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Jakarta Post

Health Sense: What'€™s lurking inside your pot belly

  • Ben Ng Jen Min. MD

    The Jakarta Post

Singapore   /   Wed, November 12, 2014   /  12:19 pm

Let'€™s face it: Too much of fatty foods, delicious meals and indulgence with alcohol creates a beer belly or in short a big fat abdomen.

 If you'€™re the butt of jokes it might seem trivial to have a beer belly but do you know that a beer belly is more than a joke? Seriously, men with beer bellies are more prone to diabetes, heart attacks and strokes.

Generally, fat is stored in two different ways - subcutaneously and viscerally. Subcutaneous fat refers to fat stored below the skin while visceral fat as the name implies is stored in your abdominal cavity and around internal organs in your abdomen such as your intestines, liver and pancreas and contributes to that special shape called beer belly. However, visceral fat may not be obvious.

Researchers say this originated in the early times when our ancestors were hunter and gatherers. They needed to have speed when they hunt, trap prey, fight and flee to evade their predators.

The belly fat stored in their upper bodies is rapidly broken down in a process called lipolysis.

Their endurance comes from a steady supply of fatty acids stored in their bellies and are used by the muscles for energy.

Their daily lifestyle was spent much in walking, hunting and gathering. The fat stored in their abdomens undergoes lipolysis at a fast rate of construction and reconstruction.

Modern men do not need this storage of fat. However, the body is genetically programmed to store fat in the abdomen and this is usually due to too much caloric intake without adequate physical activity to get rid of it.

Further, as men age their metabolism slows and they accumulate fat around their middle more than they can burn it off.

Studies have shown that excess visceral fat is a major risk factor for the development of type II diabetes mellitus. Genetics may play a role plus being obese but visceral fat lurking in your abdomen doesn'€™t always make you look fat.

When you'€™re overweight, your pancreas produces more insulin than normal to maintain normal blood sugar levels.

Overproduction of insulin causes the pancreas to fail. When there is too much insulin in the blood stream the cells start to die.

 The high concentration of fat compounds accumulate in the liver giving rise to fatty liver and affects the ability of liver to function efficiently as the body'€™s chemical regulating center. As a result, diabetes occurs.

In this case, the pancreas doesn'€™t produce enough insulin or there might be the presence of insulin but the cells do not utilize it properly - the so-called insulin resistance. Consequenlty, blood sugar levels rise in the blood stream.

In the long term, the high blood sugar that circulates in your blood stream wreaks havoc to your essential organs and cause many serious complications.

It can give rise to end stage kidney failure, heart disease, heart attack, blindness, and foot amputations among others. When the kidney cannot function anymore it can cause toxic chemicals to accumulate in the body and cause coma and death.

Diabetes presents with very few or unnoticed symptoms in the very early stages unless you go for a screening. Most times it'€™s an incidental finding.

 There is the misconception that when your aren'€™t fat you don'€™t develop diabetes. You may have visceral fat but is not obvious. Most times, genetics play a role. Thus, it is always important to go for a diabetes screening at age 35.

This is crucial if you have high cholesterol levels and a smoker.

When you consult an endocrinologist he will determine what test you will need to confirm the diagnosis of diabetes.

 One test is the oral glucose tolerance test which detects how your body processes sugar under different conditions. The fasting blood sugar determines blood glucose level in a fasting test and the HBA1C show you your average glucose level in a span of three months.

There is no cure for diabetes mellitus as yet. It can only be managed to keep your blood sugar under control and prevent dreadful complications.

Your endocrinologist will determine what medications are best - oral medications or insulin. Excerise helps muscles cells utilize glucose, weight loss can help in decreasing your risk of diabetes mellitus - and so does a balanced diet.


The writer, a physician and endocrinologist, is vice president of the Diabetic Society of Singapore.

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