Poochy Belly or Flat Tummy?

After menopause, our metabolism and body shape both change.

The look of our tummies seems to be a focus for women all through the ages and stages. It’s a frequent topic at my clinic….let’s dive in and do some tummy talk. Is a flat tummy normal and expected at all ages and stages? And what does the shape of my tummy have to say?

Firstly, let’s begin by accepting our body composition or morphology, just as we are. Body positivity is a really great place to start, accepting ourselves just as we are today. However, being overweight is a concern. If we’re holding excess belly fat, we’re putting ourselves at risk of some long term disease states…..in effect, promoting poor health. Paying attention to a healthy weight to height ratio (look online for calculators of that), BMI indicators (body mass index calculators) and the waist to hip ratio is a good place to start. The WHO states that abdominal obesity is defined as a waist-hip ratio above 0.90 for males and above 0.85 for females or a body mass index (BMI) above 30.0. Excess belly fat correlates to high blood pressure, Type 2 Diabetes, increased risk of heart attacks and cancers (breast, pelvic and colon). It’s worth paying attention to!

Secondly, after menopause, our metabolism and body shape both change. We can more easily store fat on our tummies and it’s more difficult to lose it. We lose weight by reducing our stress factors, eating whole foods, minimizing cheap calories (daytime snacks, wine, late evening eating), and upping our movement. Huff and puff exercise (cardio) for 22 – 25 minutes, 3 or 4 times per week, not only exercises our heart but will also raise your metabolism for the rest of the day. Getting good, restorative sleep helps you lose weight! Really!!! Pay attention to your sleep habits and start a devoted, consistent routine that promotes brilliant sleep.

Thirdly, let’s talk Diastasis Rectus Abdominus…..the split middle that we all enjoy after pregnancy. About 30% of women are able to naturally find “forced closure” of the separated abdominal walls after they’ve delivered their baby and they’ve recovered for 2 – 3 months. You will never “heal” your DRA…..it served you to help you maintain your pregnancy but your abdominals have changed for life. This pressure management system (your core) needs to learn new strategies to help support your front abdominal wall, your pelvic organs, and your pelvic floor. Sit-ups, V-sits, Pilates exercises, and Crunches are NOT a good strategy to start with – they will promote prolapsed organs (uterus, bladder, rectum) later on in life. You will be able to do these wonderful strong exercise habits as well as powerlifting (if you’d like) IF you find forced closure of your muscles in a healthy, well-timed and synergistic fashion. Ask a women’s health physio to guide you!

Fourthly, there is bloat…..the cranky tummy that puffs up after eating and drinking. Paying attention to what your very own digestive system loves to eat is important. The best evidence base for Irritable Bowel Syndrome is from Australia, called FODMaP; it was thoroughly studied and developed at Monash University. Check it out online! It can guide you into a healthy digestive system for life and eating a varied diet once you figure out your own pesky triggers.

Finally, consider some of the varied, complex tummy concerns, of which there are many. One example is Abdominal Phrenic Dyssynergia, a condition in which your respiratory diaphragm and pelvic diaphragm get confused. Instead of your respiratory diaphragm rising up to accommodate a full colon after eating, it heads downward. If you have a tight pelvic floor that rises up (this may be a tight pelvic floor with slow, weak urination and/or pain with intimacy and/or constipation) when you eat, there is only one way to accommodate a full tummy…..outward. APD is treatable with retraining of the respiratory diaphragm and manual therapy for releasing all components in the system. It takes commitment. Changing your body’s mind is often hard work.

Is there some component of women’s health that you’d to hear about? Email me at jgphysio@shaw.ca.

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