Published: March 16, 2006
Bad Apple: The Risks of Stress for People Prone to Abdominal Fat Retention
By Caroline J. Cederquist, M.D. 
Back in the bad old hunter-gatherer days, the human species got a lot of use out of the hormone cortisol. That's the stress hormone activated during the fight-or-flight response, causing our blood pressure to rise and heart rate to increase.
Throw in a little adrenalin and these useful, even essential, physical adjustments made it possible for our forebears to do things like battle marauding tigers on a moment's notice, or scoop up their offspring and flee from raging wildfire.
But in the modern world, there's little need to either fight or flee, yet the cortisol release remains functional in the species, only now, it's activated in response to the stressors of modern society - bad traffic, malfunctioning machinery, domestic discord - rather than natural perils or challenges to survival.
There are some real downsides to this artifact of our rugged past. Research indicates that cortisol is also associated with abdominal fat production. And without the physical release demanded by, say, wrangling an enraged wildebeest, cortisol seems to end up accelerating abdominal fat production.
For virtually anyone, this can lead to higher cholesterol levels, blood sugar levels and elevated blood pressure, all factors for heart disease. But people who are genetically prone to holding their fat stores around the middle are especially susceptible, which makes this a bigger concern for these apple- shaped people than it is for those pear-shaped individuals who tend to carry their extra on the hips and thighs.
And there is other research that shows that abdominal fat retention - distinct from lower-body fat retention - causes specific, recognizable chemical changes in the body that can ultimately lead to lowered metabolism and symptomatic cravings for sweets.
In this way, abdominal fat retention can lead to ever more weight gain, putting overweight people with a predisposition to the apple shape at a much elevated risk for disease. Add a stressful lifestyle and excess cortisol production to those factors, and you have a time-tested recipe for a heart attack.
The majority of the patients I see have abdominal weight issues, especially the hurried executives, single parents, and those caring for an elderly, dependent parent, and there are many in that category here in Southwest Florida. While we're not likely to be protecting our parents from wild animals anymore, there are so many stresses associated with that care-taker role, that people serving that function are likely to become all too familiar with their cortisol-induced symptoms, including that central weight gain.
Even so, the array of risk factors generated by abdominal fat retention can often be very successfully mitigated solely with a dietary approach.
For instance, many people with abdominal fat retention benefit from limiting foods that aggravate the hormonal imbalances present, things like highly processed carbohydrates, including pastries, cookies, white breads, chips and snack foods, candies and sweetened beverages.
Also, by ensuring that the body's nutritional needs are met in small meals throughout the day, very quick progress can often be made in reducing abdominal fat, and with it, blood sugars, cholesterol, and disease risk.
That can be a real challenge for people entrenched in common habits of the high-stress lifestyle, like skipping meals all day and eating late in the evening. People with rushed, on-the-go schedules are often resistant to this simple, apparently common-sense change. Their usual routine may seem necessary, or even desirable, to the efficiency minded go-getter.
But the big picture has to be taken into consideration; a short-term payoff in minutes is no bargain when compared to the long-term cost in health. And these people do find that when they make the necessary adjustments, the stress-gain cycle can usually be broken in fairly short order.
But if dietary and lifestyle intervention are not sufficient, behavioral therapy and medications may be necessary. Often people develop a high-stress lifestyle that feeds on itself, as the anxiety of one stressful obligation provides the energy to get through the strain of the next.
Sometimes a more focused behavioral approach is necessary to help people see how they are unconsciously stimulating their own unhealthy stress responses, but usually, once a person understands the distinct physical dangers of those habits, they're willing to make conscious choices to change them.
That's a win all the way around. Learning simple coping mechanisms can reduce the lifestyle stress quotient, which in turn supports the initial weight loss necessary to cut back the stress-induced weight gains.
That doesn't mean it's easy. But for people with the greatest risk factors and the highest propensity for stress and weight gain, the choices are to commit to that sort of comprehensive improvement, or else get back to ancestral basics, and take up running from tigers.
THROUGH THICK & THIN: If you're prone to abdominal fat retention, think about reducing stress in your life, and make a point to eat a more scheduled diet, with small intakes of protein throughout the day. While these are good ideas for just about anyone, people prone to cortisol- induced fat production need to be more vigilant than most in guarding against the dangers of both stress and weight gain.
Caroline J. Cederquist, M.D. is a board certified Family Physician and a board certified Bariatric Physician (the medical specialty of weight management). She specializes in lifetime weight management at the Cederquist Medical Wellness Center, her Naples, FL private practice, you can also get more information about Dr Cederquist and her weight management plan by visiting
www.DietToYourDoor.com
She is the author of Helping Your Overweight Child - A Family Guide, which is available at, DrCederquist.com, Amazon.com, or by calling toll-free 1-800-431-1579.
Search News
Daily News
