The Dangers of Hidden Abdominal FatEn Español (Spanish Version)
The bad news about visceral fat is that it can accumulate quickly. The good news about visceral fat is that regular moderate physical activity can help prevent it and regular vigorous physical activity can help get rid of it.
Body fat comes in two varieties. There’s subcutaneous fat, a noticeable layer of fat that lies just below the skin, and then there’s visceral fat, which is buried beneath the muscles. Visceral fat is considered to be the more worrisome variety because it is associated with a higher rate of heart disease. Men tend to have more visceral fat, while women carry more subcutaneous fat.
Visceral fat can go largely unnoticed because it’s not visible to the naked eye. One effective way researchers can locate visceral fat is by
magnetic resonance imaging (MRI)
, which uses magnetic fields and radio waves to take a picture of the inside of the abdomen. Researchers can use this picture to estimate the amount of visceral fat a person is carrying.
Your genetic makeup is responsible for some of the amount of visceral fat you carry. Nevertheless, research shows that both your diet and your level of physical activity contribute to your level of visceral fat. People who consume large amounts of calories and people who perform little or no physical activity are likely to have high stores of visceral fat.
Short of talking to a physician into performing an MRI on your abdomen, how do you know how much of this unhealthy fat you have? Check your waistline. A trim waistline is a good indicator that you don’t have a large build-up of visceral fat. The National Institutes of Health (NIH) has set the following cutoff points to identify people who are at high risk of developing obesity-related diseases:
GenderWaist CircumferenceWomenGreater than 88 centimeters (35 inches)MenGreater than 102 centimeter (40 inches)
If your measurements fall above these cutoff points, there is a good chance that you are carrying a dangerous amount of visceral fat. Even if your waist circumference does not exceed the cutoff value, making an effort to reduce your waistline can still significantly improve your health.
Increased visceral fat, which accumulates deep within the abdomen to surround organs like the liver and insulin-generating pancreas, can pose certain dangers to health, especially in those with a body mass index (BMI) above 30 kg/m
. Although men are more likely to be at risk than women of developing certain diseases, both should be aware of the dangers:
- Type 2 Diabetes—Studies have shown that adults with large deposits of visceral fat develop lower sensitivity to insulin (insulin resistance). Since these people do not respond to the effects of insulin, which lowers blood sugar levels, they can develop type 2 diabetes.
- Coronary Heart Disease—Visceral fat may promote the release of cytokines, chemicals that regulate the immune response. Cytokines promote inflammation that affects the coronary arteries, which contributes to the development of
atherosclerosis. Extra fat around the waist may also lead to
high blood pressure, lower levels of HDL (the ‘good’ cholesterol), and can increase the risk of
- Metabolic Syndrome—This combination of abnormal blood sugar levels, elevated triglycerides, low good cholesterol, and elevated blood pressure has been observed even in some normal-weight people (BMI less than 25 kg/m
2) with extra abdominal fat.
- Sleep Apnea—Increased visceral fat has been associated with the occurrence of obstructive sleep apnea since deep abdominal fat can restrict the movement of the diaphragm and limit lung expansion.
The health risks associated with extra abdominal fat increase with age (> 45 years in men and >55 in women), ethnicity (African-American, Hispanic, and Asian) and family history, as well as with behaviors like cigarette smoking and lack of physical activity. Some of these risks factors can be altered with modifications in diet and lifestyle.
Research shows that people whose diets contain polyunsaturated fats in place of saturated fats have less visceral fat. Polyunsaturated fats are found in high concentrations in sunflower, corn, and soybean oils, as well as in fish. Also, just exercising moderately—doing things such as walking, swimming, or playing tennis—for 30-60 minutes on most days of the week will help prevent visceral fat from accumulating. What’s even better is that doing regular bouts of vigorous exercise can reduce the amount of visceral fat you already have.
National Heart, Lung, and Blood Institute
National Institute of Diabetes and Digestive and Kidney Diseases
Big tummy could mean big trouble.
Duke University Medical Center website. Available at:
http://www.dukehealth.org/health_library/news/8324. Accessed July 12, 2012.
Obesity in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 3, 2012. Accessed July 12, 2012.
Goodpasture B, Krishnaswami S, Harris T, et al. Obesity, regional body fat distribution, and the metabolic syndrome in older men and women.
Arch Intern Med.2005; 165:777-783.
Determination of degree of abdominal obesity. National Heart, Lung, and Blood Institute website. Available at:
http://www.nhlbi.nih.gov/guidelines/obesity/e_txtbk/txgd/4112.htm. Accessed on July 12, 2012.
Klein S. The case of visceral fat: argument for the defense.
J Clin Invest. 2004; 113:1530-1532.
Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. National Heart, Lung, and Blood Institute website. Available at:
http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf. Accessed July 12, 2012.
Excess fat around the waist may increase death risk for women.
National Institutes of Health website. Available at:
http://www.nih.gov/news/health/apr2008/niddk-07.htm. Accessed July 12, 2012.
Ogretmenoglu O, Ahmet S, Omer Y, et al. Body fat composition: a predictive factor for obstructive Sleep apnea.
Laryngoscope. 2005; 115:1493-1498.
Rendell M, Hulthen U, Tornquist C, et al. Relationship between abdominal fat compartments and glucose and lipid metabolism in early postmenopausal women.
J Clin Endocrinol Metab. 2001; 86:744-749.
Ross R, Freeman J, Hudson R, et al. Abdominal obesity, muscle composition, and insulin resistance in premenopausal women.
J Clin Endocrinol Metab. 2002;87: 5044-5051.
Sharma A. Mediastinal fat, insulin resistance, and hypertension.
Hypertension. 2004; 44:117-118.
Sung J, DeRegis JR, Bacher AC, et al. Lower dietary polyunsaturated to saturated fat ratio is associated with visceral adiposity. Presented at: Annual Meeting of the American College of Cardiology; March 30, 2003.
Tanne D, Medalie J, Goldbourt U. Body fat distribution and long-term risk of stroke mortality.
Stroke. 2005; 36:1021-1025.
Tracy RP. Is visceral adiposity the “enemy within”?
Arterioscler Thromb Vasc Biol
. 2001; 21:881-883.
Vgontzas A, Papanicolaou A, Bixler E, et al. Sleep apnea and daytime sleepiness and fatigue: relation to visceral obesity, insulin resistance, and hypercytokinemia.
J Clin Endocrinol Metab
. 2000; 85:1151-1158.
Last Reviewed July 2012