Visceral fat deep dive: The impact of belly fat on your health

It seems to have become commonplace that most of us men will form bellies as we age. I’m all for endearing nicknames — “beer belly”, “spare tyre”, or “dad bod” — that ensure we avoid body shaming but we shouldn’t normalise it either.

Not all fat is equal, nor is it all bad, but the fat beneath your abdominal muscles and around your organs — known as visceral adipose tissue (VAT) — is a leading risk factor for heart disease and metabolic disease.

We may be more pre-disposed than women but there are clear steps we can take to address hazardous belly fat and it’s not just “dad bods” that suffer from high VAT [1].

Even those with lean-looking bodies can have high VAT because of unhealthy habits and pre-dispositions to body fat deposition.

So, what is your gut telling you? Let’s dive in.

Why do we form fat?

Despite all the negativity, a minimum amount of body fat is essential to our health and optimal performance.

At sub-10% body fat, our sex hormones can suffer (e.g. testosterone drops), however, excessive body fat also undermines our endocrine system (e.g. lower leptin sensitivity, higher estrogen) and can set off a vicious cycle that is hard to break (obesity).

Nevertheless, fat serves as “reserve fuel” for our ongoing energy needs when we’ve already burnt all the calories from food. For simplicity’s sake, fat is stored in the body when we consume excess calories and is released when we don’t consume enough. In optimal conditions, excess calories are stored as “subcutaneous fat” in the body.

However, food and ‘empty calories’ are ever-abundant in our modern world so we too often consume excess calories and higher-GI calories that rush sugar into our system and trigger energy storage.

We run into trouble as unhealthy habits undermine our metabolic health and result in a greater share of excess calories being deposited as “visceral fat” [2].

Bad habits that result in elevated visceral fat:

• Alcohol [3]

• Smoking and even reformed smokers are at higher risk [4]

• Processed foods such as soft drinks, chocolate, chips, etc [5]

• Inactivity and a sedentary life will compound bad habits too [6]

Why is visceral fat bad?

Visceral fat (VAT) is fat around your organs. This is not good, and it’s not just “beer belly” body compositions that have high VAT. 

Visceral fat (VAT) results in an increase in free fatty acids (FFAs) and inflammatory molecules (aka adipocytokines) that enter the bloodstream and the liver.

The combination of higher plasma FFAs and inflammatory cytokines undermines effective liver function and overall metabolic health, resulting in increased insulin resistance, hypertension, and fatty liver disease [7].

High VAT is strongly correlated with an increased risk of cardiovascular disease, cancer, diabetes, and all-cause mortality [8][9][10]. These are all major risk factors for men.

Overall, VAT is a much higher risk factor than subcutaneous fat [11].

How do we measure visceral fat?

At Compound, we use DEXA body composition scans as the most practical tool to quantify visceral fat, however, a CT scan or MRI could also be used (at a much greater expense).

We assess and stratify visceral fat levels from healthy to high-risk and then evaluate holistically against blood biomarkers, cardiovascular conditioning, diet observations, and lifestyle habits to form a more powerful perspective on a member’s cardiometabolic health [12].

Many health practitioners rely on simplistic measures such as waist circumference or Body Mass Index (BMI), however, DEXA scans provide more valuable insights into risk factors related to body composition.

What can I do about it?

We’re not trying to be alarmist but if you have a beer belly or you have high VAT (via a DEXA) then you really should work hard on healthier habits to bring this down.

Here are some practical actions in order of priority:

Alcohol

Eliminate or moderate and substitute to healthier drinking options.

Exercise

A combination of low-intensity steady state (LISS or Zone 2) cardio training with high-intensity interval training (HIIT) will reduce VAT [13][14], and it can’t hurt to combine with resistance training [15] for overall health and performance.

Diet

Opt for higher protein, low-GI carbs and moderate healthy fats in a wholefoods-based diet as this helps regulate blood sugar and increase fat loss — it really is that simple.

Recovery

Focus on sleep quality to improve metabolic health as well as active recovery practices to reduce stress levels as cortisol is a key mediating factor for visceral fat.

If you have a family history of cardiometabolic disease, or you have an unhealthy lifestyle and significant abdominal fat then it’s worthwhile getting your visceral fat checked via a DEXA.

Should we keep deep-diving into fat in the next few topics? White fat, brown fat, beige fat, trans fat, and more. Fat identifies itself in many different ways but doesn’t have pronouns yet.