Bye-bye bellyhttps://www.telegraphindia.com/1170529/jsp/knowhow/story_153930.jsp

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Your Health - Dr. Gita Mathai

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Everyone wants a flat and toned six pack abdomen: the youngster trying to zip up a pair of pants, the middle aged executive trying to hold his stomach in and the mother squeezing herself into a "shaper" and blaming childbirth for her loss of form. No one wants a paunch or potbelly.

You know you have a paunch when you:

• Are no longer able to see your toes when you stand straight

• Swing your arms across your body while walking and not side to side

• Have BMI (body mass index: weight divided by height in meter squared) greater than 27

• A waist circumference more than 35cm (women) or 40cm (men)

• Are able to pinch up more than inch of subcutaneous fat on the back of the arms or abdomen.

The bad news is that after the potbelly, which is aesthetically undesirable but fairly harmless subcutaneous fat, fat starts getting deposited around the organs inside the abdominal cavity as visceral fat. It is a risk factor for diabetes, hypertension, stroke, gall bladder stones, arthritis, some cancers and dementia. The effective area available for breathing decreases as the abdomen pushes up against the chest. This causes sleep apnoea and snoring.

Once you start gaining weight, the area where fat is deposited is genetically determined. Hips and thighs usually increase in size first, followed by the paunch. In some unfortunate individuals, any increase in weight first shows up on the belly. The abdominal contents are held in place by muscles. These get stretched during pregnancy. The "core muscles", the entire group of muscles between the chest bone and hip bone, have to be strengthened for good posture and a flat abdomen. Weak abdomen and core muscles contribute to the protruding belly.

Very rarely, the sudden appearance of a paunch may be due to accumulation of fluid in the abdomen or a tumour. It is worth visiting a physician if the change has occurred within a short span of time.

There is no food supplement, medication or miracle exercise to get rid of just the paunch. Without overall weight loss, crunches will only strengthen your muscles, not get rid of the paunch. Also during the weight loss process, weight from other areas such as the cheeks, neck and arms may go before it makes a dent in the paunch.

Men require around 2,500 calories a day and women 2,000. A person with a sedentary lifestyle needs only 1,800-2,000 calories. If you can maintain a caloric deficit of 500 calories a day, it will result in weight loss.

Weight loss diets succeed when they are close to your normal food habits. Reduce intake of snacks, fat, aerated beverages, and refined carbohydrates. Serve all the food on the plate and estimate the calorie content. Do not have a second helping no matter how tasty the food is.

Dieting needs to be combined with exercise to prevent loss of muscle mass. If you have the time then try an hour of brisk walking, jogging, cycling or swimming at least five days a week. If there is no time, you could do 10 minutes of HIIT (High Intensity Interval Training) or stair climbing. Remember to run up the stairs but walk down. Climbing them two at a time is also a good idea. Exercises using light weights, crunches and core strengthening are essential and beneficial.

Losing a paunch and keeping it off is a lifetime commitment.

Dr Mathai is a paediatrician and author of Staying Healthy in Modern India. Mail your questions to yourhealthgm@yahoo.co.in