In the end, fewer calories and more exercise is what works, says Jo Ann Hattner, a nutrition consultant with Stanford University School of Medicine and coauthor of Help! My Underwear Is Shrinking!
"It's the prudent diet. It's more vegetables, more fruits, more whole grains," Hattner says. Emphasize healthy foods containing potassium, calcium, dietary fiber and vitamin D. Cut back on sugars — especially sugar-sweetened beverages — as well as saturated fats and refined grains such as those found in pastries.
"You have to understand that this is a lifelong change," she says. "This is not a diet in which you lose weight and then you can go back to your normal eating patterns. That just doesn't work."
Which diet is best?
One recent study suggests a low-carbohydrate diet may best target visceral fat. A Johns Hopkins University study of people with large bellies found that those who ate a healthy low-carb diet lost both more pounds and more belly fat than the group on a low-fat diet, says Kerry Stewart, director of exercise physiology at Johns Hopkins School of Medicine, the lead author of the study.
Cummings of the University of Washington, however, doesn't put too much stock in any one diet. "Go on whatever diet you think you can stick to," he suggests. Once you start losing weight, the payoff comes quickly. With every pound of belly fat that's lost, health risks diminish, too. Several studies have shown that you don't need to lose all the weight to get dramatic improvement. Scherer says even a weight loss of 5 to 10 percent lowers dangerous levels of insulin and estrogen.
Know your waist size
Only an MRI or a CT scan can show how much visceral fat you really have. But your waist size is a good indicator. The danger zone for women is a waist that's 35 inches or larger; for men it's 40 inches or larger. To measure correctly, wrap a measuring tape around your bare abdomen, just above the hip bone. Another way to take stock? Watch how your pants fit. Says Hattner: "The clothes really tell the truth."
Also of interest: How healthy is your weight?