The other day, I was shopping at a local grocery store when I saw a man with the biggest protruding belly I had ever seen. His arms, legs and the rest of his body looked normal-sized for his height, but his belly protruded out as far as a full-term mom carrying six babies.

Sadly, this is all too common in middle age. Many people find their middle starts to disappear in middle age. I have often wondered what happened to my waist. I starting losing it around age 40. I am still trying to find it and will never give up looking, as I was kind of fond of it.

But seriously, I felt bad for the man in the grocery store because his outward appearance could be hiding a lot of turmoil going on underneath with his organs.

This kind of fat is called "visceral fat." It lies under the muscle, and is not the kind of fat you can pinch. (The pinching kind of fat is called "subcutaneous fat.")

Visceral fat is a really bad and toxic thing. It can swarm your intestines, liver, heart and pancreas and can interfere with how your organs are supposed to function.

Having that kind of excess fat on the waistline in mass quantities can cause higher blood pressure, plaque in arteries and lots of other problems.

Metabolic Syndrome is a collection of these issues and other risk factors that include high cholesterol, high blood pressure, high blood sugar and extra abdominal fat.

The American Heart Association states that if you have three out of five of the following problems, you may have Metabolic Syndrome:

1. Central or abdominal obesity: Men, waist circumference of 40 inches or above; women, 35 inches or above.

2. Triglycerides: Greater than or equal to 150 milligrams per deciliter of blood (mg/dL).

3. HDL cholesterol: Men, less than 40 mg/dL; women, less than 50 mg/dL.

4. Blood pressure: Greater than or equal to 130/85 millimeters of mercury (mmHg).

5. Fasting glucose: Greater than or equal to 100 mg/dL.

We know that waist size is an indicator of health and that we do not want fat around our middle. Spare tires are good in cars but bad on people.

We have to fight every single day to combat that and to keep our waistlines to less than half our total height in inches.

Diet is super-important. But it’s so darn hard to do the right thing all the time. In fact, I would go so far as to say it is almost impossible. But maybe we can do the right thing 80 percent of the time. That’s very doable.

And then there is the other component, my favorite component, EXERCISE! Change your lifestyle, get moving and do some type of vigorous exercise several times a week. This can reduce that visceral fat so you can reduce your waistline.

Even losing a little can help a lot. Small changes really help your important numbers.

We all need to know what our numbers are: blood pressure, blood sugar, weight and cholesterol. Many of these health problems have no symptoms, so we have to be vigilant.

Sadly, our family histories may work against us, but that does not mean we give into them. Women in menopause may see progressive weight gain, but we don’t have to give into that, either.

A sedentary lifestyle and a horrendous diet are the main problems for a lot of people. Those two things together can kill you over time, but thankfully we are in control of both of these aspects of our lives.

Remember: Try to control your stress, stay active, be mindful of what you eat and be aware of your important health numbers so you can keep that spare tire in your car and off your body.

Ann Angell is a certified instructor and personal trainer and manager of the Oxford YMCA. And she’s over 50. "Fitness over 50" is published the third Sunday of each month.