Men's Health, the magazine that annually reminds the Queen City that we could lose a few pounds, is back to deliver a punch to the gut: It gave Cincinnati's males a "D" for "best abs."

There is some consolation: Cleveland scored a big fat "F," as did St. Louis; Memphis, Tenn.; Jacksonville, Fla.; Detroit; Virginia Beach, Va.; and El Paso, Texas.

San Francisco earned an "A" for its taut tummies. Also earning top marks were Oakland, Calif.; Austin, Texas; Boston and Washington.

Columbus also earned a "D" on the survey, while Toledo came in tops in Ohio with a "C."

Some might see a six-pack as the epitome of male vanity, says David Zinczenko, editor-in-chief of Men's Health and writer of The Abs Diet (Rodale; $24.95), but a tubby gut increases the risk for diabetes, heart disease, several cancers and impotence.

Ratings were based on body mass index counts by county; back surgery rates, usage rates for gyms and abdominal machines; numbers of weightlifters per city; diabetes rates and blood pressure rates.

Dr. Robert Finlay, an internal medicine specialist with UC Physicians, isn't surprised by Cincinnati's less-than-stellar grade.

"I do see my share of flabby men," he says.

But, he adds, the city's flab "does cross gender lines."

Finlay talks to a lot of his male patients about safe ways to lose weight.

"I probably have this conversation more than once a day with men," he says.

But while more men are asking for advice, he says, "as far as following through, there's varying success. I do see enough success stories, though, that I joke with them that they ought to give lectures in the waiting room."

He advises cutting back on calories and adding moderate exercise to lose two to four pounds a month.

"Anyone can tell them to go to the gym, but most people won't do that," Finlay says.

In The Abs Diet, Zinczenko offers these pointers for busting guts:

• Eat six small meals a day.

• Eat filling, muscle-building foods, including nuts, beans, greens, dairy products, oatmeal, lean meats, peanut butter, olive oil, whole grains, whey powder and berries.

• Mix up the exercise: Use cardio, strength and abs and back exercises.

• Invite your significant other to join in.

E-mail pofarrell@enquirer.com