Sandra Bueckert is a 45-year-old mother of two and one of the best-known personal trainers in my hometown, and she is indeed muscularly ripped. Some people appreciate this look; some don't.

But I was more curious about whether women can achieve it without harming their health. So I set out to learn how some ripped women do it, and whether the experts approve of their methods.

For decades, doctors have cautioned that women should avoid overly low body fat to prevent negative health consequences. According to the International Olympic Committee, the problem is more prevalent in athletic women, especially those in sports that emphasize leanness.

Low body fat among female athletes even has a syndrome named for it: the female athlete triad. The disorder is defined by three interrelated conditions — low calorie intake that can lead to menstrual disturbance and/or bone loss — that exist on a continuum of severity.

Turns out it doesn't have to be that way.

"It's a complicated issue," said Greg Wells, an associate professor of kinesiology at the University of Toronto in my native Canada. Wells works with elite athletes and has conducted research on body fat levels and health.

"We used to say the minimum body fat to maintain reproductive health was 20%, but that's been debunked," Wells continued. "Now we've found that women [with] over 20% body fat are more likely to have reproductive problems, and those below it may have better function."

As long as they don't go too low. For a woman to start seeing abdominal definition, she needs to get down to 14% to 15% body fat. Just last fall, researchers from the Norwegian School of Sport Sciences in Oslo published a study of 938 female athletes, reporting that those with less than 12% body fat — classified as "under-fat" — were more likely to have menstrual irregularities, stress fractures and be diagnosed with eating disorders.

This implies a pretty narrow margin between the low percentage of body fat you need for abdominal definition and a percentage that's potentially dangerous.

But Wells says it's more nuanced than that — it's more about women paying close attention to how their bodies tolerate what they're doing to achieve their leanness. "They need to monitor their own health and get regular medical checkups," he said.

The calorie deficits should be small, with focus on a nutritious diet; this needs to be a glacially slow process that involves lots of fruits and vegetables. If you starve yourself too much or work out too much without adding enough extra calories, you run the risk of disrupting your reproductive and metabolic hormones — thereby messing up your menstrual cycles and losing bone, said Anne Loucks, a professor of biological sciences at Ohio University and a specialist on the female athlete triad.

"The longer the energy deficit … the more serious the outcomes can be on bone health," added Dr. Aurelia Nattiv, a UCLA professor and director of the university's Osteoporosis Center. That's why Nattiv, who was influential in defining the triad, discourages rapid weight loss and emphasizes setting realistic goals that can be achieved in a healthful way.

So that's the doom-and-gloom portion. What about women getting ripped abs in a healthful way?

It can be done — so let's get back to the coffee shop.

"I started training when I was 16 in an all-male, hard-core bodybuilding gym," Bueckert said, sipping a coffee with full-fat cream that I assumed she would burn off later. "Cutting fat was hard because I'm Jamaican, where if it's not covered in an inch of fat, it isn't cooked."

At age 19, she was junior Canadian bodybuilding champion — no steroids, she said. "I've always been natural." She left the sport a few years later when, she said, a judge at the national level told her that she'd have to start taking the substances in order to win. "I wanted to have babies," she said, and she knew that anabolic steroids could interfere with reproduction.

She lost her physique (in a big way) during childbearing years but fought to get it back six years ago through training hard and eating a balanced, nutritious diet, and she has kept it ever since. "I work out six to 10 hours a week. I prefer to burn fat off as opposed to starve it off. My physician has never said I'm suffering health consequences from my leanness."

But not everyone takes Bueckert's approach. "Back when I competed, I knew a lot of girls who would lose their cycle for a year or more. It never happened to me, because I didn't go on ridiculous diets and cut out whole food groups. Some of those girls would eat like birds."

My friend Heather Giorgi is another example of a woman who revealed her abs the healthful way. The 34-year-old mother of two used to compete in female fitness competitions involving a variety of challenging tests of athleticism. Competitors were also assessed on how they looked in a bikini. Giorgi won an overall world championship title in 2003.

She said that she may have missed her period once but that there were no challenges when it came to getting pregnant.

"I was training two to three hours a day, five to six days a week when getting close to competition," she said. "I was clean eating [meaning no junk food] a lot every two to three hours to fuel the exercise. I didn't have a choice but to eat."

The recurring healthful theme here is just what Bueckert said: Don't starve it off; burn it off. If a defined midsection is your goal, remember the importance of slow and steady with minimal caloric deficits. With the weight loss industry making promises to women to "get ripped, fast!," a potentially dangerous health situation is created. Such commercials are more than unrealistic — they're harmful.

And perhaps most important, know that you need not be able to bounce quarters off your midsection for it to be considered attractive.