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Apples, Berries, and Tea: Flavanols Effective for BP Lowering?

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Apples, Berries, and Tea: Flavanols Effective for BP Lowering?

A high intake of dietary flavanols, compounds found in plant-based foods, is associated with significantly lower systolic and diastolic blood pressure, new research shows.

The results reinforce the message that dietary interventions, especially those that emphasize fruits and vegetables, “can have a beneficial effect on blood pressure,” lead author Gunter Kuhnle, Dr rer nat, professor of nutrition and food science, University of Reading, UK, told Medscape Medical News.

However, the study did not show a statistically significant association between biomarkers of flavanol intake and cardiovascular disease (CVD) incidence or mortality.

The study was published online October 21 in Scientific Reports.

Kuhnle likened the reduction in blood pressure from high flavanol intake to what could be achieved with dietary interventions such as the Mediterranean diet, which emphasizes fresh fruits and vegetables, or the low-salt Dietary Approaches to Stop Hypertension (DASH) diet.

The study results “clearly show an inverse association” between flavan-3-ols and blood pressure, and “thereby contribute to the data available to investigate a causal effect,” the investigators note.

In addition to cutting back on sodium and decreasing body weight, increasing flavanol intake “is yet another strategy” to keep systolic and diastolic blood pressure below the recommended 120/80 mm Hg, said Kris-Etherton.

Eating more plant-based foods, including fruits, vegetables, whole grains, legumes, and nuts “aligns with American Heart Association current dietary recommendations,” said Kris-Etherton.

And although the literature suggests flavonoids have antioxidant and anti-inflammatory effects, “now we’re learning they play a role in controlling blood pressure,” she said.

“We all know that fruits and vegetables are high in potassium, which has a blood pressure-lowering effect, and are also high in dietary nitrates and nitrites, which play a role in achieving healthy endothelium and healthy vasculature, but now we know that fruits and vegetables and plant foods have yet another compound that helps achieve healthy blood pressure, and that’s the flavanols.”

Sci Rep. Published October 21, 2020. Full text

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Metformin Linked to Reduced Cognitive Decline, Dementia Risk

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Metformin Linked to Reduced Cognitive Decline, Dementia Risk

Older people taking metformin, the first-line treatment for type 2 diabetes, show significantly lower rates of dementia and cognitive decline compared to those with diabetes not receiving the drug, with the former having dementia rates that are, in fact, similar to people without diabetes, new research shows.

“After controlling for dementia risk factors that might promote cognitive aging, metformin appeared to mitigate the effect of diabetes on cognitive decline in older people,” first author Katherine Samaras, MBBS, PhD, told Medscape Medical News.

The findings are notable considering the increased risk of cognitive decline that is associated with diabetes, said Samaras, leader of the Healthy Ageing Research Theme at the Garvan Institute and an endocrinologist at St Vincent’s Hospital, Sydney, Australia.

“As they age, people living with type 2 diabetes have a staggering 60% risk of developing dementia, a devastating condition that impacts thinking, behavior, the ability to perform everyday tasks, and the ability to maintain independence,” she said in a press release issued by her institute.

And the results are particularly remarkable in that “few prior studies have controlled for multiple dementia risk factors, including the dementia susceptibility gene APOE4,” Samaras emphasized. 

As the front-line drug treatment for type 2 diabetes, metformin has been extensively studied and, with some other research also showing cognitive benefits, “these results are not surprising,” Mark E. Molitch, MD, told Medscape Medical News.

Nevertheless, “this reinforces the idea that metformin should be the first drug used to treat diabetes, and it should be continued if other drugs are added for blood glucose control,” said Molitch, of the Division of Endocrinology, Metabolism & Molecular Medicine, at the Northwestern University Feinberg School of Medicine in Chicago, Illinois

Diabetes Care. Published online September 23, 2020. Abstract

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Exercise Cuts Diabetes Death Risk by a Third

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Exercise Cuts Diabetes Death Risk by a Third

Type 2 diabetes patients could lower their risk for death from any cause by up to a third by exercising at a moderate to high level or by cycling, according to data from two studies reported at the virtual annual meeting of the European Association for the Study of Diabetes.

Yun-Ju Lai, MD, and colleagues from the Puli branch of Taichung Veterans General Hospital in Nantou, Taiwan, found that persons with type 2 diabetes who exercised at moderate to high intensity had a 25%-32% decreased risk for death, compared with those who did not exercise.

In a separate study, Mathias Ried-Larsen, MSc, PhD, group leader at the Centre for Physical Activity Research, Rigshospitalet, Copenhagen, and associates found that cycling was associated with a 25%-31% decreased risk for all-cause death compared to no cycling, and that cycling also reduced cardiovascular mortality.

Tailored Exercise Program Important

Advice for exercise “should be tailored to the individual and based on starting fitness levels and activity levels,” Dr. Colberg-Ochs recommended.

“Those who are the most sedentary and the least fit have the most to gain from doing any activity. They should be advised to start out slowly and progress slowly with both aerobic activities and some resistance training,” Dr. Colberg-Ochs said.

She added: “In addition, individuals over 40 should engage in regular balance training, and all individuals should do some flexibility exercises.”

The studies received no commercial funding and all those mentioned in this article had no conflicts of interest to disclose.

SOURCE: Lai Y-J et al. EASD 2020, Poster presentation 267; Ried-Larsen M et al. EASD 2020, Oral presentation 194.

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More Proof That High White Rice Intake Increases Type 2 Diabetes Risk


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More Proof That High White Rice Intake Increases Type 2 Diabetes Risk

Consuming more than 3 cups/day of white rice significantly increases the risk of diabetes compared with eating lower amounts, a new analysis of the multinational, multiethnic Prospective Urban Rural Epidemiology (PURE) study suggests.

In addition, the results show that those living in South Asian countries ate the most white rice and subsequently had the highest likelihood of developing type 2 diabetes.

Compared with participants who ate less than 1 cup/day (150 g/day) of cooked white rice, those who ate more than 3 cups/day (> 450 g/day) had a 20% higher risk of developing diabetes over a mean follow-up of 9.5 years (P = .003).

However, among South Asian participants, who consumed a median of 630 g/day of white rice, the risk of diabetes was 61% higher compared to those who consumed less than 150 g/day (P = .02), Balaji Bhavadharini, MD, McMaster University, Hamilton, Ontario, Canada, and colleagues report in their article, published online in Diabetes Care.

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Hot Tubs Improve A1c, BMI, and Blood Pressure in Type 2 Diabetes

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Hot Tubs Improve A1c, BMI, and Blood Pressure in Type 2 Diabetes

Frequent hot tub bathing had a positive impact on glycemia, blood pressure, and body weight in patients with type 2 diabetes, in the first real-world study to analyze the effect of this type of heat therapy in such individuals.

“The data from our analysis showed that the frequency of hot tub bathing could have beneficial influences on diabetic control, hypertension, and obesity even after adjusting for confounding factors,” Hisayuki Katsuyama, MD, told Medscape Medical News.

Katsuyama presented the findings as a poster at the virtual European Association for the Study of Diabetes (EASD) Annual Meeting 2020. The study aimed to explore the real-world influence of habitual hot tub bathing on the control of type 2 diabetes and other cardiovascular risk factors.

“Heat therapy, shown here with hot tub bathing, can be one effective therapeutic option for type 2 diabetes in daily life. An alternative form of heat exposure might be nutrition therapy and exercise,” noted Katsuyama, from Kohnodai Hospital, Ichikawa, Chiba, Japan.

EASD 2020. Presented September 22, 2020. Abstract 342.

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Even Moderate Drinking May Raise Hypertension Risk in Diabetes

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Even Moderate Drinking May Raise Hypertension Risk in Diabetes

New research suggests that even moderate alcohol consumption may raise hypertension risk in adults with type 2 diabetes (T2D).

Investigators analyzed data from over 10,000 adults participating in the ACCORD trial and found that moderate alcohol consumption raised the odds of elevated blood pressure (BP), stage I hypertension, and stage II hypertension by 79%, 66%, and 62%, respectively.

After accounting for covariates, the researchers found that heavy alcohol consumption was associated with an almost twofold risk of elevated BP, a 2.5-fold increase of stage I hypertension, and a threefold risk of stage II hypertension.

“Since moderate and heavy alcohol consumption are independently associated with higher odds of hypertension in patients with diabetes in this trial, we advise discussing the effects of moderate and heavy alcohol consumption on blood pressure in patients with diabetes, especially those who are having difficulty achieving adequate control of their hypertension,” senior author Matthew J. Singleton, MD, chief electrophysiology fellow at Wake Forest School of Medicine, Winston-Salem, North Carolina, told theheart.org | Medscape Cardiology.

The new results from ACCORD were published online September 9 in the Journal of the American Heart Association.

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20 Effective Tips to Lose Belly Fat (Backed by Science)

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20 Effective Tips to Lose Belly Fat (Backed by Science)

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Belly fat is more than a nuisance that makes your clothes feel tight.

It’s seriously harmful.

This type of fat — referred to as visceral fat — is a major risk factor for type 2 diabetes, heart disease, and other conditions (1).

Many health organizations use body mass index (BMI) to classify weight and predict the risk of metabolic disease.

However, this is misleading, as people with excess belly fat are at an increased risk even if they look thin (2).

Though losing fat from this area can be difficult, there are several things you can do to reduce excess abdominal fat.

Here are 20 effective tips to lose belly fat, backed by scientific studies.

1. Eat plenty of soluble fiber

Soluble fiber absorbs water and forms a gel that helps slow down food as it passes through your digestive system.

Studies show that this type of fiber promotes weight loss by helping you feel full, so you naturally eat less. It may also decrease the number of calories your body absorbs from food (345).

What’s more, soluble fiber may help fight belly fat.

An observational study in over 1,100 adults found that for every 10-gram increase in soluble fiber intake, belly fat gain decreased by 3.7% over a 5-year period (6).

Make an effort to consume high fiber foods every day. Excellent sources of soluble fiber include:


Soluble fiber may help you to lose weight by increasing fullness and reducing calorie absorption. Try to include plenty of high fiber foods in your weight loss diet.

2. Avoid foods that contain trans fats

Trans fats are created by pumping hydrogen into unsaturated fats, such as soybean oil.

They’re found in some margarines and spreads and also often added to packaged foods, but many food producers have stopped using them.

These fats have been linked to inflammation, heart disease, insulin resistance, and abdominal fat gain in observational and animal studies (789).

A 6-year study found that monkeys who ate a high trans fat diet gained 33% more abdominal fat than those eating a diet high in monounsaturated fat (10).

To help reduce belly fat and protect your health, read ingredient labels carefully and stay away from products that contain trans fats. These are often listed as partially hydrogenated fats.


Some studies have linked a high intake of trans fat to increased belly fat gain. Regardless of whether you’re trying to lose weight, limiting your intake of trans fat is a good idea.

3. Don’t drink too much alcohol

Alcohol can have health benefits in small amounts, but it’s seriously harmful if you drink too much.

Research suggests that too much alcohol can also make you gain belly fat.

Observational studies link heavy alcohol consumption to a significantly increased risk of developing central obesity — that is, excess fat storage around the waist (1112).

Cutting back on alcohol may help reduce your waist size. You don’t need to give it up altogether, but limiting the amount you drink in a single day can help.

One study on alcohol use involved more than 2,000 people.

Results showed those who drank alcohol daily but averaged less than one drink per day had less belly fat than those who drank less frequently but consumed more alcohol on the days they drank (12).


Excessive alcohol intake has been associated with increased belly fat. If you need to reduce your waistline, consider drinking alcohol in moderation or abstaining completely.

4. Eat a high protein diet

Protein is an extremely important nutrient for weight management.

High protein intake increases the release of the fullness hormone PYY, which decreases appetite and promotes fullness.

Protein also raises your metabolic rate and helps you to retain muscle mass during weight loss (131415).

Many observational studies show that people who eat more protein tend to have less abdominal fat than those who eat a lower protein diet (161718).

Be sure to include a good protein source at every meal, such as:

  • meat
  • fish
  • eggs
  • dairy
  • whey protein
  • beans


High protein foods, such as fish, lean meat, and beans, are ideal if you’re trying to shed some extra pounds around your waist.

5. Reduce your stress levels

Stress can make you gain belly fat by triggering the adrenal glands to produce cortisol, which is also known as the stress hormone.

Research shows that high cortisol levels increase appetite and drive abdominal fat storage (1920).

What’s more, women who already have a large waist tend to produce more cortisol in response to stress. Increased cortisol further adds to fat gain around the middle (21).

To help reduce belly fat, engage in pleasurable activities that relieve stress. Practicing yoga or meditation can be effective methods.


Stress may promote fat gain around your waist. Minimizing stress should be one of your priorities if you’re trying to lose weight.

6. Don’t eat a lot of sugary foods

Sugar contains fructose, which has been linked to several chronic diseases when consumed in excess.

These include heart disease, type 2 diabetes, obesity, and fatty liver disease (222324).

Observational studies show a relationship between high sugar intake and increased abdominal fat (2526).

It’s important to realize that more than just refined sugar can lead to belly fat gain. Even healthier sugars, such as real honey, should be used sparingly.


Excessive sugar intake is a major cause of weight gain in many people. Limit your intake of candy and processed foods high in added sugar.

7. Do aerobic exercise (cardio)

Aerobic exercise (cardio) is an effective way to improve your health and burn calories.

Studies also show that it’s one of the most effective forms of exercise for reducing belly fat. However, results are mixed as to whether moderate or high intensity exercise is more beneficial (272829).

In any case, the frequency and duration of your exercise program are more important than its intensity.

One study found that postmenopausal women lost more fat from all areas when they did aerobic exercise for 300 minutes per week, compared with those who exercised 150 minutes per week (30).


Aerobic exercise is an effective weight loss method. Studies suggest it’s particularly effective at slimming your waistline.

8. Cut back on carbs — especially refined carbs

Reducing your carb intake can be very beneficial for losing fat, including abdominal fat.

Diets with under 50 grams of carbs per day cause belly fat loss in people who are overweight, those at risk for type 2 diabetes, and women with polycystic ovary syndrome (PCOS) (313233).

You don’t have to follow a strict low carb diet. Some research suggests that simply replacing refined carbs with unprocessed starchy carbs may improve metabolic health and reduce belly fat (3435).

In the famous Framingham Heart Study, people with the highest consumption of whole grains were 17% less likely to have excess abdominal fat than those who consumed diets high in refined grains (36).


A high intake of refined carbs is associated with excessive belly fat. Consider reducing your carb intake or replacing refined carbs in your diet with healthy carb sources, such as whole grains, legumes, or vegetables.

9. Replace some of your cooking fats with coconut oil

Coconut oil is one of the healthiest fats you can eat.

Studies show that the medium-chain fats in coconut oil may boost metabolism and decrease the amount of fat you store in response to high calorie intake (3738).

Controlled studies suggest it may also lead to abdominal fat loss (39).

In one study, men with obesity who took coconut oil daily for 12 weeks lost an average of 1.1 inches (2.86 cm) from their waists without intentionally changing their diets or exercise routines (40).

However, evidence for the benefits of coconut oil for abdominal fat loss is weak and controversial (41).

Also, keep in mind that coconut oil is high in calories. Instead of adding extra fat to your diet, replace some of the fats you’re already eating with coconut oil.


Studies suggest that using coconut oil instead of other cooking oils may help reduce abdominal fat.

10. Perform resistance training (lift weights)

Resistance training, also known as weight lifting or strength training, is important for preserving and gaining muscle mass.

Based on studies involving people with prediabetes, type 2 diabetes, and fatty liver disease, resistance training may also be beneficial for belly fat loss (4243).

In fact, one study involving teenagers with overweight showed that a combination of strength training and aerobic exercise led to the greatest decrease in visceral fat (44).

If you decide to start lifting weights, it’s a good idea to get advice from a certified personal trainer.


Strength training can be an important weight loss strategy and may help reduce belly fat. Studies suggest it’s even more effective in combination with aerobic exercise.

11. Avoid sugar-sweetened beverages

Sugar-sweetened beverages are loaded with liquid fructose, which can make you gain belly fat.

Studies show that sugary drinks lead to increased fat in the liver. One 10-week study found significant abdominal fat gain in people who consumed high fructose beverages (454647).

Sugary beverages appear to be even worse than high sugar foods.

Since your brain doesn’t process liquid calories the same way it does solid ones, you’re likely to end up consuming too many calories later on and storing them as fat (4849).

To lose belly fat, it’s best to completely avoid sugar-sweetened beverages such as:

  • soda
  • punch
  • sweet tea
  • alcoholic mixers containing sugar


Avoiding all liquid forms of sugar, such as sugar-sweetened beverages, is very important if you’re trying to shed some extra pounds.

12. Get plenty of restful sleep

Sleep is important for many aspects of your health, including weight. Studies show that people who don’t get enough sleep tend to gain more weight, which may include belly fat (5051).

A 16-year study involving more than 68,000 women found that those who slept less than 5 hours per night were significantly more likely to gain weight than those who slept 7 hours or more per night (52).

The condition known as sleep apnea, where breathing stops intermittently during the night, has also been linked to excess visceral fat (53).

In addition to sleeping at least 7 hours per night, make sure you’re getting sufficient quality sleep.

If you suspect you may have sleep apnea or another sleep disorder, speak to a doctor and get treated.


Sleep deprivation is linked to an increased risk of weight gain. Getting enough high quality sleep should be one of your main priorities if you plan to lose weight and improve your health.

13. Track your food intake and exercise

Many things can help you lose weight and belly fat, but consuming fewer calories than your body needs for weight maintenance is key (54).

Keeping a food diary or using an online food tracker or app can help you monitor your calorie intake. This strategy has been shown to be beneficial for weight loss (5556).

In addition, food-tracking tools help you to see your intake of protein, carbs, fiber, and micronutrients. Many also allow you to record your exercise and physical activity.


As a general weight loss advice, it’s always a good idea to keep track of what you’re eating. Keeping a food diary or using an online food tracker are two of the most popular ways to do this.

14. Eat fatty fish every week

Fatty fish are incredibly healthy.

They’re rich in high quality protein and omega-3 fats that protect you from disease (5758).

Some evidence suggests that these omega-3 fats may also help reduce visceral fat.

Studies in adults and children with fatty liver disease show that fish oil supplements can significantly reduce liver and abdominal fat (596061).

Aim to get 2–3 servings of fatty fish per week. Good choices include:

  • salmon
  • herring
  • sardines
  • mackerel
  • anchovies


Eating fatty fish or taking omega-3 supplements may improve your overall health. Some evidence also suggests it may reduce belly fat in people with fatty liver disease.

15. Stop drinking fruit juice

Although fruit juice provides vitamins and minerals, it’s just as high in sugar as soda and other sweetened beverages.

Drinking large amounts may carry the same risk for abdominal fat gain (62).

An 8-ounce (240-mL) serving of unsweetened apple juice contains 24 grams of sugar, half of which is fructose (63).

To help reduce excess belly fat, replace fruit juice with water, unsweetened iced tea, or sparkling water with a wedge of lemon or lime.


When it comes to fat gain, fruit juice can be just as bad as sugary soda. Consider avoiding all sources of liquid sugar to increase your chance of successfully losing weight.

16. Add apple cider vinegar to your diet

Drinking apple cider vinegar has impressive health benefits, including lowering blood sugar levels (64).

It contains acetic acid, which has been shown to reduce abdominal fat storage in several animal studies (656667).

In a 12-week controlled study in men diagnosed with obesity, those who took 1 tablespoon (15 mL) of apple cider vinegar per day lost half an inch (1.4 cm) from their waists (68).

Taking 1–2 tablespoons (15–30 mL) of apple cider vinegar per day is safe for most people and may lead to modest fat loss.

However, be sure to dilute it with water, as undiluted vinegar can erode the enamel on your teeth.

If you want to try apple cider vinegar, there’s a good selection to choose from online.


Apple cider vinegar may help you to lose some weight. Animal studies suggest it may help to reduce belly fat.

17. Eat probiotic foods or take a probiotic supplement

Probiotics are bacteria found in some foods and supplements. They have many health benefits, including helping improve gut health and enhancing immune function (69).

Researchers have found that different types of bacteria play a role in weight regulation and that having the right balance can help with weight loss, including loss of belly fat.

Those shown to reduce belly fat include members of the Lactobacillus family, such as Lactobacillus fermentumLactobacillus amylovorus and especially Lactobacillus gasseri (70717273).

Probiotic supplements typically contain several types of bacteria, so make sure you purchase one that provides one or more of these bacterial strains.

Shop probiotic supplements online.


Taking probiotic supplements may help promote a healthy digestive system. Studies also suggest that beneficial gut bacteria may help promote weight loss.

18. Try intermittent fasting

Intermittent fasting has recently become very popular as a weight loss method.

It’s an eating pattern that cycles between periods of eating and periods of fasting (74).

One popular method involves 24-hour fasts once or twice a week. Another consists of fasting every day for 16 hours and eating all your food within an 8-hour period.

In a review of studies on intermittent fasting and alternate-day fasting, people experienced a 4–7% decrease in abdominal fat within 6–24 weeks (75).

There’s some evidence that intermittent fasting, and fasting in general, may not be as beneficial for women as for men.

Although certain modified intermittent fasting methods appear to be better options, stop fasting immediately if you experience any negative effects.


Intermittent fasting is an eating pattern that alternates between periods of eating and fasting. Studies suggest that it may be one of the most effective ways to lose weight and belly fat.

19. Drink green tea

Green tea is an exceptionally healthy beverage.

It contains caffeine and the antioxidant epigallocatechin gallate (EGCG), both of which appear to boost metabolism (7677).

EGCG is a catechin, which several studies suggest may help you lose belly fat. The effect may be strengthened when green tea consumption is combined with exercise (787980).


Regularly drinking green tea has been linked to weight loss, though it’s probably not as effective on its own and best combined with exercise.

20. Change your lifestyle and combine different methods

Just doing one of the items on this list won’t have a big effect on its own.

If you want good results, you need to combine different methods that have been shown to be effective.

Interestingly, many of these methods are things generally associated with healthy eating and an overall healthy lifestyle.

Therefore, changing your lifestyle for the long term is the key to losing your belly fat and keeping it off.

When you have healthy habits and eat real food, fat loss tends to follow as a natural side effect.


Losing weight and keeping it off is difficult unless you permanently change your dietary habits and lifestyle.

The bottom line

There are no magic solutions to losing belly fat.

Weight loss always requires some effort, commitment, and perseverance on your behalf.

Successfully adopting some or all of the strategies and lifestyle goals discussed in this article will definitely help you lose the extra pounds around your waist.

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22 effective tips to lose belly fat, according to experts

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22 effective tips to lose belly fat, according to experts

isceral fat, also known as abdominal or ‘belly’ fat, is fat that develops around your mid-section, surrounding vital organs like your liver and pancreas. It’s different to subcutaneous fat, which you can pinch with your hands.

In healthy amounts, subcutaneous fat has several important functions – it insulates and regulates the temperature of your body, for example. Belly fat, by contrast, promotes long-lasting inflammation, which can increase your risk of chronic diseases.

We asked Dr Samantha Wild, GP at Bupa UK, and Clarissa Lenherr, nutritionist at Bioniq, for their tips on how to lose belly fat for good:

How to lose belly fat: 22 effective tips

Fat cells don’t simply store energy, they also produce hormones and secrete inflammatory substances into the body. For this reason, having high levels of any type of body fat is bad for your health – but this type of belly fat is the most villainous.

“Whether you’re overweight or not, carrying more visceral fat around your stomach can increase your risk of health problems, such as high blood pressure, heart and circulatory problems, type 2 diabetes and sleep apnoea,” Dr Wild explains.

Since this kind of belly fat wraps around your internal organs, it’s hard to tell how much you carry. “We’re all at risk of developing visceral fat, so it’s really important we manage our lifestyle by making small, sustainable changes to help keep us healthy,” says Wild.

Here’s how:


If you aren’t already eating a source of lean protein such as salmon, eggs, or lentils at every mealtime, now’s the time to start. Not only is it incredibly satiating – eating protein stimulates the hormone PYY, which reduces appetite and promotes fullness – but it also protects your body composition as you lose weight.

When you’re in a calorie deficit, you risk losing muscle as well as fat. Eating adequate amounts of protein staves off hunger while preserving muscle mass, a University of Illinois study found. Recommended intake varies from person to person – the reference intake in the UK is set at 0.83 grams of protein per kilogram of body weight, Lenherr explains.


Keeping well hydrated is important for many reasons – but did you know that drinking a pint of water three times a day before mealtimes could also help your weight loss efforts? In a 12-week University of Birmingham study, obese adults who drank 500ml of water half an hour before eating their main meals lost 3.5kg more than a control group who did so once or not at all. “Aim to drink around six to eight glasses of water each day,” says Wild.


When you eat soluble fibre, it forms a gel-like consistency that slows digestion, promoting fullness and decreasing the number of calories your body absorbs from food. It’s also linked to lower levels of belly fat. For every 10g increase in soluble fibre eaten per day – the equivalent of eating two small apples, 130g green peas and 85g pinto beans – belly fat was reduced by 3.7 per cent over five years, an observational study by researchers from Wake Forest Baptist Medical Centre found.

“The recommended daily intake of fibre is 30g, while the average UK individual consumes just 18g, according to the British Dietetic Association,” says Lenherr. “Fibre plays a huge role in digestion, cardiovascular health, balanced blood sugar, weight management, hormone health and more. To increase your fibre intake, include whole grains, nuts and seeds, pulses and fruits and vegetables into your daily diet.”


Cortisol is a stress hormone released by the adrenal glands. It affects fat distribution by causing fat to be stored centrally – as belly fat – rather than peripherally, at the hips. The more cortisol you release, the greater your levels of this type of fat, a Yale study found. “Think about your lifestyle – where you can, try to reduce your stress levels,” says Wild. “Your mental wellbeing is just as important as your physical health, so take some time to focus on yourself. Make sure you spend time relaxing, too.”


The type of fat you eat determines where it will be stored in your body. In a seven-week study by Uppsala University, participants gained weight by consuming excess calories from either muffins made of saturated fat (palm oil) or polyunsaturated fat (sunflower oil). Those who ate the saturated fat muffins gained more body fat, more belly fat, and three times less muscle than the group who ate muffins made with polyunsaturated fat. Additionally, monounsaturated fatty acids – found abundantly in olive oil, as well as peanuts and avocados – have been shown to have beneficial effects on belly fat.


Soft drinks appear to be even worse for belly fat than consuming high sugar foods, since your brain is less efficient at registering liquid calories (this is true of fruit juice, too). Studies have consistently shown a correlation between sweetened beverage consumption and an increase in belly fat. In a six-year observational study by the American Heart Association, among those who drank one soft drink daily, belly fat volume increased by 852 centimetres cubed.


They may be free from sugar, but diet drinks – packed with artificial sweeteners, such as aspartame, saccharin, or sucralose – also play havoc with your waistline. Another observational study, this time by the University of Illinois, found that drinkers of diet soda compensate for the absence of calories by eating greater quantities of ‘discretionary foods’ such as cookies, ice cream, chocolate, fries and pastries.


People who pay a high degree of attention to their present thoughts and feelings – known as “dispositional mindfulness” – are less likely to be obese and have less abdominal fat than people who do not exhibit as much awareness, a study from Brown University found. Dispositional mindfulness is more like an “inherent personality trait”, the researchers said, rather than mindfulness meditation, which is a focused and deliberate awareness of the present moment. However, it can be learned by regularly practicing meditation.


While physical inactivity leads to a significant increase in belly fat, a randomised clinical trial by Duke University Medical Centre found, high amounts of exercise can lead to significant decreases relatively quickly. Participants who did not exercise had an 8.6 per cent increase in belly fat after eight months, while those who exercised the most saw a 8.1 per cent decrease in belly fat in the same period.


Interval training may shed more pounds than a continuous moderate intensity workout, according to analysis published in the British Journal of Sports Medicine, with sprint interval training the most effective for fat loss. “HIIT – high intensity interval training – is a great option for those with a busy lifestyle, as you’ll increase your heart rate and burn fat in a short amount of time,” says Wild. “Your body will reap the benefits of a HIIT workout for hours after your workout, too.”

‘High intensity interval training is a great option for those with a busy lifestyle, as you’ll increase your heart rate and burn fat in a short amount of time.’

And if high intensity workouts aren’t for you? No sweat. Even moderate amounts of exercise can reduce the amount of inflammation in belly fat, according to a rodent study by the University of Illinois, helping to safeguard your health. Belly fat produces inflammatory molecules that enter the bloodstream and increase the risk of heart disease and diabetes.


Ditch refined grains such as white bread, white rice, and white pasta for their healthier whole counterparts. People who consume three or more daily servings of whole grains – for example, whole wheat bread, brown rice and oats – while limiting their daily intake of refined grains to less than one serving per day, have around 10 per cent less belly fat than those who choose refined grains every time, research from Tufts University found.

Not all calories are created equal, says Lenherr. “The calories in an avocado might be the same as a portion of fries, but the impact and nutritional intake of these two foods are definitely not the same,” she says. “Calorie counting is a popular way of losing weight, which may work for some individuals, but there is a significant difference between a low-calorie diet of plant foods versus a diet filled with refined carbohydrates and sugars.”


We know this deep down, but now science has confirmed it: snacking on high-fat and high-sugar foods is independently associated with an increase in abdominal fat. According to a study published in Hepatology, eating high-calorie snacks in addition to three main meals a day increases the accumulation of abdominal fat and fat in the liver, whereas eating larger balanced meals at mealtimes does not.


Omega-3 fatty acids are a family of fats that are essential for human health. They’re found in high amounts in fatty fish like salmon and herring, and also in algae supplements. There’s scientific evidence that getting adequate omega-3s – either through your diet or as a supplement – helps to reduce your appetite, increase your metabolism, and amplify the number of calories and amount of fat you burn during exercise. Multiple studies of patients with fatty liver disease have shown that fish oil supplements can significantly reduce abdominal fat.


Good news for your morning cup of joe. Women who drink two or three cups of coffee a day have lower total body and abdominal fat than those who drink less, a study by Anglia Ruskin University found, with drinkers between the ages of 20 and 24 having 3.4 per cent less belly fat than those who did not consume coffee. ‘Our research suggests that there may be bioactive compounds in coffee other than caffeine that regulate weight and which could potentially be used as anti-obesity compounds,’ wrote lead researcher Dr Lee Smith.


There are so many reasons to mix up your workouts with a range of activities – not least because it makes exercise more interesting. But when it comes to burning belly fat, cardio is king. Researchers from Duke University Medical Center compared aerobic exercise, resistance training, and a combination of the two, to find out which was best for fighting belly fat.

Aerobic exercise – performed as the sole exercise method or alongside resistance training – was found to be more efficient and effective than resistance training alone, significantly reducing belly fat, liver fat, liver enzyme levels and fasting triglyceride levels, and improving insulin resistance. Plus, it was found to burn 67 per cent more calories than hitting the weights.

17. DON’T ‘DIET’

While you have most likely heard or gluten-free or dairy-free, many popular diets are also calling for people to be nightshade-free, sugar-free, lectin-free or grain-free, says Lenherr. “There are a number of problems with eliminating whole food groups unnecessarily, especially without the support of a nutritionist,” she says – from risking nutritional deficiencies to missing out on essential protein and fibre.

“On top of this, a reductionist way of eating can leave people feeling unmotivated and bored, which increases the likelihood of unhealthy cravings and giving up on the diet altogether,” Lenherr continues. “For those still wanting to cut out whole food groups, make sure you speak with a nutritionist to ensure you avoid any unwanted health implications.”


A lack of shut-eye has long been associated with a wider waistline. A poor night’s sleep has an effect on your hunger hormones – causing levels of appetite stimulant ghrelin to rise, and appetite suppressant leptin to fall – which can make you feel especially ravenous. And unfortunately, many sleep disorders, like sleep apnea, are worsened by weight gain.

meta-analysis by the University of Warwick Medical School found that short sleep duration increased the likelihood of obesity by 55 per cent in adults. And there have been controlled studies, too – when 16 adults were allowed just five hours of sleep per night for five nights, they each gained an average of 0.82kg.


Intermittent fasting is an eating pattern that alternates between set periods of eating and fasting – typically eating all your food in an eight hour window, and abstaining from eating for 16. In a review of studies on intermittent fasting by the University of Illinois, people experienced up to a 7 per cent decrease in abdominal fat within 24 weeks. This approach to eating doesn’t suit everyone, and for people with certain health issues such as diabetes, it may even be dangerous. Seek advice from a healthcare professional before attempting this approach.


Probiotics are live microorganisms that provide a wealth of health benefits when eaten. Certain probiotics, such as those from the Lactobacillus family, inhibit the absorption of fat from your diet. They also stimulate the release of a hormone called GLP-1, which helps to burn calories and fat. A strain called Lactobacillus gasseri has been found to have impressive anti-obesity effects. In a Japanese study spanning 210 participants, taking this supplement for 12 weeks reduced belly fat by 8.5 per cent on average.


There’s a reason it’s called a ‘beer belly’. As well as being high in calories, alcohol decreases leptin levels – the hunger suppressant – making you want to eat more. It also interferes with your body’s ability to process carbohydrates and fats from food, and several studies have shown that drinking too much alcohol may encourage fat to be stored as belly fat, so limiting your intake is advised. Unfortunately, a study by the University of Verona found that even moderate alcohol intake is linked to carrying more belly fat.


There’s no quick fix to lose your belly fat, so make sure you find a healthy lifestyle that works for you, says Wild. ‘Vary your exercise routines and find a few exercises that you enjoy. Swapping for healthier food habits doesn’t need to be boring, there’s lots of tasty alternatives to your favourite meals,’ she says. ‘It’s important to make healthy habits that you enjoy to help keep you motivated to achieve your health goals. Set yourself small, achievable goals each week and write them down – it will help you to stick to them.’

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Good Lifestyle Choices Prevent Kidney Disease as Well as CV Disease

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Good Lifestyle Choices Prevent Kidney Disease as Well as CV Disease

Many of the same healthy lifestyle choices recommended for the prevention of cardiovascular disease (CVD) also stall the development of chronic kidney disease (CKD), according to a new systematic review and meta-analysis in a healthy adult population.

“No evidence-based lifestyle recommendations for the primary prevention of CKD” have previously been apparent, write Jaimon Kelly, PhD, a postdoctoral fellow, Griffith University, South East Queensland, Australia, and colleagues in their article published online August 31 in the Journal of the American Society of Nephrology.

“We discovered that lifestyle plays a big role and identified a number of recommendations that can be conveyed to healthy people wanting to reduce their risk of developing chronic kidney disease,” said Kelly in a press release.

“We found higher intake of potassium and vegetables, lower intake of sodium, physical activity, moderate alcohol consumption, and avoidance of tobacco smoking to be consistently associated with lower risk of CKD,” he and his colleagues emphasize.

Adherence to these recommendations could reduce the risk of CKD by 14% to 22%, they calculate.

“In the absence of randomized intervention studies in the field, this study is the best evidence we have to date on what lifestyle choices can help for primary prevention of kidney disease,” said senior author, Juan Jesus Carrero, PhD, professor of epidemiology at the Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Sweden.

“The results can be used in the development of public health recommendations and in discussions with patients on how to lower their risk of kidney disease,” he added.

The researchers stress that the advice applies to healthy people at risk of developing kidney problems and that people already suffering from renal disease are to follow other lifestyle recommendations to avoid unnecessary strain on their kidneys.

Studies Looked at Diet, Physical Activity, Smoking, and Alcohol Intake

Their research looked at the association between lifestyle factors and risk of incident CKD in 51 studies involving 1,221,018 adults who did not have established CKD at baseline.

“The primary outcome was incident CKD, defined as the development of estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 during follow-up,” the investigators observe.

Thirty-one studies involving 176,625 participants explored the association between dietary factors and risk of CKD and 10 studies involving 78,301 participants assessed the effect that physical activity has on the same risk endpoint.

Lifestyle factors associated with CKD risk in adults are summarized in below.

Table 1. Factors Associated With Risk of CKD in Adults

Factor Odds ratio
Higher vegetable intake 0.79
Higher potassium intake 0.78
Physical activity 0.82
Moderate alcohol intake 0.87
Smoking 1.18
Higher sodium intake 1.21


Markers of Kidney Damage

The meta-analysis also showed risk factors aligned with other markers of kidney damage, including the need for renal replacement therapy (RRT), a decline in eGFR, and risk of albuminuria.

For example, the risk of a decline in eGFR was 51% lower in participants with a higher potassium intake (relative risk [RR], 0.49), the authors note.

Higher levels of vegetable consumption were associated with a higher potassium intake, and the latter was “associated with reduced incident CKD and GFR decline, adding to the growing evidence base for the protective association of potassium intake,” they observe.

“Similarly, higher sodium intake showed a consistent association with increased risk of incident CKD, RRT, and GFR decline,” Kelly and colleagues note.

And among those who were more physically active, risk of a decline in eGFR was 34% lower in those who were less physically active (OR, 0.76). Likewise, the risk of albuminuria was 12% lower among physically active adults (OR, 0.88).

This finding aligns with the results of other studies and supports the idea that physical activity — defined as at least 30 minutes/day of physical activity — reduces the risk of kidney damage.

Meanwhile, the inverse association between alcohol intake and risk of CKD, as well as secondary endpoints of RRT and eGFR decline, has been previously supported by multiple studies, the researchers point out.

However, this association would appear to hold true only for moderate alcohol consumption in the range of 1 to 4 drinks/day, as higher levels of alcohol consumption are believed to directly damage the kidney.

Lastly, the risk of RRT was 59% higher among current and former smokers compared with never smokers (RR, 1.59), and the risk of albuminuria was 67% higher among smokers compared with never smokers (OR, 1.67).

“Taken together, these risk factors for kidney function decline clearly support a public health message to avoid tobacco smoking to prevent kidney disease as well as CVD,” Kelly and colleagues advise.

The study received no funding. Kelly has reported receiving consultancy fees from Amgen and HealthCert.

J Am Soc Nephrol. Published online August 31, 2020. Abstract

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A Visual Guide to PCOS

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A Visual Guide to PCOS

mri of ovarian cysts

What Is It?

Polycystic ovary syndrome is a hormonal disorder that affects millions of women. Sometimes it’s called Stein-Leventhal syndrome.

All bodies need both “male” and “female” hormones to work right, but a woman with PCOS has too much of the male kind. This creates problems with your ovaries: You might have irregular periods or no periods, and you could get cysts in a “string of pearls” pattern. PCOS is also a common cause of infertility.

The condition can’t be cured, but it can be treated.

woman with facial hair

Other Symptoms

You’ll tend to gain weight, especially around the waist, and have a hard time losing it. You’ll often grow extra hair or have thinning hair. You may get acne or dark patches of skin. Pelvic pain and depression are also possible symptoms.

family with photo album


Doctors don’t know exactly why you get it, but some researchers think high levels of insulin are at the root of the illness. If you’re overweight, your chances of developing it are greater.

Your genes play a role, too. If your mother or sister has PCOS, you’re more likely to have it. Most women are diagnosed in their 20s or 30s. But even girls as young as 11, who haven’t gotten their period yet, can have it.

blood sample


PCOS symptoms affect as many as 5 million women. To be diagnosed, you’ll have at least two of these: infrequent and irregular periods, a high level of specific hormones, and more than 12 cysts. Find a doctor who specializes in it. They’ll ask you about your family, check your body and your ovaries, and take a blood sample. They’ll probably rule out other issues, such as a thyroid problem, first.

birth control pills


You can take medicine to help relieve symptoms. Your doctor may give you birth control pills to regulate your period or another hormone occasionally to start your period. Metformin, a diabetes medicine, may lower your “male” hormone levels. So does the drug spironolactone (Aldactone). You can also try medicated creams and laser treatments to get rid of extra hair.

woman stretching

Natural Treatments

Weight loss is one of the best things you can do: It makes your periods more normal, and it can also lessen hair growth and depression. Eating well is a big part of that. Also pay attention to how foods affect your blood sugar and insulin, like you would for diabetes. Exercise, the kind that gets your heart pumping, as well as lifting weights to keep your muscles strong, will help control your weight, your stress, and your feelings. If you smoke, quit.

in vitro fertilization

Infertility Treatment

In a very small study of women with this condition, most of them who dropped more than 5% of their weight either got pregnant or had more regular periods. The most common drug used for infertility caused by PCOS, clomiphene, triggers the release of mature eggs. Your doctor may suggest other drugs, too, or in vitro fertilization.

pregnant woman with doctor


Your doctor will want to watch you for signs of gestational diabetes, high blood pressure, and early labor and delivery. New research suggests that the diabetes drug metformin will help prevent pregnancy-related issues.

Babies who are born to moms with PCOS may spend more time in intensive care.

checking blood pressure

Related Health Risks

When you have PCOS, you need to see your doctor regularly for checkups. You’re more likely to have trouble from:

  • High cholesterol, which may lead to heart disease, including high blood pressure and heart attack
  • Insulin resistance, metabolic syndrome, and type 2 diabetes
  • Obesity
  • Sleep apnea
  • Mood disorders, like depression and bipolar disorder
  • Endometrial cancer, especially when you’re older

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