Belly Fat, is it forever? How to get your flat belly back with lifestyle and exercise changes.

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The right diet, exercise, and vitamins are the key elements to losing belly fat.

While you cannot fight your genetics or your past medical history anymore, you must take action as soon as possible to lose belly fat, improve your abdominal strength, and decrease your abdominal girth (measurement around your abdomen). 

I hope you watched our last Healthcast that explained the inevitability of belly fat in people over 40 without testosterone pellet replacement.  We change all that with testosterone replacement and estradiol replacement with pellets, and a complete preventive medicine plan.

Diet + exercise of the abdominal muscles + aerobic exercise is necessary if you want a flat belly.

First Diet:

  1. Eat a low carb diet (mostly cut out foods made of sugar, flour and all grains), while continuing to eat large amounts of fruit and veggies.
  2. Cut out the lectins that slow down your metabolism by eating according to your own blood type.
  3. Give your body the nutrients that assist in weight loss:Vitamin D3, Iodoral 12.5 mg/day with food, Magnesium 200-800 mg per day based on formulation, Zinc 15-30 mcg per day, DIM (di-indomethane (made from broccoli and cauliflower), Methyl folate 5000mcg/methyl B12 2000 mcg/day, and arginine to increase muscle mass.
  4. Feed your muscles with PROTEINS:
    1. You need a lot of protein to make muscle especially if you have a normal testosterone level, so eat enough protein made of whey-ultrafiltered (eg. Phorm Level 1 protein powder) or for vegans, use pea protein. Dose is ½ of your weight in pounds, in grams of protein. For example, if you weigh 200 lbs you should eat at least 100 grams of protein a day to maintain muscle mass. If you are trying to build muscle, then eating between half -100% of your body weight in grams of protein/day. Remember to drink a lot of water to metabolize your protein
    2. Eat red meat, eggs and fish: these proteins are excellent sources of protein to build muscle by altering your diet.
    3. Take arginine to help make muscle and treat your sexuality
    4. Take DIM to lower estrone levels.
  5. AVOID SOY! Soy acts as an estrogen and increases your belly fat and shuts your thyroid down.
  6. Do aerobic exercise every other day one hour a day.
  7. Have your deficient hormones replaced or balanced by a doctor specializing in hormones especially testosterone and thyroid hormones.
  8. Exercise your abdominal muscle daily e.g. Planks, side planks, leg lifts, leg drops, crunches, etc.

The rest of the Healthcast will be dedicated to abdominal exercises: You must know anatomy for you to be able to decide what exercises will strengthen and flatten your stomach.

Your abdominal musculature is made up of 4 muscle groups:

  • Rectus muscles These two muscles are attached to the rib cage and the pelvic bone and run longitudinally alongside the midline of the abdomen. This muscle group is more commonly referred to as the “six pack.” (picture)
  • External Obliques muscles run obliquely (at an angle to the rectus muscles) These sit on the sides of the rectus abdominis and allow your trunk to twist. Working on these muscles narrow the waistline. (picture)
  • Internal ObliquesThese are also located on either side of the rectus abdominis, the run obliquely, but deep to the external 0bliques.They run between the hipbone, the ribs and rectal muscle. They also help with twisting motions. The stronger they are the smaller your waistline.
  • Transversus Abdominis These muscles sit behind the obliques and help stabilize your trunk. They’re sometimes called the corset muscles.

The abdominal muscles are responsible for curling up, turning sideways, twisting at the waist, and holding in the contents of the abdominal cavity. The abdominal muscles are the anterior or front part of the human body’s muscles of the core. They integrate with the flank and back muscles to complete the core. A strong core brings with it a flat stomach, good balance, good posture, mobility and prevents injury to the body.

We will discuss the simple exercises most patients can do on their own to tighten the abdominal muscles.  These exercises are both isometric and active dynamic exercises.  Sit ups only exercise your rectus muscles and to have a flat stomach you should work out all of your abdominal muscles!

The exercises should be done in order and should be repeated 3 times. The more in strengthen your abs the more repetitions you should do. Video for each one less than 30 sec each.


  1. PLANK

Get on your hands and knees, then put your elbows on the ground, directly below your shoulders, step your feet backwards until your body is parallel to the a plank. Tighten your core and hold for 45 seconds, rest for 15 seconds and repeat 2 more times.


Begin in plank position. Place right elbow directly beneath the middle of your chest facing forward, then lift left hand to your waist, and place your left foot on top of your right (so left leg is stacked on top of right, too). Lift your left arm to the sky, keeping hips lifted and glutes squeezed. Hold for up to 45 seconds, then rest for 15 seconds. Repeat two more times, then switch to the other side and repeat.


Lie on your back with your arms extended, reaching straight from shoulders to the sky. Bend and raise knees so they form a 90-degree angle. (Shins should be parallel to the floor.) Squeeze abs and press lower back into the floor. hold this position for as long as possible up to 45 seconds, then rest for 15 seconds. Repeat two more times.


Sit on the floor with your arms supporting you behind you and your knees bent—you will be in a V shape. Bring right elbow toward left knee, keeping chest open and extending right leg out long. Repeat on opposite side with left elbow coming to right knee. Do as many reps as possible while maintaining proper form, up to 20 reps.


Forearms resting on the ground supporting your body weight with hips slightly elevated in a piked position. Drop the left hip to the floor twisting at the waist,  return to piked hip position, and drop right hip to the floor. Continue alternating to do as many reps as possible, up to 18 reps

  1. LATERAL HIGH KNEE with aerobic action.

Stand with your feet directly under your shoulders. Bring left knee up towards chest and right palm to your ear in a runner’s stance. Quickly switch your arm and leg (as if you were jogging) and move a step to the left. Continue alternating for three steps; that’s one set. Move back the opposite way for three steps; that’s a second set. Do 12 sets total.

While you are doing these exercises think about the abdominal muscles you are exercising.  By thinking about them they will work more effectively. The rest of the day think about holding in your stomach, when you are standing, waiting in line, and walking. Abdominals can be done any time, like Kaegles are, without anyone knowing.

Ideally if you need to lose belly fat, you should follow these exercises daily with aerobic exercise for at least 30 minutes. Run, quickly walk, elliptical training, run in place or run up and down your own stairs.

It is not an effort that can be taken in a series, like doing one thing, then stopping and then doing another, this effort is done in concert, all things need to be accomplished at the same time.  The many boxes that need to be checked include  abdominal strengthening exercises, daily aerobic exercise taking only one day off a week, a high protein, low carb, low lectin diet with appropriate supplements, Testosterone replacement with pellets,  medications to treat insulin resistance and even diet pills,  all of which were discussed in the last Healthcast, # 559.

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