Tag Archives: visceral fat

Fat: More than skin deep

Everyone knows that fat is where the extra calories you eat end up and the reason your clothes fit too tightly. Body fat, or adipose tissue, is an efficient way to store excess energy. When you eat more calories than you expend, the extra energy can be stored as fat. Body fat is essential for storing extra energy, something that allowed our caveman ancestors to survive times when food was scarce. Beyond simply storing energy, research also shows that fat plays an active role in health and disease. This is the topic of my Health & Fitness column in the Aiken Standard this week.

waist circumference


Some fat is stored beneath your skin, which you can feel when you “pinch an inch.” This is called subcutaneous fat, and it is what most people think about when they think of body fat. It is also the fat that people see change when they gain or lose weight. But you also store fat in other places in your body, which can have important health effects.

Subcutaneous fat is stored between the skin and muscle and may or may not be distributed evenly throughout the body. Some people tend to store fat in their hips and thighs while others store it in their upper body. Much of this is determined by genetics, which also influences where fat is lost during weight loss.

Fat is also stored beneath the muscle wall in the abdomen. This is called visceral fat because it surrounds the intestines and other internal organs. Visceral fat is known to be associated with a greater risk for diabetes, high blood pressure, and heart disease than subcutaneous fat. This is in part due to the chemical signals called adipokines that are released from visceral fat and have effects on other organs and tissues resulting in insulin resistance and inflammation.

A simple way to tell if you have excess visceral fat is to measure your waist circumference. If it is greater than 36” for females or 40” for males, you are at risk. This is especially true if you aren’t able to pinch much fat around your waist, which suggests you have less subcutaneous fat and more visceral fat. Keep in mind that this isn’t foolproof, and a high waist circumference doesn’t always mean excess visceral fat, but it’s a good indicator.

Fat can also accumulate inside the liver, a condition is called fatty liver disease. You might expect this to be the result of eating too much fat in your diet, but a more common cause is too much sugar. When you eat excessive amounts of sugar, the liver can turn it into fat. This is especially true if the sugar is fructose, which is found in many artificially sweetened foods and beverages as high fructose corn syrup. When the liver converts fructose to fat it damages the liver and can lead to inflammation, cirrhosis, and liver failure.

The bottom line is that excess fat anywhere is unhealthy, but some forms of fat are particularly dangerous. Losing weight and body fat can reduce the negative effects of body fat. Improving your diet to reduce sugar intake is important for weight control and to minimize liver damage. Exercise also plays an essential role in reducing or reversing some of the negative effects of excess fat so you should strive to be more active every day regardless of your body weight.


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Loosening our belts. Expanding waistlines means expanding health problems.

In a report published this week, researchers showed that the waistlines of Americans are still expanding. This is bad news, since excess fat, especially around the waist, has serious implications for our health. Fortunately, there is much we can do to lose weight and improve our health.

This is the topic of my Health & Fitness column in the Aiken Standard this week.

The study, published in the Journal of the American Medical Association, looked at the percentage of adults who had a high waist circumference (over 35 inches for women and over 40 inches for men). Overall, the average American added over one inch to their waist circumference over the past decade. As of 2012, over half of U.S. adults (51%) meet the criteria for abdominal obesity, compared to 46% in 2000.

Since excess muscle tends to compress the abdomen, this really does reflect an increase in fat around the waist, not the benefits of a national sit-up campaign. And it is the location of the fat that makes this worrisome. Excess fat around the waist includes both subcutaneous fat beneath the skin (what you can pinch) as well as visceral fat stored deep in the abdomen.

Excess visceral fat is associated with an increased risk of high blood pressure, type 2 diabetes, and heart disease, among other chronic conditions. The only way to determine how much visceral fat a person has is through an imaging test like a CT scan. (In my lab we can estimate visceral fat by making a few abdominal measurements.) The important point is that the bigger your waist circumference, the more visceral fat you likely have.

You may have heard of people’s body shapes described as “apple” or “pear.” Upper body obesity (apple), sometimes called android obesity because it is more common among men, is associated with a high waist circumference and visceral fat. Lower body, or gynoid, obesity (pear shape) tends to involve a narrower waist but more fat storage in the hips, thighs, and buttocks.

These body shapes become apparent when you measure both waist and hip circumferences. A high ratio between waist and hip measurements indicates more upper body fat; a low waist-to-hip ratio suggests lower body fat. That said, just measuring your waist circumference can give you the same information. A waist measurement greater than 40 inches for men and 35 inches for women indicates excess upper body—and visceral—fat.

There is no single explanation for why waist circumference has increased so much in the population. But it almost certainly has to do with a combination of individual factors including what foods we eat, how much we eat, and how active we are. The average American with an expanding waistline likely eats too much poor quality food and doesn’t get enough exercise.

These are exactly the same factors that, when reversed, can lead to fat loss. Indeed, research shows that even modest weight loss from a low-calorie diet and exercise can result in reduced body fat, including visceral fat. This is one reason why weight loss is effective for reducing high blood pressure and controlling blood glucose.

Even if you don’t lose weight, increasing your level of physical activity, particularly regular exercise, can offset some of the negative health effects of excess visceral fat. In addition to helping you lose weight, exercise can also help you maintain your waistline and prevent abdominal obesity.

The bottom line is that when your pants start to feel tight, they are trying to tell you something. Listen to them!