What is visceral fat?

There are two types of fat that our body stores, subcutaneous fat and visceral fat. Subcutaneous fat is stored just under the skin that we can feel in our arms, legs, and hips. Think of the fat on your body that your are able to pinch with your fingers.  

Visceral fat, or visceral adipose tissue, is the fat that our body stores inside the abdominal cavity and wraps itself around the heart, liver, intestines and other internal organs. This fat is metabolically active and functions like another organ that produces negative hormonal effects on the body.  Some call it "angry" or "inflammatory" fat!

What risks are associated with high visceral fat?

Visceral fat is also referred to as "active fat" because it produces hormones that contributes to insulin resistance leading to type 2 diabetes. Insulin resistance is the prediabetic state where your body is losing its ability to properly process insulin and regulate blood glucose. The visceral fat secretes a protein called retinol-binding protein 4 (RBP4) that increases insulin resistance in the body. Visceral fat also releases inflammatory substances called cytokines leading to chronic inflammation and issues with hormone regulation. 

High levels of visceral fat are associated with increased risk for: 

  • Type 2 diabetes
  • Heart disease 
  • Breast cancer
  • Colorectal cancer
  • Alzheimer's disease
  • Non alcohol fatty liver disease 

How do we test for it?

There are many ways to test for and estimate how much visceral fat a person is carrying. MRI and CT scans are accurate but extremly costly as a tool to find and monitor visceral fat levels. You can take an estimate based on your waistline measurements, over 35 inches for women and 40 inches for men. 

At The Center for Prevention we have found the most effective way to measure and monitor visceral fat levels is the InBody 570. This machine allows us to get accurate body composition data on our patients. This data allows us to monitor not only visceral fat levels but percent body fat, skeletal muscle mass, and hydration levels. This information is crucial in monitoring changes in our patients to see what treatment plans are working and how we can find optimal results. The InBody data gives us an overall picture of changes going on with our patients that goes far beyond the scale and helps us provide motivation for ongoing lifestyle improvements. 

How can i get rid of it?

  • Reduce your sugar intake, especially sugary drinks and refined white carbohydrates
  • Exercise- make an effort to get 30 to 60 minutes of exercise a day 
  • Eat a healthy diet
  • Get a good night's sleep. Too little sleep, 5 hours or less, or too much sleep on a regular basis both lead to storing more visceral fat
  • Manage Stress- find mindfulness practices like meditation or yoga to help manage your body's stress response to lower cortisol levels
  • Limit alcohol- when your liver is processing alcohol it is not processing fat. The sugars found in alcohol also trigger the body's insulin response 
  • Quit tobacco use- tobacco use can negatively affect your ability to deal with glucose and increase insulin resistance 
  • Supplements and medications that improve insulin sensitivity are options for some. 

Supplements and Medications for Insulin Resistance and Stubborn Visceral Fat

Sometimes insulin resistance is so severe that a low carbohydrate diet and exercise do not achieve the reduction in fat that one might expect.  This can be due to an incomplete commitment to carbohydrate restriction and insufficient time.  But sometimes a little help is needed.

The highest reported visceral fat measurement on our InBody is 20.  This can represent a plateau which may be reflecting visceral fat burdens much higher.  Therefore, perseverance and focus on body fat mass reduction is the key to maintaining motivation and momentum until that number drops below 20.

Insulin resistance and high insulin levels are a vicious cycle.  Rising insulin levels cause ingested glucose to be stored as fat, worsening insulin resistance and leading to rising insulin levels. 

Medications used to treat insulin resistance include pioglitazone and rosiglitazone.  Used in treatment of diabetes, their side effects have limited their use.  But prescribed “off label” to patients with prediabetes, they are well tolerated and are associated with benefits, including improved arterial disease related outcomes. 

Effective supplements include cinnamon, chromium, vanadyl, alpha lipoic acid and biotin.  All support noninsulin dependent pathways for glucose to enter the cell.  This creates less signaling for higher insulin levels and less glucose stored as fat. This would, in theory at least, make fat reduction more likely for any given level of glucose intake reduction. 

Therefore, for those who are struggling to see any decline in their fat, including visceral fat, we can offer these supplements and sometimes medication.  Diaxinol, which we stock in our office, contains all these supplement ingredients. 

Eventually, these supplements may not be needed.  But they can provide a kickstart for difficult cases. 

 

Links with more information:

InBody: A guide to body fat

Biochemistry of adipose tissue

Visceral Fat (Active Fat)