In my last column a couple of weeks ago I gave some attention to the notion that it’s not just our size, but also our shape, that determines the likely health effects of any excess body baggage we happen to be carrying. Increasing evidence suggests that individuals with an overflow of fat around the midriff (sufferers of so-called abdominal obesity) tend to be at greater risk of succumbing to conditions such as heart disease and diabetes, and might do well to pinch a few inches off their waistlines. With the spectre of abdominal obesity looming large, my aim this week is to explore the lifestyle strategies that seem to be most helpful for those of us who find things have gone belly-up.

As with most things, the best chances of success in bringing down a burgeoning belly come from addressing its underlying cause. As I mentioned in my last offering, abdominal obesity is often to be found in conjunction with a range of physiological and biochemical imbalances that are collectively referred to as ‘metabolic syndrome’. One substance that has been heavily implicated in the development of metabolic syndrome is the blood sugar-lowering hormone insulin. Sufferers of metabolic syndrome generally have raised levels of insulin in their systems, though the body tends to be somewhat numb to its effects. Recognition of the importance of under-functioning insulin in metabolic syndrome is reflected in one of the alternative names for this condition - ‘insulin resistance syndrome’.

Quelling insulin levels in the body and boosting its effectiveness seem to be key to countering metabolic syndrome. The principle dietary strategy here is to avoid foods which tend to stimulate surges of insulin in the system. Sugary fare (such as biscuits, cakes and sugared soft drinks) are renowned for their ability to upset the body’s chemistry, but many starch-based foods can be very disruptive in this respect too. Potatoes, as well as most forms of rice, pasta, bread and breakfast cereals liberate their sugar quickly into the bloodstream, and tend to induce excesses of insulin as a result.

Theoretically at least, cutting back on sugar and starchy staples should help counter the biochemical basis for metabolic syndrome, and help reduce the middle-weight excess that goes with it. In fact, more than one study has found that lower-carb diets tend to improve insulin sensitivity, and to a greater extent than diets low in fat. Also, while studies have not looked at waist size per se, there is evidence that carbohydrate-restricted diets are more effective for the purposes of weight loss than those that cut back on fat. In general, I advise those seeking to slim down their circumference to base their diets on slow sugar-releasing foods such as meat, fish, eggs, green vegetables, beans, lentils and nuts.

While appropriate changes to the diet may be very effective in combating abdominal obesity and the metabolic syndrome, activity and exercise can play a part here too. One study in men found that three months of daily exercise (the equivalent of about one hour of jogging or brisk walking each day) reduced waist size and helped reverse insulin resistance even without any dietary changes. In practice, a less arduous exercise regime, coupled with some dietary change tends to bring the desired results. Cutting back on sugar and starch, and stretching the legs each day seem to be the right moves to be making for those of us looking to bust a gut.

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