Ask Tufts Experts: Belly Fat; Diverticulosis Diet

I have a normal BMI, I eat right, and I stay quite active for a woman my age. Should I be concerned that I have a belly no matter what I do?

Alice H. Lichtenstein, DSc, director of the Cardiovascular Nutrition Laboratory and executive editor of Tufts Health & Nutrition Letter, answers: “A large waist (over 35 inches for women and 40 inches for men) is one of the components of metabolic syndrome, a cluster of conditions that increases risk for heart attack, stroke, and type 2 diabetes (see the November 2020 issue, page 4, for more information). Here’s why: a large waistline can be an indication that fat has built up around the organs in your abdomen. This type of fat is considered “metabolically active” and can lead to adverse health outcomes. One thing we can’t tell from measuring waist circumference is whether an individual’s belly fat is visceral (around organs) or subcutaneous (under the skin). The latter is of less concern than the former. If your healthcare provider finds blood pressure, blood glucose, and plasma triglyceride and HDL-cholesterol concentrations are normal, you are on the right track.

“Genetics has a major impact on body fat distribution. In addition, distribution can shift with age. We don’t have much control over either of these forces. Regardless of some claims about specific diets and foods or types of activity, recent work has confirmed that little can be done to target weight loss (or gain) to specific regions of the body. The important thing is to achieve and maintain a healthy body weight (a.k.a., BMI), be physically active, avoid tobacco products, get adequate sleep, and identify ways to manage stress. Different things work for different people, so identify strategies that work for you, in the long term.

“Again, if health metrics like your weight, blood pressure, blood sugar control, and blood lipids are normal, I would not be too concerned about your waistline. Stay active, continue your good eating habits, and embrace your healthy, changing body.”

I have been told I shouldn’t eat nuts because of my diverticulosis. Is this true?

Alicia Romano, MS, RD, a dietitian at the Frances Stern Nutrition Center, answers: “Nuts are healthy foods that are good choices to incorporate into your diet for the long term, given their general healthy nutrient profile. They are a plant source of protein and naturally high in fiber and healthy fats (omega-3 and polyunsaturated fatty acids). Nuts are an important dietary component in many healthy dietary patterns, such as the DASH diet and Mediterranean-style dietary patterns. They are associated with overall digestive health and lower risk of diabetes, cardiovascular diseases, and many other chronic diseases.

“It is a common misconception that nuts, seeds, and even popcorn should be avoided to help control diverticulosis, a fairly common condition in which little pockets form in the lining of the intestines. These pockets can become infected and inflamed, causing severe pain (diverticulitis).

“It has been suggested that undigested fragments of foods like nuts and seeds may reside in the colon and cause diverticular trauma and complications. There is no scientific evidence to back up this assertion. Unfortunately, there is not a great deal of research conducted in this area. However, some studies suggest consumption of nuts (at least twice per week) may actually result in a decreased risk of developing diverticulitis.

“If you are dealing with a flare of your diverticular condition (diverticulitis), fiber should be avoided. Nuts, seeds, and other high fiber foods should slowly be reintroduced back into the diet once your flare has resolved. And, as always, follow the advice of your healthcare provider.”

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