Lose That Terrible Horrible Inflammatory Disease-Causing Visceral Belly Fat with Whole Grains? Tufts Researchers Say It Helps!

 

Flat Bellies at 25 are Easy (me & my husband on the left) - Getting Closer to Revisiting It at 60

"People who consume several servings of whole grains per day while limiting daily intake of refined grains appear to have less of a type of fat tissue (visceral adipose tissue AKA belly fat) thought to play a key role in triggering cardiovascular disease and type 2 diabetes, a new study suggests."

"Obesity rates continue to escalate in the United States with 1/3 of the population classified as obese...predisposing them to type-2 diabetes..The economic burden  associated with this epidemic is enormous, and estimated medical costs for an obese patient are 42% higher than for those who are normal weight."

-American Journal of Clinical Nutrition 2010;92:1165-1171, Nov. 2010-

 

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Sure it's great to have low blood pressure and healthy cholesterol levels--but if you ask me, the BEST part of my plant-based no-added oil diet is my shrinking belly fat! 

Never dropped a pound on a healthy Mediterranean diet.  Never dropped a pound on a plant-based diet that included nuts, avocados, chocolate, olive oil & some refined grains.  And that's with plenty of exercise. 

But since I dropped the oil, chocolate, avocados, and nuts (except for small amounts of walnuts)--and started reading labels carefully to make sure that I'm eating only whole grains--I've lost about 11 pounds in 3 months--to the tune of 8.3% of my body weight.  I went from a BMI of 23.3 to a BMI of 21.3, and my % of body fat has dropped.   My husband has seen similar results--11 pounds lost--went from a BMI of 24.4 to a BMI of 22.7.  And most of that weight just came off of my belly & behind.  I really didn't think I needed to lose weight.  I didn't expect to lose weight.  But, now that I see an ever-shrinking belly--much closer to what it was 35 years ago--I'm a pretty pleased plant-based person!

Believe me, I'm not starving myself or counting calories--I'm eating large quantities of delicious food.  But, I'm also reading labels very carefully.  How can this weight loss be possible? 

When I spotted this hot-off-the-press article, "Whole- and refined-grain intakes are differentially associated with abdominal visceral and subcutaneous adiposity in healthy adults: the Framingham Heart Study,"  KcKeown, NM et al Am J Clin Nutr 2010;92:1165-71, my interest was piqued.  For the Tufts University press release click here.

 

Banishing Bad Belly Fat (visceral adipose tissue) with Whole Grains

 

Why Give a Hoot about Belly Fat, Besides How Unattractive It Looks?

Belly fat is completely different from the subcutaneous fat that surrounds our bodies. It's called omentum, and it acts just like an organ, secreting its own chemicals and hormones like adipokines that produce angiotensin II, that raises blood pressure. It also secretes tumor necrosis factor, interleukin 6, and C-reactive protein which lead to high blood pressure, insulin resistance, high cholesterol and inflammation that damages our brains & blood vessels.

Inflammation, high blood pressure & high cholesterol are all associated with heart disease, aging, Alzheimer's, stroke and cognitive decline.  Big surprise!  And I almost forgot to mention--the belly fat puts mechanical pressure on the kidneys, further raising blood pressure.

Who was in the Whole and Refined Grain & Belly Fat Study? 

2834 Framingham Heart Study participants (about 50/50 men & women; age range of 32-83)

How did the Tufts researchers analyze the grains that the participants ate?  How did they measure the amount of their belly fat?

The type of grains eaten was assessed through periodic questionnaires.  

Examples of 1 serving of whole grains: 1/2 cup of oatmeal, 1 slice of whole-grain bread, 1/2 cup brown rice.   

Examples of 1 serving of refined grains: 1/2 English muffin, 1 slice of pizza, 1/2 cup of white rice.

Belly fat (which includes visceral adipose tissue (VAT) & subcutaneous adipose tissue (SAT)) was measured both by waist circumference, and with the aid of an 8-slice multidetector-computed tomography (MDCT) scan.   The MDCT scans were able to separate the amount of visceral fat (VAT), which is the more biologically active & dangerous type, from the subcutaneous fat (SAT) that's just beneath the skin

Then, they examined the association of whole and refined grains eaten to the amount of visceral fat in each person--and controlled for factors like exercise, calories, fat, fruits, vegetables, etc.

What were the results?

• Visceral belly fat was 10.1% lower in individuals who ate 3 or more servings of whole grains a day, compared to those who ate no whole grains, "even after accounting for other lifestyle & dietary factors."
• But, here's the Catch-22.  You don't lose belly fat if you eat BOTH refined grains and unrefined grains!  If you think you can have your cake--and eat it, too--forget about it!  The folks who ate 3 servings of whole grains--but continued to eat refined grains (think one tiny piece of French bread, white rice, pasta, crackers, pizza) showed no decrease in their visceral fat.  Eat 1/2 an English muffin, a handful of fat-free pretzels, 1 slice of pizza, & 1/2 cup of rice--and you'll lose any belly fat busting benefits from all the healthy whole grains you eat throughout the day!

"Whole grain consumption did not appear to improve VAT (visceral adipose tissue) volume if refined grain intake exceeded four or more servings per day.  This result implies that it is important to make substitutions in the diet, rather than simply adding whole grain foods.  For example, choosing to cook with brown rice, instead of white or making a sandwich with whole grain bread instead of white bread."

-Nicola McKeown, PhD, scientist with the Nutritional Epidemiology Program at the USDA Human Nutrition Researcher Center of Aging at Tufts University-

• Waist circumference decreased as whole grain consumption increased.  The opposite effect was seen for refined grains, even when other diet & lifestyle factors were taken into account.
• This is the first study to show how whole grains and refined grains have different effects on the direct measures (with CT scans) of adipose tissue in adults--as far as the authors know.  And very few studies have shown how making dietary changes--independent of body weight--can alter body composition--so this is an important study.

Why would eating whole grains have such a positive effect on belly fat?

• It's not just about the added fiber or added bran.  The authors were able to adjust the results for fiber & bran, and the relationship between whole grains & loss of belly fat still persisted--which means it's something more than just fiber that is preventing belly fat build-up.
• The Prebiotic Effect.  Think Good Stomach Bacteria.  The authors think that the rich fermentable (gas-producing) carbohydrates in whole grains "exert a pronounced prebiotic effect on the human gut microbiota composition in healthy adults" (think, good intestinal bacteria) and this may explain how whole grains prevent belly fat build-up.  Turns out, the predominant non-digestible prebiotic fiber in the U.S. is "oligofructose"--and at least in animal studies, it's associated with decreased belly fat.  Hmm, does this mean that gas is a good sign as far as belly fat is concerned?
• Whole grains increase fullness hormones, they prevent overeating, delay gastric emptying, and slow the release of sugars into the bloodstream.  Unlike refined grains, they naturally contain dietary magnesium, vitamin E, B vitamins, iron, and larger particle sizes.  All of these, the authors speculate, may improve the body's insulin sensitivity and decrease belly fat.

Shortcomings of the study?

• The study was just observational
• More research is needed to investigate the relationship between whole grain intake and belly fat in larger, more diverse populations--this study group was primary white, and over 30.
• Researchers need to identify exactly what mechanism in whole and refined grains affects belly fat.

There's More to the Whole-Grain Story.  A Calorie is Not Just a Calorie.  Carbs Affect Our Genes.  What?

 Some recent landmark studies have confirmed that the kind of carbohydrates we consume actually affect the genes in our abdominal fat--which has a tremendous impact on developing or curbing Metabolic Syndrome.  Click here for the FUNGENUT Study in Finland.

• The Carbohydrate/Gene Study.  Here's how the the low vs high glycemic carb study played out in 2 groups of people with Metabolic Syndrome.  One group was fed carbs that were high fiber low-glycemic (think oats, beans, quinoa).  The others group was fed carbs that were high fiber high-glycemic (think potatoes, whole wheat bread).  Both carbs had the same amount of protein and fat.  The low-glycemic carb meal produced a low insulin response, and the insulin-signaling genes in the abdominal fat were actually down-regulated.  But after the high-glycemic carb meal,  insulin shot up, and 62 different genes that are linked to the stress response, insulin-signaling and cytokine-mediated immunity were turned on.  Pretty amazing!  This study prompted endocrinologist Dr. David Ludwig to write an editorial called, "Putting your genes on a diet: the molecular effects of carbohydrate."
• Take away point:  The kind of carbs we eat have a significant effect on the gene regulation that affects how our bodies handle insulin--and don't forget that abdominal fat is a marker for an insulin response that is out of whack.  This process has nothing to do with how many calories we consume, or how much we weigh--but it has everything to do with what kind of carbs we are consuming.
• The effect of whole grains vs refined grains on the risk of cardiovascular disease in Metabolic Syndrome.   In this study the two groups being compared both reduced their calories by 500/a day for 12 weeks--but one group ate whole grains while the other consumed refined grains.   After 12 weeks both groups had the same weight loss--but the whole grain group had lost more belly fat, and had a 38% decrease in their C-reactive protein levels (inflammation marker).  The magnitude of the this C-reactive protein reduction was similar to the reduction achieved with statins.  "The Effects of a whole grain-enriched hypocaloric diet on cardiovascular disease risk factors in men and women with metabolic syndrome." Am J Clin Nutr 2008 Jan;87(1):79-90.  Click here for the article.

• Bottom line: you want very grainy "kibbled" least-processed breads & carbs that move slowly through your digestive system. How do I find out which foods are low-glycemic?  The University of Sydney maintains the most reliable database.  Look for foods that have a glycemic index of 55 or under.  Click Here for the database.  Click Here for their excellent newsletter.

A Mini-Review of Why Belly Fat is Such a Bad Guy and Needs to be Banished

 This was posted back in April 2008 but it's still a good review about why belly fat so bad.

 

"The take-home message is that it's not what you weigh, but it's where you carry your weight in midlife."

        -Rachel Whitmer, Kaiser Permanente, Oakland, CA-

 

In the past six weeks there have been 4 major studies all telling us what we already know.  This belly fat is going to be the death of us, yet!

No exaggeration here.  That jiggly poochy stuff that appears around our middles in midlife is now blamed for strokes in women ages 35-54, increased dementia in later life, dying earlier from cancer or heart disease, increasing your risk of metabolic syndrome and type-2 diabetes. And you don't have to be overweight for it to cause you trouble!

So what's so special about belly fat & why does it do so much damage?  This was news to me and I heard a great explanation from Dr. Erminia Guarneri, who is the co-founder & medical director of the Scripps Center of Integrative Medicine & an attending cardiologist at the Scripps Clinic in La Jolla, CA.

Belly fat is completely different from the subcutaneous fat that surrounds our bodies. It's called omentum, and it acts just like an organ, secreting its own chemicals and hormones like adipokines that produce angiotensin II, that raises blood pressure. It also secretes tumor necrosis factor, interleukin 6, and C-reactive protein which lead to high blood pressure, insulin resistance, high cholesterol and inflammation that damages our brains & blood vessels.

Inflammation, high blood pressure & high cholesterol are all associated with heart disease, aging, Alzheimer's, stroke and cognitive decline.  Big surprise!  And I almost forgot to mention--the belly fat puts mechanical pressure on the kidneys, further raising blood pressure.

STUDY 1.  Belly fat & stroke. Dr. Amytis Towfighi, Assistant Professor of Neurology at the University of Southern California, reported at the February 2008 International Stroke Conference that there has been a tripling of stroke in middle-aged women age 35-54 in recent years.  Her research group compared two studies - one conducted from 1988-1994 and one conducted from 1999-2004.

Her group controlled for all the usual suspects, when it comes to stroke, like diabetes, cholesterol, & high blood pressure, and Dr. Towfighi said, "The one thing that was driving this increase in stroke risk was the waist circumference and body mass index."

• Women are heavier on average than they were even a decade ago.
• Our waist sizes have increased by almost 2 inches as compared to a decade ago.
• Stroke prevalence tripled in  middle-aged women, double the prevalence of men.
• Even if you're just moderately overweight, you increase your stroke risk.

STUDY 2.  Just a Little Belly fat & heart disease/metabolic syndrome & type 2 diabetes. Dr. Francisco Lopez-Jimenez, a cardiologist with the Mayo Clinic reported at the April 2008 American College of Cardiology meeting on his findings that more than half of us with normal weight, are in fact part of the  "NORMAL WEIGHT OBESE".  You may look "just right", and your doctor might say "your weight is fine", but if your body fat is over 20% for a man, or over 30% for a woman, you're not all right.

Don't confuse body fat with your Body Mass Index (BMI). To find your body fat you would need to be checked on a special scale, or have your waist measured with fat calipers.  This is best done at a reputable gym or doctor's office.  So why is a higher fat percentage a problem?  Same old story. It puts you at risk for heart disease, type-2 diabetes and other metabolic disorders.  That little bit of extra fat just changes your blood chemistry, upping your cholesterol and leptin, the hormone that regulates your appetite.

If you tend to put that fat on in the middle (belly fat) watch out!  Dr. David Katz, the Yale University nutrition expert says, "Even a small amount of extra fat where it matters most can wreak havoc. Excess body fat in the belly is a menace, whatever your weight."

And by the way, a fit muscular woman could have a high body weight, but if her fat content is low, she's perfectly healthy.  It's not about the weight - it's all about the fat, especially in your belly.

STUDY 3. Belly fat & dementia. Rachel Whitmer, a research scientist at Kaiser Permanente in Oakland, California, reported in the March 26 online issue of Neurology on her study that followed 6,583 Kaiser Health Plan members.  The study began in the late 1960s and early 1970s and measured the abdominal fat of this large group of 40 and 45 year olds.  She followed up with them between 1994 and 2006 when they had reached their 70s and beyond.

Back in 2005 Whitmer had previously reported that senior citizens who were overweight at middle age were 74 percent more likely to develop dementia.  This new study specifically looked at whether belly fat was the culprit.

• Those people who were obese and had the most belly fat in their 40s were 3.6 times more likely to develop dementia than those with the least amount of belly fat.
• Those who were overweight--a step below obese--and had large bellies in their 40s, were 2.3 times more likely to develop dementia.
• 21 percent of those with high levels of belly fat developed dementia.
• The belly fat dementia connection persisted, even when researchers adjusted their statistics to take into account the effect of stroke & diabetes.

STUDY 4. Belly fat & death from cancer & heart disease. Dr. Cuilin Zhang, of NIH's Kennedy-Shriver National Institute of Child Health & Human Development, published his study online April 7th, in  Circulation. This was one of the largest extended (16 years) investigations of abdominal fat, following 44,000 women in the Nurses Health Study.  The NIH press release said:

"Women who carry excess fat around their waists were at a greater risk of dying early from cancer or heart disease than were women with smaller waistlines, even if they were of normal weight."

• Waist size equal or greater than 35 inches doubled the risk of premature death by heart disease compared to women with a waist size less than 28 inches.
• Waist size equal or greater than 35 inches  doubled the risk of premature death by cancer as compared to women with a waist size less than 28 inches.
• Women who were obese (a BMI over 30) & had a greater waist circumference were at the greatest risk.
• Women are advised to maintain a waist size of 30 inches or less, and a Body Mass Index between 18.5-24.9.

I can think of about 4 women over 50 who have flat bellies.  Most of them are vegetarians who eat fish, vegans, and dedicated exercisers.  In case you think getting your waist measurement under 30 inches in middle age is easy, the measurement is around the belly-button which can add an inch or two to what you think your waist is.  Isn't it interesting that we're likely to be given a prescription for high blood pressure and high cholesterol without coaching & direction to reduce belly & body fat, the main drivers of inflammation and many of our chronic diseases?

Recap on the goal numbers: 

Women: Waist size of 30" or less is ideal (under 35 is the general recommendation), Body Mass Index 18.5-24.9, Body Fat 30% or under. 

For men: Waist size of less than 40", BMI less than 25.

Most people would think my weight is just right, I eat mostly veg, and I'm definitely a dedicated exerciser, but after reading these studies, I now know I have some serious whittling to do around my waistline!  I'm motivated!  Is anyone else surprised by their measurements?

 

 

Comments

[Steven Rice Fitness]

I think carbs and grains have a bad reputation based on the effects of abusing the refined forms. It's good to see research showing that unprocessed grains actually are very beneficial.

[Victoria]

So is 100% whole wheat flour in or out?

[deb pero]

I am a 56 year old woman, also an avid hiker and runner.. and was "mostly vegetarian" for the past couple of years. However, even with running 50+ miles a week, and eating a healthy diet without a lot of processed foods, I could not lose weight or get rid of that blob around my middle!! Looking back, I realize we ate refined flour in the form of pizza dough and in our "multi-grain" (but not whole grain) bread, and occasional crackers and bagels... and white rice.
In May, I started the Engine 2 diet, which does allow nuts and avocados, but my intake of them is limited. I have concentrated on the whole grains, as well as leaving out the added oil, and as a result I have lost 20 pounds (possibly more, I don't weigh frequently) but the best part is that the weight I've lost has been around my middle. I finally have a flat tummy again!
I am never hungry, I am able to keep training hard on this diet, and actually, am even running better than before (gotta be not lugging that extra weight around!)
I love this way of eating!! Of course, after only a short time on this eating plan, all of my numbers also dropped -cholesterol was 156 after only a week and a half, down from the 180's, and is probably lower now... blood sugar down, blood pressure healthier.. all good stuff!

[Healthy Librarian]

Victoria, 100% whole wheat flour is in! But, whole grains do beat flour--takes longer to digest. If you're talking bread--try Ezekiel sprouted grain products.

Deb, thanks for sharing your experience. It's so interesting that it parallels mine-except for your amazing 50 miles a week of running. I'm completely hooked on this way of eating, too--never hungry--and plenty to eat. Who would have ever thought it possible to lose our middles. Just wondering--with your hard training, do you up your intake of protein at all?

[Gael in Vermont]

First of all, the photo of you and hubby is adorable!
Secondly, I agree with Deb and Debby on the diet-life style changes. In my case, I recall the days of the South Beach Diet where the first 14 days were without flour products. The result for me was the loss of belly! That was 10 years ago. Now, eating a plant-based, gluten free diet has done much the same for me. 21 pounds lighter, feeling "cleaner" and loving the mostly flat belly. Even though I have no allergies to wheat, I choose to eat this way, and feel so much better.

[Cynthia Bailey MD]

Once again you bring an interesting article to my attention. You're a fabulous scout for these important lifestyle and diet articles that aren't in my dermatology literature. Thank you.

In the past 10 days I did have some refined carbs and sugar and poof like magic the belly fat reappeared. I suffered a few other dietary indiscretions this week as well and I have my blood work scheduled to be drawn on Monday. Should be a wake-up call. Hmmm.

[Donna]

Check out the Omron Body Fat Monitor, Model # HBF-306C. This is a handheld device that sends a slight unfelt current through your body to measure bodyfat %, and only costs about $40. I've been using mine steadily for over a year, and do this right after I weigh in the mornings. It tracks well over time, and I've gone from 34% to 24/25%. Keeping track this way also allows you to see body composition changes over time - is it fat weight or is it muscle weight? Keep a chart: first get your weight, then get your bodyfat %. Then multiply your weight by your percentage (if weight is 127 and % is 24.8%, then 127 x .248 = 31.49). This is your fat in pounds. Then substract this number from your weight - that is your lean body weight ! (127 - 31.49 = 95.51 lean body weight). Works for me !

[Healthy Librarian]

Donna, the Omron monitor sounds like a worthwhile product to have--because no one want to be losing muscle--just body fat. Was continuing to exercise with weight training the key to keeping muscle while losing fat?

Cynthia, oops, I wonder if the indescretions will show up on the lipid panel. I stupidly ate chocolate & drank a glass of wine the evening before one & it definitely made a difference in the triglycerides.

Gael, Big congratulations! That's fantastic. It really is so crazy how the belly fat & weight come off when you eat only whole grains--cut out the oils & nuts.

[Donna]

Hi Healthy Librarian, yes, the Omron bodyfat monitor is very useful ! I lost 30 lbs. overall, mostly with the help of the BodyBugg armstrap and wrist readout, also which I highly recommend...do I sound like a gadget freak or what!?). Thru the whole 30 pound loss, approximately 6 to 7 pounds of that was muscle loss. When I was getting down to my last 10 pounds I decided to stop weight lifting temporarily, because it is very difficult to lose fat and gain/maintain muscle at the same time. I kept walking 3.5 miles to/from work with a 10 pound vest on plus a backpack. I gain muscule pretty quickly so wasn't worried about it. Once the 10 pounds was gone over 3-4 months, I started back with the weights, plus started wearing a 25 pound vest plus a backpack - and put on 4 pounds of muscle in 2 months. Let me tell you - without the Omron monitor, that gain would have freaked me out - but with it and tracking over time, I was able to see that it was muscle weight. So my recommendations - get a 10 pound or 25 pound weighted walking vest which you can usually find at Walmart, the Omron, and a Bodybugg if anyone needs to lose weight. And thanks to you and your blog, I'm now learning to eat a vegan diet, and the weight will never creep back again! I really truly appreciate what you do!