When we think about body fat, we tend to think of the little extra cushion around our midsection.
But there’s another type of body fat that is actually way more problematic.
It’s called visceral fat, and having high levels is associated with inflammation, reduced life expectancy, and chronic disease.
Visceral Fat: What Is It?
You know that belly fat around the waistline you can pinch with your fingers? That’s called subcutaneous fat, and it’s located just beneath the skin.
Visceral fat, on the other hand, is located deep within the abdomen, wrapping around vital organs and tissues, including the liver, stomach, and intestines.
The problem with visceral fat is that you can’t see it with the naked eye. Therefore, it's hard to know how much of it we have. Yes a good proxy for understanding visceral fat stores is how much subcutaneous fat or belly fat one has because what’s happening on the outside is often a sign of what’s happening on the inside BUT this is not always the case!
TOFI (Thin on the Outside, Fat on the Inside)
There’s a certain subgroup of people who have higher-than-normal levels of visceral fat on the inside without much visible subcutaneous fat.
We call this TOFI, and it impacts men and women of all ages, races, and ethnicities. If you’re a lean individual but still eat a lot of ultra-processed food, drink alcohol, don’t get quality sleep, or spend most of your time being sedentary, these are risk factors for accumulating visceral fat.
Asian and Indian ethnicities are particularly prone to TOFI!
It's Possible to be Overweight and Healthy
It is possible to be visibly overweight but have little visceral fat. This phenomenon is mostly linked to diet quality. Excess calories from minimally processed whole-food sources tend to favor gaining subcutaneous fat over visceral fat.
Excess calorie intake from ultra-processed foods results in the gain of visceral fat
The Role of Visceral Fat in Chronic Disease and Longevity
Visceral fat leaks inflammatory cytokines that travel to and negatively impact all other areas of the body, including the brain, heart, liver, and gut.
These cytokines create a fire of inflammation, initiating a cascade of hormonal and metabolic destruction that results in more weight gain and inflammation.
Many doctors now believe chronic conditions we see today, such as Alzheimer’s, dementia, cancer, heart disease, and stroke, can be linked to visceral fat driving systemic inflammation.
When our organs are surrounded by visceral fat, the body has to work extra hard to deliver blood, nutrients, and oxygen to our tissues. And when combined with inflammation, this takes a massive toll on our healthspan and longevity.
The harder an organ has to work, the more oxidative stress it causes. More oxidative stress means more inflammation, which winds up aging us from the inside out.
The Top 5 Contributors to Visceral Fat
1 Ultra-processed foods.
Ultra-processed foods are made from refined starch, sugar, salt, and fat, making them hyper-palatable and super easy to overconsume. Excess calories from ultra-processed foods contribute to visceral fat stores. Additionally, insulin resistance from eating a diet rich in ultra-processed foods increases fat deposits inside the abdomen.
2 Lack of quality sleep.
Not getting enough quality sleep increases the risk of overeating the next day, especially foods high in starch and sugar. A 2022 crossover study found that sleep-deprived individuals ate, on average, 300 more calories per day and gained more body fat, mostly as visceral fat, than their well-rested counterparts.
Sleep deprivation combined with overeating appears to alter the way we store fat and favors the accumulation of visceral fat.
3 High stress levels.
Psychological stress increases cortisol levels, which can negatively affect body fat distribution, causing it to be stored centrally around the organs.
Many factors, such as lifestyle, genetics, sex, and age, affect our body’s sensitivity to cortisol and can increase our susceptibility to gaining visceral fat. Professor of psychiatry at UCSF, Elissa Epel, examined this idea in her landmark study. Women who were prone to stress had higher visceral fat levels regardless of whether they were lean or overweight. And those with higher visceral fat levels were more sensitive to life stressors.
4 Drinking alcohol.
There is a dose-dependent relationship between alcohol consumption and visceral fat. Studies done in Japan show that the more someone drinks, the more visceral fat they accumulate due to the metabolic impact of alcohol.
The more you drink, the more your metabolism is burdened, creating more stress, more cortisol, and more hormone disruption, which impairs fat metabolism and increases its deposit in and around the liver.
5 Being sedentary.
A sedentary lifestyle is bad for many reasons: it increases insulin resistance, the risk for sarcopenia (muscle loss), osteoporosis (weak bones), and falls and fractures and is associated with more visceral fat.
Research shows that time spent being sedentary is directly correlated to visceral fat, highlighting the importance of getting in regular physical activity throughout the day.
Note: Even if you exercise once per day but spend the rest of the time sitting (8+ hours) the body will still preferentially deposit visceral fat!
How to Reduce Visceral Fat
1 Eat a whole-food diet and feed your gut microbiome.
Eating a whole-food diet and minimizing ultra-processed food consumption is key for whole-body health. Focusing on this will pay massive dividends for shifting body composition, reducing visceral fat, and optimizing metabolic health.
What you might not know is that microbiome diversity from eating a variety of whole plant and fermented foods is linked to lower levels of visceral fat too.
In one study, visceral fat was more closely related to gut microbiome diversity than BMI or waist circumference. This means prioritizing dietary fiber and fermented foods and greatly reducing your intake of ultra-processed foods can aid in reducing visceral fat.
2 Prioritize sleep.
Never underestimate the power of sleep, especially when it comes to fat loss. Programming your circadian rhythm with morning and evening sunlight, addressing sleep disorders, trying mouth taping, taking a magnesium supplement, and setting a caffeine curfew can do wonders for your sleep.
3 Find healthy ways to manage stress.
This might be the most challenging visceral fat contributor to address because it is so personal.
Find an activity or outlet that works best for you that allows you to reset, release, or channel your stress into something positive.
Exercise, meditation, lifting weights, walking, yoga, journaling, or even calling a friend can help lift the burden of stress. Additionally, if you can, working under the care of a licensed therapist can be extremely helpful.
4 Reduce or eliminate the consumption of alcohol.
If you are drinking more than 14 drinks per week there is going to be a health cost, probably many!
Alcohol disrupts fat metabolism and increases visceral fat stores, especially around the gut and liver, which can lead to nonalcoholic fatty liver disease and metabolic dysfunction.
Regular alcohol consumption also increases the risk of cardiovascular and neurodegenerative disease, which research suggests could be due to the impact of visceral fat on the rest of our organs.
5 Exercise for at least 150 minutes per week.
This is the minimal viable dose, according to experts, to reap the benefits of exercise. Try a combination of resistance training (2–3 days a week), HIIT workouts, and zone 2 cardio (e.g., brisk walking, biking, or jogging) to meet your weekly exercise goals.
Interval training and sprinting at near maximal levels for brief 10-30sec efforts has been found to be an extra-special type of exercise for targeting and reducing visceral fat.
Final Thoughts:
The more I learn about visceral fat, the more I am convinced that many many of our health issues could be eliminated or severely reduced by focusing on reducing this highly inflammatory and destructive fat around our organs!
In fact, there may be no more important physical or biological marker to control including BP, weight and cholesterol!
AND BEING SKINNY IS NO CERTAINTY!
Up to 40% of people with ‘normal weight’ are metabolically unhealthy with an estimated 20% also having high risk levels of visceral fat!
Yes the chances of having greater obesity means a greater likelihood of also having high levels of visceral fat but the only true way to know is to get a Dexa scan using MRI technology.
This is the safe scan we mostly know of for bone density or whole body fat percentage BUT the best and biggest health indicator the Dexa scan gives us is actually our amount of visceral fat.
I am now recommending all clients to get a yearly scan. I have recently met with the Measure Up Dexa Scan exercise physiologist and will hopefully be arranging a mobile van to come out to our studio to scan all Manly based clients. City clients will visit the city store.
But I highly recommend getting a Dexa scan to see where you are at! It may be just the ‘kick in the pants’ you need to take action!
Note: Much of the article comes from Dhru Porohit Podcast.
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