If you are a man or woman approaching 50, look down at your middle. If you’re like many people, you might have to lean over a bit to see your feet.

Yes, it’s the dreadful midriff bulge — that expanding waistline that can often creep up on you as you age, much like a receding hairline or extra wrinkles.

Tough to combat, it almost seems like a rite of passage, just part of the cycle of life, right? But a new study has found that allowing your middle to expand will do more than send you shopping for the next size up in britches -— it can also harm your physical abilities later in life.

The study, which followed 4,509 people who were 45 years old or older in Norway for over two decades, found participants who had a high or moderately high waist circumference at the start of the study were 57% more likely to be “frail” than those with a normal waistline.

But frailty is not that “tottering” elderly person bent over a cane that comes to mind. Instead, frailty includes a poor grip strength, a slower walking speed, overall exhaustion, unintentional weight loss and low physical activity.

People who were obese at the start of the study, defined as having a body mass index (BMI) of 30 and higher, were also 2.5 more likely to be frail than those with normal BMI (18.5 to 24.9), according to the study published January 23, 2023, in the journal BMJ Open.

There could be several reasons, according to study authors. Obesity leads to an increase in inflammation in fat cells, which can damage muscle fibers “resulting in reduced muscle strength and function,” study coauthor Shreeshti Uchai, a doctoral research fellow in nutritional epidemiology at the University of Oslo in Tromsø, Norway, and her colleagues wrote.

The results highlight the need to stay on top of both overall weight gain and any rise in waist circumference, and to broaden the definition of frailty, the authors concluded.

“In the context where the population is rapidly ageing and the obesity epidemic is rising, growing evidence recognises the subgroup of ‘fat and frail’ older individuals in contrast to viewing frailty only as a wasting disorder,” they wrote.

Combat the decline

Exercise can help counter the growing frailty that aging may bring. Adults should perform muscle-strengthening exercises involving all major muscle groups on at least two or more days each week, in addition to exercising at least two hours and 30 minutes per week at a moderate intensity, according to the US Department of Health and Human Services’ physical activity guidelines for Americans.

Reducing body fat and building lean muscle can help improve balance and posture, Dr. Nieca Goldberg, the medical director of Atria New York City and clinical associate professor of medicine at New York University’s Grossman School of Medicine, told CNN previously.

To stay strong and healthy, try to do both aerobics and strength exercises.

They “appear to work together and help each other move toward better outcomes,” said Dr. William Roberts, a professor in the department of family medicine and community health at the University of Minnesota Medical School.

“A balanced program of strength and aerobic activity is probably best and probably more closely mimics the activities of our ancestors, which helped determine our current gene sets.”

To get started on strength exercises, CNN fitness contributor Dana Santas, a mind-body coach in professional sports, suggests mastering body-weight movements first before moving on to free weights.