Tips For a Flatter Belly

In this Article (Index)

Tips and advice on how to get a flat stomach with diet and exercise.

• Our Flat Belly Plan
• What Causes Belly Fat?
• What is Visceral Fat (VAT)?
• Subcutaneous Fat (SAT)
• Health risks of excessive Visceral Fat
• How fat are you anyway?
• You gain more visceral Fat as you age (Causes)
• How to Get a Flat Stomach
• A Flat Belly Diet Plan
• Exercises for a Flat Stomach
• High-Intensity Intermittent Training (HIIT)
• Other Belly reducing exercises (squats & deadlifts)
• Some Tricks to flatten your Stomach
• Getting a Flat Stomach: a Recap

Our Flat Belly Plan

What Causes Belly Fat?

Fat in your midriff is the main cause of a prominent stomach.

Abdominal fat is noticeable in both men and women, and aging plus hormones influence weight gain around the middle.

There are two types of fat in the abdominal area:

1. Visceral fat
2. Subcutaneous fat

Both types of fat have to go if you want a flat tummy.

Belly Fat is the combination of Visceral Fat and Subcutaneous Fat

First of all: What is abdominal or visceral fat?

Visceral Fat (VAT)

Visceral or Abdominal Fat (we use the abbreviation VAT - for the scientific term: Visceral Adipose Tissue). VAT is the fat that is stored by your body inside your abdomen, it fills the spaces within the abdominal cavity, surrounding the internal organs that are located there, such as the liver, the intestines, and the pancreas.

Normally Visceral Fat represents 10% of our body's total fat stores. However in obese or overweight people, fat accumulates in the abdomen in larger quantities.

VAT secretes proteins called cytokines in higher quantities than the other type of body fat (subcutaneous fat or SAT).

These cytokines trigger inflammation and increase the risk of heart disease.

VAT also produces a precursor to angiotensin, a protein that constricts blood vessels causing high blood pressure.

The abdominal fat cells as they grow, inhibit the production of a hormone (adiponectin) which is a "potent insulin-sensitizing, anti-inflammatory, and anti-atherogenic ... hormone". Lower levels of it, lead to obesity and the development of insulin resistance. (1)

This is summarized up by Britton's 2013 study as follows (2):

Visceral adiposity is associated with incident cardiovascular disease and cancer Britton (2013)

Subcutaneous Fat (SAT)

Subcutaneous Fat or SAT (for Subcutaneous Adipose Tissue) is the fat that lies beneath your skin as a layer between the muscles and the skin (that is why it is "Sub" = "beneath" and "cutaneous" = "skin").

Its purpose is isolation (think of whale blubber). It keeps your body from losing internal heat or absorbing it from the environment.

Your body stores fat as SAT, like the fat on your thighs or hips. And this fat is far less risky than the fat stored in your middle. Remember: Belly fat is an indicator of higher health risk.

Normally 90% of your body fat is subcutaneous fat (SAT).

SAT also produces cytokines so it is not harmless, on the contrary, in obese people, increased deposits of "abdominal SAT may have a pathogenic function, as additionally evidenced by endocrine and inflammatory responses" (3), in other words, SAT inflames and disrupts hormonal channels just like VAT does.

On its positive side, subcutaneous fat secretes the hormones leptin, an appetite suppressor, and also (like VAT does) adiponectin which regulates how fats and sugars are processed, protecting against diabetes. It also has anti-inflammatory effects on our blood vessels.

However, the SAT fat in obese people produces less adiponectin (1) proving that obesity and high body fat, whether SAT or VAT fats are a bad combination.

Health risks of excessive Visceral Fat

The fat that is buried within you, layering your abdomen's vital organs is a real health risk associated with cardiovascular disease, high blood pressure, dementia, asthma, cancer (colorectal and breast cancers), and increased blood sugar associated with higher type 2 diabetes risk.

We discuss these risks in our "The Dangers of Belly Fat" webpage:

Fortunately, you can fight Visceral Fat and take action to minimize its build-up. You can lose VAT and improve your health.

How fat are you anyway?

First of all, measure your waist; your waist circumference should be less than 31.5 in. (80 cm) in women and less than 37 in. (94 cm) in men.

We discuss the Waist size and the Waist-to-Hip Ratio in our "Waist Size Matters" webpage:

Also, calculate your Body Mass Index or BMI, it will give you an idea of where you stand. Ideally, your BMI should be 25 or lower.

We discuss Body Mass Index on our "BMI" webpage:

Now you have a clear picture of where you stand, you have your actual BMI and your actual waist size, and you know the goals (for waist circumference and a BMI of 25). So now take action!

You gain more visceral Fat as you age

A fact of life is that as people grow older, they increase their body mass, become plumper and, add fat to their midsection. This is a fact of life. Hunter (2010) (4) studied the possible causes of this "aging" effect:

Hormones

Gonadal hormone output declines with age, and this contributes to the increase of VAT in both women and men.

In men, testosterone decreases by 1% each year after the age of 30. In women, estrogen drops as they approach menopause, and this shifts fat deposition from thighs and hips to the abdomen.

Body weight gain

Adults in industrial countries tend to gain weight as they age, in the US, men increased by 14.1 lb and women by 19.2 lb between 1960 and 1991. However, visceral fat grew by 200% in men and 400% in women during the same period.

Loss of Muscle Mass

Sedentary lifestyles lead to a loss of what is known as the body's "fat-free mass" or "FFM" (which includes muscle), some estimates show that 60 to 69-year-old men lose 14 lb. of FFM when compared to men aged 20 - 29. For women in the same age group, the loss is more than 13 lb.

Muscle loss is caused by a lack of exercise and the drop in hormones that promote muscle growth.

Muscle mass loss means fewer calories burned by the resting body (Basal Metabolic Rate or BMR). So aging adults eating the same amount of food will have an energy surplus which the body will store as fat.

Fat Location Shifts

Finally, as people age, their body fat moves from the face, arms, and legs to a more central location, inside the abdomen. The reasons for this are not known. Perhaps it is promoted by hormones.

So don't sit passively watching your abdomen bulge out. You can do something about it. Below we will tell you what to do:

How to Get a Flat Stomach

No Quick or Magic Solutions

There are no shortcuts, no flat tummy drinks or easy flat belly plans, the road to a flat belly is based on persistence and staying power.

Forget about special teas, apple cider vinegar, herbal detoxes, TV stomach-flattening gadgets, electrodes, wrapping your midriff in plastic wrap, home gym devices, ab rollers, etc.

None of these are effective in reducing your abdominal fat.

You will have to do it the hard way: metabolizing the stored fat (that means burning it) by exercising, and by adjusting your diet to make your body burn these stored fat reserves.

Below we will look into this two-pronged strategy:

• A Flat Belly Diet Plan
  • Calcium
  • Fiber
• Exercises for a Flat Stomach
  • High-Intensity Intermittent Training (HIIT)
  • Other Belly reducing exercises

A Flat Belly Diet Plan

A Diet is a key tool in removing visceral fat. If your energy deficit is around 500 calories a day, in one week you will have eaten 3,500 calories less, and your body will have burned stored fat to generate the "missing" energy it needs. As one pound of fat is roughly 3,500 calories, with this energy deficit you will lose one pound of fat each week.

Although you can't control which fat deposits will be consumed by your energy-avid body, an overall balanced diet will help you lose weight and achieve your goals.

The effect of Calcium on Visceral Fat

Bush, at the University of Alabama, (2010) (5) studied a group of healthy premenopausal women and found that consuming more calcium in the diet was associated with a lower gain of visceral fat.

Check your calcium intake but don't overdo it. Remember that the recommended dietary allowance of calcium is 1000 mg⁄day.

Fiber reduces Visceral and Subcutaneous fat

Hairston (2011) (6) conducted a five-year study of a group of 1,114 subjects (roughly 30% African American and 70% Hispanic) and found some interesting relationships between diet, Visceral (VAT), and subcutaneous (SAT) adipose tissue:

• Soluble fiber keeps VAT at bay: "For each 10 g increase in soluble fiber, rate of VAT accumulation decreased by 3.7%."
• Fiber did not impact on SAT.

Diet is important in tackling Visceral Fat

The importance of diet as a way to reduce abdominal fat was highlighted by Liu et al. (2017) (7). They followed a group of 183 overweight and obese men and women for 12 weeks. They all ate a low-calorie diet but one group ate "pre-portioned prepackaged entrées" and the other "self-selected" their diet meals.

Liew found that diet was the most relevant factor in reducing abdominal fat, regardless of the subjects' levels of physical activity:

• Those with more visceral fat or higher weight lost more visceral fat and weight than leaner subjects.
• Greater visceral adiposity loss was not associated with age or physical activity.
• The prepackaged entrées group lost more abdominal fat than the "self-selected" diet followers. (perhaps they overindulged less than the self-select group).

Healthy Eating Plan

Eating a healthy diet will make you feel your best and keep you in good health. Follow this simple eating plan and include the right mix of foods and nutrients so you can feel energetic and accomplish your weight-loss goals.

More...

Exercises for a Flat Stomach

Diet is one way to reduce belly fat. The other is exercise.

We are too sedentary!

We live sedentary lives, driving to work, to do our shopping, taking escalators or elevators. We do not get enough physical activity in our daily lives.

The recommended physical activity guidelines are 150 minutes of moderate physical activity each week (split into 30 minutes during 5 days). But most people don't even manage that.

Any activity is better than none, so you should try to increase your physical activity:

• Sit Less and be more active: get your 150 minutes per week of exercise. It's easy: Brisk walking or just parking your car further away from your destination to walk a bit more, taking the stairs instead of the elevator, standing up from your desk, and taking a stroll through your office once an hour. Stand up while you talk on the phone.
• Be more active at home: gardening and home chores can help you burn calories and improve your physical condition.

Exercise reduces Abdominal Fat

Liu et al. (6) also studied the effect of exercise (in addition to dieting) and found that:

• Strenuous physical activity was associated with a reduction in total body percent fat.
• Those who exercised more (higher amounts of strenuous physical activity) also lost less muscle than those who exercised less.

Kay and Singh (2006) (8) reviewed studies involving obese or overweight subjects to find if physical activity reduced abdominal and visceral fat.

They found that 70% of the studies "reported significant reductions" of abdominal fat in comparison to controls.

They concluded that these "studies suggests a beneficial influence of physical activity on reduction in abdominal and visceral fat in overweight and obese subjects."

Even Walking helps reduce belly fat

Irwin (2003) (9) studied a group of 173 sedentary, overweight and postmenopausal women and found that those who exercised with moderate intensity by walking on average 3.5 days per week for a total of almost 3 hours a week, lost more weight, total body fat, intra-abdominal fat, and subcutaneous abdominal fat than those who didn't exercise.

Walking also has many positive effects on your overall health: "walking decreases the risk or severity of various health outcomes such as cardiovascular and cerebrovascular diseases, type 2 diabetes mellitus, cognitive impairment and dementia, while also improving mental well-being, sleep, and longevity." (30)

Also, those who exercised longer had greater body fat loss.

A drop in abdominal and subcutaneous fat will reduce your midriff.

You won't get a flat tummy in 7 days!

Working out your excess blubber takes time (no quick-fixes). It will require patience and persistence:

A landmark study by Katch et al., (1984) (10) at the University of Massachusetts showed that sit-up exercise training does not decrease the diameter of abdominal adipose cells, abdominal SAT, or abdominal circumference.

So sit-ups won't cut it to flatten your stomach.

Vispute (2011) (11) studied 24 men and women, all of them healthy but sedentary. They subjected a group of them to abdominal exercises (a series of 7 abdominal exercises in 2 sets of 10 reps. five days a week for 6 weeks). The other group did no exercise and served as a control.

The study found that "There was no significant effect of abdominal exercises on body weight, body fat percentage, android fat percentage, android fat, abdominal circumference, abdominal skinfold... Six weeks of abdominal exercise training alone was not sufficient to reduce abdominal subcutaneous fat and other measures of body composition."

Those who exercised however had a greater muscular endurance in their abs.

So maybe abs and crunches don't help when it comes to reducing abdominal fat.

You (2006) (12) studied 45 obese middle-aged women with an average BMI of 33 and divided them into three groups: one on a low-calorie diet, another added low-intensity exercise to the diet, and the third added high-intensity exercise.

After 20 weeks all three groups "reduced body weight, fat mass, percent fat, and waist and hip girths to a similar degree."

However, the size of the subcutaneous abdominal adipocytes (fat cells) was smaller in those who exercised. The gluteal adipocytes (fat in the buttocks) dropped similarly in all groups.

Ross and Janssen (1999) (13) reviewed the evidence on the impact of regular exercise on abdominal fat and found that:

• "Exercise with or without weight loss is associated with reductions in both visceral and subcutaneous fat."
• "There is insufficient evidence to determine whether exercise-induced weight loss is associated with reductions in abdominal fat."

The type of exercise is important too!

Vigorous Exercise reduces Visceral and Subcutaneous fat

Hairston (2011) (6), besides finding that soluble fiber helped to reduce Visceral Fat (VAT) gain, also found that:

• Vigorous physical activity reduces VAT: the rate of accumulation of VAT in participants who "sometimes" engaged in vigorous activity decreased by 7.4 % and the rate of SAT fell by 3.6%, compared to those who rarely or never did vigorous exercise.

Aerobic training is not so effective

If your goal is to reduce the abdominal fat, maybe aerobics is not the best choice: Nicklas et al., (2009) (14) carried out a test similar to You's (12).

They wanted to find out if the intensity of aerobic exercise influenced the loss of abdominal fat. They studied 112 overweight and obese postmenopausal women for 20 weeks.

The women were divided into three groups: (i) low-calorie diet, (ii) diet plus moderate aerobic exercise, and (iii) diet plus vigorous-intensity exercise.

Outcome:

• On average all women lost 26.7 lb. (12.1 kg) and the weight loss was similar across the three groups.
• All groups showed similar decreases in abdominal visceral fat (approximately 25%).

High-Intensity Intermittent Training (HIIT) is better

HIIT (High-Intensity Interval Training) is also called High-Intensity Intermittent Exercise (HIIE) or Sprint Interval Training (SIT).

It is a form of exercise that involves periods of all-out intensity followed by periods of low-intensity exercise or rest.

There are different exercise protocols and the duration of sprint - intense activity periods, and the recovery periods are quite variable, from 6 seconds to 4 minutes. Some are quite demanding and may not be suitable for sedentary overweight people, but they can be adjusted to suit individual needs.

Apparently, the short, intense bursts of energy burned during HIIT workouts push the body to its limit and increase metabolic rate: your body will burn fat for the rest of the day.

A typical HIIT protocol is the "Wingate."

The Wingate Protocol

This type of HIIT involves a spurt of 30 seconds ('all-out' intensity), followed by approximately 4 minutes of recovery. This sequence is repeated 4-6 times for up to half an hour. It can be done on an outdoor bike, a stationary bike, or running.

Some of the studies mentioned below modified the Wingate to make it easier for sedentary people: they alternated 8-second cycle sprints with 12 seconds of low-intensity cycling for 20 minutes. This means 60 sprints per session.

Science backs HIIT as an effective way to tackle abdominal fat in a localized manner:

Kuo (2016) (15) looked into the model that explains how fat is burned during exercise. They found that "anaerobic high-intensity intermittent training produces greater abdominal fat reduction than continuous aerobic training at similar amounts of energy expenditure."

Boutcher (2011) (16) reviewed studies involving HIIT and found that was effective in reducing both subcutaneous and abdominal fat, citing the following experimental outcomes:

• 15 weeks of HIIT in untrained young women, led to significantly reduced body mass, abdominal fat (0.15 kg), and significantly more subcutaneous fat (2.5 kg) than those in the steady-state aerobic exercise program (Trapp, 2008) (17).
• 12 weeks of HIIT in overweight young women led to a .12 kg decrease in abdominal fat and a 2.6 kg reduction in subcutaneous fat (8%) (Dunn, 2009) (18).
• 8 weeks of HIIT in older type 2 diabetic men: no change in body mass occurred; however, abdominal adiposity was decreased by 44% (Boudou, 2013) (19).
• 8 weeks of HIIT one day a week and steady-state exercise 2 days a week in Type 2 diabetic men and women: 48% reduction in visceral fat and 18% decrease in subcutaneous fat (Mourier et al.)
• Another study found that trunk muscle mass was significantly increased after 15 weeks of HIIT.
• 24 weeks: subjects in the HIIT group lost more subcutaneous fat compared to a steady-state exercise group (Temblay et al.)
• 12 weeks, young overweight men: significantly reduced total, abdominal, trunk, and visceral fat (Heydari, 2012) (20)

Giannaki et al. (2012) (21) recruited 39 healthy adults and split them into two groups: one doing regular gym training 4 days a week, and the other doing High-intensity interval training (HIIT) twice a week, and regular gym training twice a week. The outcome after 8 weeks was the following:

• Both groups lost total body fat and VAT.
• The HIIT group besides improving cardiorespiratory fitness levels also had a "significantly greater reduction in both abdominal girth and visceral adiposity compared with conventional training."

The study concluded that HIIT was "found to be superior compared with conventional exercise training alone in terms of reducing more visceral adiposity levels."

Other Belly reducing exercises

Squats and Deadlift

Martuscello (2013) (22) evaluated how effective different types of exercise were in their stomach-flattening effects. They found that the squat and deadlift produced activity of the multifidus muscle. They were against ball exercises due to the risk of back injuries and the lower multifidus muscular activity.

Lumbar Multifidus Muscle

The lumbar multifidus acts to extend, laterally flex, and rotate the spine and prevent lower back pain. Not using it enough leads to an atrophic replacement of multifidus muscle with fat! (Freeman, 2010) (23).

Squats

Yes, plain and simple squats which consist of sitting down with your legs set apart the distance of your hips, keeping your back straight, and not letting your knees protrude forward beyond the tips of your toes.

Stop when you reach a sitting position slightly above knee height. And then rise back up again to an upright position.

You can do this by holding a weight to your chest or with dumbells in each hand. You can do it slowly or at a quick tempo. There are many options.

Deadlift

This exercise consists of lifting a weight off the floor (if that is too difficult, you can elevate the bar by resting it on a sturdy box). To do it safely you should keep your feet hip-width apart, use an overhand grip, and keep a flat neutral spine throughout the whole sequence.

Keep your shoulders back and down.

Do the "hip hinge": imagine your hips are a hinge, so when you move up, you sit back (not down like in the squat), your bottom moves back and you stand up.

Do it safely, start with a light load. The safest option is to have a gym pro coach you to do the move safely and then do it by yourself.

Warm-up before starting and do 3 to 6 sets of 4 or 5 reps each.

Combine Diet with Exercise

Exercise alone is fine, it will give you a better muscle tone and improve your health and life quality.

But remember, firming your tummy's muscles that are sandwiched between visceral fat and subcutaneous fat won't create a flat tummy. You also have to burn off the fat, and that can only be achieved with a lower caloric intake: dieting.

There are also other things that you can do to help you tackle a plump midriff:

Some Tricks to flatten your Stomach

There are several factors apart from diet and exercise that accumulate fat in your abdomen. You can act on them too:

Don't smoke

Molenaar (2009) (24) found that men who smoked had a higher SAT than those who never smoked and that former smokers had the highest SAT (yes, quitting contributes in some cases to an increase in body weight). Men and women who smoke or had smoked had a higher VAT than those who never smoked.

Cut down on Alcohol

Molenaar also found that men who drank more than 14 drinks a week had higher VAT than those who drank less. (SAT was not affected by drinking). In women, VAT was similar in those drinking more than 7 drinks⁄week to those who drank less. Amazingly, drinking women had a lower SAT than teetotallers (perhaps due to hunger inhibition from alcohol's "empty" calories).

Sleep well

Sleep the correct amount of time: neither too much nor too little. Chaput (2014) (25)- studied 293 subjects for six years; all the participants gained VAT during the study (reflecting the current "fattening" trend in America, and also the aging of the study group).

But the fat gain was not the same for all participants:

• Those who didn't sleep enough (less than 6 hours per day) and those who slept too much (more than 9 hours per day) "gained significantly more VAT than those reporting sleeping 7-8 hours a night."
• A small change such as increasing sleep duration from less than 6 to around 7 - 8 hours per day resulted in a lower VAT Gain.

Sleep Better

The secret to better sleep: A good night's sleep is very important for your health and wellbeing. Here are scientific-based tips to sleep better every night.

More...

Mood and Visceral Fat

Your mood has an influence on abdominal fat but not on subcutaneous fat according to Everson-Rose (2009) (26). This study involved 409 middle-aged women and found that:

• Increasing the depression rating by 1 point (using the Center for Epidemiological Studies Depression Scale or CES-D scale from 0 to 60) increased the area of VAT by roughly 1%.
• Women with a CES-D score of 16 or higher, had 24.5% more VAT than women with lower scores.
• SAT, on the other hand, was unrelated to depressive symptoms.

The link between depression and visceral fat may be due to alteration in the hypothalamic-pituitary-adrenal (HPA) axis, which is the body's stress response system.

The HPA releases a hormone (glucocorticoid) that causes more visceral fat deposition than other types of fat because VAT has more glucocorticoid receptors than other fatty cells.

Food allergies, autoimmunity, and food intolerances

A study by Foley (2014) (27) reported that "Bloating and [abdominal] distension, which are possibly separate but interrelated conditions, together comprise one of the most commonly described gastrointestinal symptoms. Bloating and distension have been reported in up to 96% of patients with irritable bowel syndrome (IBS) and in 20% to 30% of the general population, with the majority of those affected describing their symptoms as either moderate or severe."

There are many possible causes for abdominal distension such as:

Celiac Disease

Celiac disease (CD) affects about 1% of the population. It appears in genetically susceptible people as a reaction to dietary gluten (a protein found in wheat, rye, and barley).

This immune-mediated disease is chronic and one of its outstanding symptoms, reported in almost 85% of cases is bloating and abdominal distension. A symptom which can continue for up to 5 years after adopting a Gluten-Free diet, and is more noticeable among women.

The only effective treatment is to follow a gluten-free diet (28).

Non-celiac gluten sensitivity

Catassi (2015) (29) mentioned the Non-celiac gluten sensitivity (NCGS) is a syndrome with similar symptoms to CD and is triggered by the ingestion of gluten-containing food in subjects who are not affected by either celiac disease or wheat allergy. It affects adults and especially women in the age group of 30-50 years. Bloating is one of its main symptoms.

Gases and Fermentation: gut bacteria and their food

Bacteria in your intestines break down and ferment certain types of foods generating methane gas. This can cause distension and discomfort.

FODMAP is the acronym for a group of sugars which are poorly absorbed by the small intestine and ferment quickly in the gut. They are short-chain carbohydrates and the name stands for "Fermentable Oligo- Di- and Monosaccharides and Polyols."

Some examples of these sugars are lactose found in milk, fructose, mannitol, and sorbitol found in fruits.

Foods that contain large amounts of FODMAPs and should be avoided by people with IBS (Irritable Bowel Syndrome).

see a list of high FODMAP foods. These include: milk, fruits, bread, cereals, cream, fruit juices, and beans among others.

Lactose intolerance which is prevalent among most ethnic groups (with some exceptions such as northern Europeans) is the inability to digest lactose, a sugar that makes milk sweet. This also causes bloating.

Probiotics may be helpful against bloating (27) but only those containing bifidobacteria, which do not generate gas during their fermentation.

Getting a Flat Stomach: a Recap

If you are concerned about a fat midsection, take action now, it is a serious health risk.

Start by measuring your waistline and calculating your BMI, that will tell you where you stand now.

Flattening your belly by reducing the amount of subcutaneous and visceral fat is not an impossible task, it requires determination and hard work:

• Diet: reduce your caloric intake to burn stored fats. Eat a healthy and balanced diet.
• Exercise: vigorous exercises and especially HIIT reduce visceral fat.
• Lifestyle: cut back on smoking and alcohol; sleep 7 or 8 hours a day and keep active.
• Other factors: check if you are allergic or have IBS, Celiac disease, or are lactose intolerant and adjust your diet accordingly.
• Keep a positive outlook and treat depressive symptoms.