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Gut Buster

Increased testosterone levels during menopause may cause a buildup of stubborn belly fat, new research says

woman pinching her fat

Middle-aged women who fight the battle of the bulge often blame age on their visceral, or belly, fat, but the culprit may actually be a more invisible threat: Hormonal changes caused by menopause.

Doctors at Rush University Medical Center, Chicago, conducted the study by examining a group of 359 women ages 42-60 in menopausal transition and using CT scans to measure the amount of fat in their abdominal cavities. Blood tests then measured the amount of testosterone and estradiol, the main form of estrogen. Subsequent statistical analysis that considered each participant's medical history found that the level of active testosterone in the body was the strongest predictor of belly fat.

"Of all the factors we analyzed that could possibly account for the increase in visceral fat during this period in a woman's lifetime, levels of active testosterone proved to be the one most closely linked with abdominal fat," said Dr. Imke Janssen, an assistant professor of preventive medicine at Rush and the study's lead investigator.

The woman's age, medical history, cardiovascular condition, race or level of estradiol did not have any strong correlations with belly fat levels.

Visceral fat - fat that surrounds the body's internal organs - is metabolically different than subcutaneous fat, which is located beneath the skin. Prior research showed that belly fat is more likely to cause inflammation and raises risk for heart disease. The same research found that rising testosterone in women also marked the onset of metabolic syndrome, which also contributes to coronary disease.

"For many years, it was thought that estrogen protected premenopausal women against cardiovascular disease and that the increased cardiovascular risk after menopause was related only to the loss of estrogen's protective effect," Dr. Janssen says. "But our studies suggest that in women, it is the change in the hormonal balance - specifically, the increase in active testosterone - that is predominantly responsible for visceral fat, and for the increased risk of cardiovascular disease."

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