The better reason is that
such fat, known as visceral fat, is seriously unhealthy.
"The issue is health, not cosmetics," says Dr. Garth Davis, a bariatric surgeon at Houston Methodist.
"The presence of visceral fat is a good predictor of
the development of chronic metabolic disease, whether it's hypertension, heart
disease or diabetes."
It's impossible to target
belly fat when you start a program to slim down. But a reduction in
weight will shrink
your waistline and, most importantly, help reduce visceral fat, which lies
underneath the abdominal wall in organs and in the lining around the
intestines.
How do you know if you have visceral fat, why is it so dangerous and what can you do about it? Dr. Davis is here to answer those questions and more.
Not all fat is created equal
The fat that lurks just below
your skin in much of your body - the kind you can pinch - is called
subcutaneous fat. Such padding around the sides, glutes, thighs or upper arms
may look cosmetically unpleasing, but it's actually fairly harmless.
Visceral fat, on the other
hand, is very harmful. It accumulates deep within the abdominal cavity, where
it can't be pinched, but pushes the belly out. It's called visceral fat because
of the padding around the viscera (internal organs like your stomach and
intestines).
"The heavier you
are, the fuller the standard areas to store fat become, meaning that the fat
ends up being deposited around your abdominal organs and your heart," says
Dr. Davis. "In surgery with these patients, it's a very short distance
from the skin to the belly, but then the belly is just filled with fat - fat in
the liver, fat lining the intestines, fat everywhere."
The problem is, such fat is
dangerous.
Dr. Davis notes that
visceral fat cells are biologically active, essentially an endocrine organ that
secretes hormones and other chemicals linked to diseases that afflict older
adults. Among the chemicals are cytokines that boost the likelihood of heart
disease and make the body less sensitive to insulin, which can bring on
diabetes. They also produce a precursor to angiotensin, a protein that causes
blood vessels to constrict and blood pressure to rise.
Are you an apple or a pear?
The most precise way to
determine how much visceral fat you have is to get a CT scan or MRI. But there
are easier ways to know whether you have a lot of visceral or subcutaneous fat.
The first is your body
shape. People with a "pear shape," characterized by bigger hips and
thighs, tend to have more subcutaneous fat; those with an "apple
shape," characterized by a wider waistline, have visceral fat.
A tape measure is an even
better way of keeping tabs. A waist circumference of more than 35 inches in
women and more than 40 in men indicates an unhealthy amount of visceral fat.
Measure your belly at the
level of the navel, not at the narrowest part of the torso. Don't suck in your
gut or pull the tape tight enough to compress the area.
If your overall body size
is large, those measurements might not be meaningful. Rather than focusing on
an absolute cut-off, monitor whether your waist is growing over time. That
should give you a good idea of whether you're gaining visceral fat.
The dangers of visceral fat
Cardiovascular health is
the number one casualty of visceral fat. One large study of European women aged
45 to 79 found those with the biggest waistlines had more than double the risk
of developing heart disease. It was nearly double even after adjusting for risk
factors such as blood pressure, cholesterol, smoking and body mass index. Every
additional two inches in the women's waist size raised their risk by 10%.
But visceral fat has been
implicated in a number of other conditions as well:
-Asthma: In a large study of California teachers, women with high
levels of visceral fat were 37% more likely to develop asthma than women with
lower levels of visceral fat, a find investigators attribute to such fat's
inflammatory effects throughout the body, including in the airways.
-Cancer: Visceral fat also has been linked to colorectal and breast cancer. A Korean study found that the chances of getting colorectal cancer nearly doubled among postmenopausal women who accumulate visceral fat. Similarly, a Dutch study found that participants with waistlines greater than 35 inches who lost 12 pounds had changes in biomarkers for breast cancer, like estrogen, leptin and inflammatory proteins, indicating a reduction in breast cancer risk.
-Dementia: A California study found people in their early 40s with the highest levels of visceral fat were three times more likely to develop dementia 30 to 40 years later than those who had the least abdominal fat at that age.
Other conditions linked
to visceral fat include diabetes, stroke, compromised lung function, heartburn,
sleep difficulties and migraine headaches.
The bottom line:
Excessive visceral fat can nearly double one's risk of dying prematurely,
according to a study of more than 350,000 European men and women published
in The New England Journal of
Medicine.
How you can combat belly fat
First things first:
Everyone is somewhat genetically predisposed to store fat differently. Hormones
play a role, too, notes Dr. Davis, which is why you see men carrying their
weight around the middle and women carrying it around their hips and thighs.
Also, there are no
weight-loss pills that target belly fat, and bariatric surgery is only for the
morbidly obese: those with BMIs of at least 40.
But the good news,
according to Davis, is that visceral fat is not that hard to lose. It just
requires work.
Here's what you can do:
-Diet: There's no special diet to reduce belly fat. Dr. Davis
advises his patients to eat "a predominantly plant-based diet, heavy on
fruits, vegetables and legumes and light on sugar, meat, dairy and eggs, and
ultra-processed foods."
-Activity: Remember, it's not possible to spot reduce, so no amount of sit-ups is going to get rid of that belly fat. But when you shed pounds, belly fat usually goes first. Dr. Davis tells patients to be active but not to kill themselves — just 30 minutes to an hour of exercise five days a week, another 8,000 to 10,000 steps daily will make a difference. You don't need to run a marathon or become a bodybuilder, he says.
-Sleep: Getting the right amount of shut-eye helps. In one study, people who got 6 to 7 hours of sleep per night gained less visceral fat over 5 years compared to those who slept 5 or fewer hours per night or 8 or more hours per night.
-Stress: Do your best to limit it. Hang out with friends and family, relax in nature, meditate, exercise.
"We are hardwired to eat," says Dr. Davis. That's why, in the end, the mainstay for people to lose belly fat are lifestyle changes, eating a healthier diet, becoming more active. It can be done."
May 18, 2022 Todd Ackerman
