By Sara Gottfried M.D.
Flush with anticipation about your office's big holiday party tonight, you load some essentials into your black leather clutch and reach for that new pair of skinny jeans you specifically purchased for the occasion.
Gazing in the mirror, you admire the way those jeans frame your legs and minimize your backside. But overall, you're not loving the look and you suddenly realize why: your jeans fit perfectly except for that annoying flab spilling over your waist.
Welcome to muffin top purgatory.
I needn't explain that moment: you've likely experienced it, probably at the worst possible time as you're about to head to a big party or first date. You can certainly cover it with a one-piece at the beach or a sleek black cami for the party, yet when you look in the mirror that muffin top immediately rears its ugly head, and you're convinced everyone notices it, too.
Look Under the Hood: All Fat Is Not Created Equally
Fat comes in different flavors. Ever go to a dietitian who used those scary-looking calipers to measure body fat? She was measuring subcutaneous fat, found below your skin's surface. You can pinch subcutaneous fat. It provides padding for your butt and soles of your feet. In the fat echelon, it's not so bad.
Subcutaneous fat has an evil -- even lethal -- stepsister called abdominal or visceral fat. Calipers can't measure this type of fat, which surrounds your organs and stubbornly refuses to vacate your midsection even after you've served an eviction notice.
Visceral fat doesn't just like to hang out. It also likes to create trouble, releasing signaling proteins called adipokines. Among their havoc, adipokines spike blood pressure, decrease muscle quality, and zap insulin sensitivity, setting the stage for insulin resistance and eventually diabetes and cardiovascular disease.
Oh, it gets worse. Visceral fat also increases your risk for dementia. A study with middle-aged adults in the Annals of Neurology found visceral fat (especially belly fat) could shrink your brain. Not cool.
Nothing good comes from visceral fat. A study in the Journal of Nutritional Sciencefound that even if you don't have diabetes, visceral fat could strongly predict insulin resistance, which paves the way for diabetes and heart disease.
Trouble is, visceral fat knows how to protect its existence: it keeps that muffin top firmly intact despite your strongest efforts to banish it. Want a culprit to blame? Look no further than your hormones!
Hormones that Give Your Muffin Top Free Rent
I had a smart, ambitious friend in middle school that got voted class president. She was hardworking, caring and always spoke up for the underdog. Everyone loved her.
Except once she got elected, her ego grew too big and she became a mean girl. She got a little full of herself and became obnoxious, unruly and always talking when she should be listening. She began doing more harm than good for our class.
Hormones are like that. Now, granted, a few you want to keep elevated, since they reduce visceral fat. Your fat-zapping sidekicks include interleukin-6 (IL-6), immunoglobulin A (IgA) and adiponectin.
Adiponectin, for instance, is that rare bird because adipose tissue releases it. Rather than protect fat's existence, however, adiponectin beneficially regulates glucose and fatty acid metabolism. Studies associate higher levels of adiponectin with lower levels of body fat. Simply put, the more adiponectin you've got, the less visceral fat you'll have and the leaner you'll be.
Much as in life, though, a few highs are good but balance is key for most hormones to stay lean and healthy. Adipose tissue also makes leptin, a hormone that politely whispers to your brain that you've had enough to eat. Leptin is your appetite-curbing bestie, intelligently determining whether you use food as fuel or store it in your midsection.
Except when she becomes drunk and unruly. A broken leptin meter eventually makes you leptin-resistant. You've got lots of this hormone hanging out screaming her head off, but your brain doesn't hear the message. So you eat... and eat... but your brain never gets that memo to put the brakes on the brownies. If you've got excess midsection fat, chances are you're leptin resistant.
Cortisol is another Jekyll-and-Hyde hormone. Produced by your adrenal cortex, yourbad boyfriend hormone has three main jobs: raise blood sugar (to feed muscles so you can run or fight), raise blood pressure, and modulate immune function.
Cortisol works by releasing a quick burst of glucose into your system. In the short term this can become helpful, like when someone swerves into your lane on the freeway.
Trouble starts when cortisol wants to hang out after the party's long over. Like a houseguest that just won't leave, cortisol stays cranked up when you constantly stress and worry. A gargantuan java to start your day or big glass of red wine to end it can also keep excess cortisol around, increasing blood sugar and contributing to insulin resistance.
Now, here's the rub: belly fat cells contain four times more cortisol receptors compared with other cells. In other words, every time you raise cortisol levels, you just feed that muffin top.
Insulin: Master of Your Domain
Want to place the blame for your muffin top on one out-of-whack hormone? No contest: all arrows point to insulin. You see, this master hormone regulates how your body uses fuel from your food. Insulin directs your muscle, liver and fat cells to remove glucose from your blood and store it.
Think of insulin knocking on your muscle, liver and fat-cell doors. Those cells politely receive insulin's invitation and allow glucose in. From there, your cells can tackle important tasks such as growth, movement and repair.
All is fine until your cells stop listening to insulin. They've had enough glucose and aren't greedy. None too pleased, insulin bangs on your cell doors, demanding to be let in. Your cells could care less. But insulin won't take no for an answer: pissed off, he knocks louder and louder.
Even after every type of cells puts up a "no vacancy" sign, one type of cell almost always heeds to insulin's call: your fat cells. Fat cells remain BFFs with insulin far after every other cell tells this hormone to shove off.
Pressing your foot on the accelerator will eventually burn out your engine's car. Likewise, higher and higher amounts of insulin to deliver glucose as fuel to your cells burn out your pancreas.
Insulin resistance heralds several serious problems, including excess weight, obesity, pre-diabetes, diabetes, dementia, Alzheimer's, stroke and some cancers. It affects 25 percent of middle-aged adults in the United States. Loud and clear: insulin is not something to fool around with.
Chronically high insulin levels not only keep visceral fat around, they lock the door to your fat cells so that fat-releasing hormones like glucagon get shut out. With elevated insulin levels, that muffin top's not going anywhere.
Food First: Five Foods that Reverse Your Muffin Top
Bottom line: muffin tops beget muffin tops. So do pastries, cookies, cake and other forms of sugar. A study in the Annals of the New York Academies of Science found a high-sugar/ high-fat diet combined with chronic stress was a surefire way to store fat and pave the way for metabolic syndrome.
When cortisol and insulin hook up, they create serious trouble.
It follows that your top strategy for ditching muffin tops includes nixing the white stuff that sends insulin levels surging: sugar, of course, but also rice and potatoes.
Next, you want to eat the correct foods that balance insulin levels. My friend Gary Taubes and I discuss how to get (and keep) insulin in check to break the fat-storing cycle.
Insulin is the popular kid every other hormone imitates. Get it under control and other hormones follow. Your brain once again hears leptin's call, cortisol levels chill out, and that muffin top begins to banish. To create that balance, start with food. My favorites to balance insulin and other hormones include:
• Wild salmon. A bonanza of blood sugar-stabilizing high-quality protein, nutrients, and healthy omega-3 fatty acids. If you're not eating wild-caught fish three or four times a week, human intervention trials show supplementing with omega-3s can also help reduce visceral fat.
• Avocado. Who doesn't love this sensuous creamy fruit that's rich in healthy monounsaturated fat, potassium and other nutrients, and fiber? One cup of avocado, in fact, contains 10 grams of filling, fat-busting fiber. A study in The Journal of Clinical Endocrinology and Metabolism found adolescents who ate more fiberreduced visceral fat and inflammation.
• Raw nuts. Loaded with healthy fats, fiber and protein, raw almonds and other nuts and seeds help stabilize blood sugar and make a delicious snack. Nuts and seeds are also rich in magnesium, a mineral most of us are deficient in. A study in the journalMagnesium Research found a high-fructose diet with low magnesium levels makes a surefire way to increase inflammation and store belly fat.
• Green tea. Dump the cortisol-raising java for calming green tea. Numerous studies, such as one in Obesity (Silver Springs), show that the catechins in green tea help reduce body fat. You'll need to drink a good amount to get those benefits, so supplementing might be the way to go.
• Blueberries. A University of Michigan study found obese rats had lower visceral fat triglycerides and improved insulin sensitivity after noshing on a blueberry-enriched powder for 90 days. Blueberries add a real fiber and phytonutrient punch to everything from protein shakes to Greek yogurt.
I could add lots more foods to this list, but I'd rather hear you: what are your favorite foods to get your hormones in check and banish that muffin top?
Buckley JD, et al. Long-chain omega-3 polyunsaturated fatty acids may be beneficial for reducing obesity-a review. Nutrients. 2010 Dec;2(12):1212-30. doi: 10.3390/nu2121212. Epub 2010 Dec 9.
Debette S, et al. Visceral fat is associated with lower brain volume in healthy middle-aged adults. Ann Neurol. 2010 Aug;68(2):136-44. doi: 10.1002/ana.22062.
Kuo LE, et al. Chronic stress, combined with a high-fat/high-sugar diet, shifts sympathetic signaling toward neuropeptide Y and leads to obesity and the metabolic syndrome. Ann N Y Acad Sci. 2008 Dec;1148:232-7. doi: 10.1196/annals.1410.035.
Nagao T, et al. A green tea extract high in catechins reduces body fat and cardiovascular risks in humans. Obesity (Silver Spring). 2007 Jun;15(6):1473-83.
Parikh S, et al. Adolescent fiber consumption is associated with visceral fat and inflammatory markers. J Clin Endocrinol Metab. 2012 Aug;97(8):E1451-7. doi: 10.1210/jc.2012-1784. Epub 2012 May 16.]
Rayssiguier Y, et al. High fructose consumption combined with low dietary magnesium intake may increase the incidence of the metabolic syndrome by inducing inflammation. Magnes Res. 2006 Dec;19(4):237-43.
Ukolla A, et al. Adiponectin: a link between excess adiposity and associated comorbidities? J Mol Med (Berl). 2002 Nov;80(11):696-702. Epub 2002 Sep 10.
Usui, et al. Visceral fat is a strong predictor of insulin resistance regardless of cardiorespiratory fitness in non-diabetic people. J Nutr Sci Vitaminol (Tokyo). 2010;56(2):109-16.
Sara Gottfried, M.D., is a practicing integrative physician and author of the New York Times best selling book, The Hormone Cure (Scribner/Simon &Schuster, 2013). You can follow Dr. Sara on Twitter, watch her videos on Youtube, and subscribe to her newsletter.