food. Plus, remember to drink half the number of pounds you weigh as ounces of non-iced water over the course of each day.

2) You may not be aware of them, but many, many people have “knots” (myofascial trigger points) in their abdominal muscles, which can contribute to a bizarre array of pain patterns (throughout the abdomen, up toward the chest, into the back, down to the groin) and can disturb breathing, digestion, menstruation, and our ability to deeply relax. Chronic, low grade abdominal tension can make us feel like we’re never completely at ease.

There are a number of ways we develop muscular tension, but one of the most common is by doing a bunch of abdominal exercises – often with poor form – after not having worked this area for a long time. Like, we suddenly get inspired to do 200 crunches to make up for 3 years of not exercising. Don’t do it. As with any form of exercise, start light and build up slowly.

Once you already have abdominal trigger points, the best way to deal with them is to get abdominal massage and abdominal trigger point acupuncture. Between treatments lie with a lacrosse ball under your belly and spend a minute or two with the ball on each tender point while trying to fully allow it to sink into your body.

The side benefits of releasing abdominal trigger points are often profound. I’ve had people burst into tears, breathe a massive sigh of relief, and even – get this – sometimes experience an immediate improvement in the look of the abdomen. You might think tight abs are a good thing, but if they’re perpetually contracted and they’re under a thick layer of fat, it will just make your belly protrude more. When the muscles are released, the tummy flattens. I can’t guarantee this will happen – or that it will be dramatic – but the point is, it’s work worth doing.

3) Think of the abdominal muscles like any other muscle group. If you’ve done resistance training, you know that it’s not a good idea to work the same muscle group every day. Muscles need rest to recover and grow stronger. But for some reason, even people who only work out other muscle groups once or twice a week often don’t abide by this rule when it comes to the abs – they do an intense abdominal workout every day. As with other muscles, you’ll get the most benefit – and spare yourself some effort in the meantime – if you only do your crunches (or other abdominal workout) two or three times a week.

4) Speaking of which, stop sucking your stomach in habitually. It restricts your abdomen, makes your breathing shallow, keeps you tense, inhibits good digestive flow, squelches your power, contributes to trigger points, can cause gastric reflux (heartburn), and gives you hairy palms. Ok, so maybe not hairy palms. Let your belly be soft and relaxed. If you can’t fit into your pants without sucking in your stomach, you need different pants. If you don’t like it, do the work to lose the fat. Sorry, but there’s no way around it.

5) When doing crunches or sit-ups, always start the movement by pushing your lower back against the floor and squeezing your belly button toward your spine. Initiate a slow curling up from this place. Don’t use your legs or neck to help you. Better yet, ditch the crunches altogether and choose abdominal exercises that are easier on your lower back, such as plank pose resting on your forearms and toes (if this isn't hard enough, extend one arm and the opposite leg).

6) When working out, don’t use a weight belt unless you’re lifting very heavy weight or you have a back problem that requires it. Otherwise, it allows your abdominal muscles to slack off.

7) Pay attention to how you stand. Is there a big arch in your lower back? If so, you’re letting your core be lazy. Keep it engaged. Tuck your tailbone slightly and engage your abdomen. Imagine you’re lifting your ribcage and dropping your pelvis to make more space in this area. Besides being better for your back and better for your abs in the long run, this is pretty much the fastest way to look better.

8) Just in case some of your bulging abdomen is due to bloating: Remember to eat slowly and don't talk with your mouth full (when we eat fast, we swallow a lot of air, which actually accounts for most of our gas). Gum can also contribute to swallowing air – plus it makes you look like a cow chewing its cud – so reduce it, unless you have some medical need for gum. Avoid sugar-free treats that are sweetened with sugar alcohols – especially maltitol – because they give you nasty gas. Reduce your consumption of fizzy drinks, and make sure they don’t have sugar or corn syrup in them. If you get gas from veggies and beans, try a digestive enzyme complex with your meals. Don’t overeat. Figure out if you have any food sensitivities (you may need the help of a naturally oriented healthcare practitioner) and avoid these foods. Try chewing some fennel or caraway seeds after meals. If you have gas that doesn't respond to these approaches, try several activated charcoal capsules or the mild drug simethicone.

Finally, be patient. Losing belly fat is usually not a fast process. You can do it. Get a friend to join you.

Be well,

Dr. Peter Borten

Leave a comment