Visceral Fat: What It Is and Why You Should Know About It

Our bodies need some fat. This is a fact that has been well-established by science.

You are probably familiar with the different food sources of fat – such as omega-3 and omega-6 fatty acids – but did you know there are different types of fat cells in the human body as well?

With all the societal messaging surrounding body size, weight management, and fat shaming, it can be hard to know what is true and what is opinion. It can be especially difficult at this time of year when there is heightened pressure for New Year’s resolutions, particularly ones that target health goals. 

One type of fat that you can’t always see or feel, but you should know about, is visceral fat. A deeper type of fat, visceral fat lies within the abdominal cavity, surrounding the internal organs. Having some fat around your vital organs isn’t necessarily a bad thing; in fact, subcutaneous fat, the fat that lies just beneath your skin, helps provide some level of protection for the vital organs underneath. Visceral fat, however, is highly metabolically active and can negatively impact your health.

What leads to visceral fat accumulation?

Genetic, environmental, and lifestyle factors play a role in the amount of visceral fat stored in your body. And although little can be done to alter your genetics, understanding the environmental and lifestyle factors that lead to visceral fat accumulation can help in limiting its negative impacts.

Chronic stress is a major contributor to visceral fat accumulation. Stress activates cortisol, a hormone that stimulates the body to store visceral fat. Nutritionally, a high intake of fats and simple carbohydrates can trigger excess belly fat. In addition, the lack of physical activity common to a sedentary lifestyle also leads to visceral fat accumulation.

The development of visceral fat is a hallmark of human aging, and in a bit of a chicken-or-the-egg scenario, the negative effects of visceral fat can speed up cardiometabolic aging, which in turn can lead to increased visceral fat. This age-related accumulation of visceral fat is particularly challenging among post-menopausal women.

During the post-menopausal period, visceral fat increases from 5-8 percent of total body fat to an average of 15-20 percent of total body fat. The decrease in estrogen production during this period is a contributing factor to the accumulation of abdominal fat in women. 

As visceral fat accumulates, its impact on metabolic function increases. Visceral fat releases hormones, such as leptin and adiponectin, that play a role in cardiometabolic functions. Over time, alterations in these two hormones, and others, can lead to insulin resistance, metabolic syndrome, type 2 diabetes, and cardiovascular disease.

Visceral fat causes leptin resistance

Leptin has a wide range of functions in the body, including long-term regulation of appetite and energy storage. Leptin controls hunger as it relates to changes in body composition over time. In simple terms, leptin could be described as a “feast or famine” hormone – leptin’s level increases during periods of overfeeding to slow caloric intake, and it decreases during periods of fasting to stimulate replenishment.

The amount of leptin released is directly related to the number of fat cells present in the body, and as fat mass increases, so does leptin. Generally, this process works as intended to regulate fat stores; however, visceral fat secretes high levels of leptin that can disrupt leptin signaling in the brain. This signaling disruption is called leptin resistance. Essentially, the brain continues to tell the body to bring in more energy from food when it isn’t needed, and the body never really feels full.

The importance of adiponectin balance

Another hormone produced by fat cells, adiponectin, helps balance blood sugar, lipids, insulin sensitivity, and inflammation. With adiponectin, the name of the game is balance. Both abnormally low and elevated levels of this hormone are associated with weight gain and cardiometabolic disease. And while the relationship between fat cells and adiponectin is not fully understood, research indicates adiponectin is most often out of balance in individuals who have increased visceral fat.

Visceral fat and insulin resistance

Normally, as food arrives in the stomach the pancreas is signaled to secrete insulin. This is important because insulin is required to move sugar from the blood into the cells where it is used as energy. If the pancreas is unable to make and secrete insulin, cells are starved of their main energy source and sugar builds up in the bloodstream. This is what happens in type 1 diabetes and to some extent in type 2 diabetes.

The second concern with type 2 diabetes is insulin resistance – a condition in which the cells don’t respond appropriately to insulin and are unable to take in sugar efficiently. And in individuals with increased visceral fat, the resulting imbalance in adiponectin often leads to insulin resistance. 

Insulin resistance most often begins long before type 2 diabetes develops and gradually worsens over time. Insulin resistance might initially be discovered on routine blood labs as slightly increased fasting blood sugar or hemoglobin A1c, a measure that indicates average blood sugar level over time. Sometimes your doctor might also order a fasting insulin test, which when combined with fasting blood sugar can be used to calculate HOMA-IR, a measure of insulin resistance.

Visceral fat contributes to metabolic syndrome

Along with leptin resistance, adiponectin imbalance, and insulin resistance, visceral fat creates chronic inflammation that increases the likelihood of developing metabolic syndrome (MetS), a constellation of risk factors for cardiovascular disease and diabetes. MetS is present when you have at least three of the following risk factors:

• Increased waist circumference (>102 cm/40 inches men and >88 cm/34 inches women)
• Elevated blood pressure (>130/85 mmHg)
• Elevated blood sugar (fasting glucose ≥100 mg/dL)
• High triglycerides (>150 mg/dL)
• Low levels of high-density lipoprotein (HDL) cholesterol (the “good” cholesterol) (<40 mg/dL in men and <50 mg/dL in women)

Of these MetS risk factors, waist circumference is most closely related to visceral fat. In fact, research has shown that waist circumference is so strongly correlated with visceral fat that it can be a surrogate measure when the standard, more expensive instruments, such as ultrasound, DEXA scan, or clinical bioimpedance analysis are not available. 

Metabolic syndrome is common in the United States; about one-third of adults meet the criteria for it. This is notable because MetS increases the risk for heart disease by up to four times and diabetes by up to 30 times as compared to healthy individuals without MetS. The hormonal imbalances created by visceral fat play a major role in the development of both MetS and cardiovascular disease.

How to determine your level of visceral fat

Along with waist circumference, waist-to-hip ratio can also be an indicator of the presence of excess visceral fat. Although neither measure is perfect, both provide valuable information, particularly in monitoring changes over time. 

To measure, use a stretch-resistant measuring tape that is wrapped snuggly but not constricting. For waist circumference, the tape should be placed around the abdomen, parallel to the floor, at a level halfway between the top of the iliac crest and the lowest rib. Take several normal breaths in and out, measuring after the third or fourth out-breath.

For the hip measurement, place the measuring tape parallel to the floor around the largest circumference of the buttocks/hips. Then calculate waist-to-hip ratio by dividing the waist measurement by the hip measurement. Use the same units (inches to inches or centimeters to centimeters) for both the waist and hip measurements when calculating waist-to-hip ratio.

While the ideal levels for these measurements are not exact, a general guideline for waist circumference and waist-to-hip ratio that most likely indicates normal (not elevated) cardiometabolic health risk is as follows:

Targeting visceral fat

The best way to manage visceral fat is to prevent its accumulation, but with a modern lifestyle this isn’t always possible. The good news is that both managing and preventing visceral fat accumulation can be done with similar strategies; namely, proper nutrition, regular exercise, stress management, and adequate sleep. Start by choosing one or two of the following to implement, then add others over time as your initial steps become habit.

1. Eat a Mediterranean-style diet

A Mediterranean-style diet focuses on whole, fresh foods and is predominantly plant-based. Many traditional diets around the world are centered on the same concepts – the focus being on fresh fruits, vegetables, legumes, herbs, spices, nuts, fresh fish, seeds, lean animal protein sources in modest amounts, and unprocessed whole grains.

Healthy fats high in essential fatty acids (EFAs) are another feature of this way of eating. Olive oil, avocado, nuts and seeds, fish, seafood, and algae are good dietary sources of EFAs. Aim to eat fish or seafood twice weekly and include at least one vegetarian meal per week, focusing on beans, lentils, vegetables, and whole grains.

2. Move your body

Many types of physical activity are beneficial for reducing visceral fat. Both aerobic and weight training regimens have a positive effect. However, a meta-analysis of 15 studies with more than 800 participants found that one type is better than the other and regardless of training type, the intensity is important.¹

In general, aerobic training, even without a low-calorie diet, helps decrease visceral fat in individuals with abdominal obesity better than other forms. In terms of intensity, moderate-to-high intensity aerobic training is even better at reducing visceral fat than lower intensity forms. To reap the highest reward without committing hours of your day to exercise, try high-intensity interval training (HIIT), a type of exercise that involves alternating short bursts of intense aerobic activity with periods of lower intensity movement.²

3. Manage stress

Because chronic stress causes cortisol levels to remain elevated, which results in accumulation of more visceral fat, incorporating stress management techniques can help prevent increased abdominal fat. Incorporating meditative movement exercises, like yoga or tai chi, practicing breathwork, deepening your spiritual connection, and spending quiet time in nature are ways to decrease the physiological response to stress and keep stress hormones in balance.

4. Implement good sleep hygiene

Lack of sleep and visceral fat accumulation go hand in hand, which can be especially challenging with modern, busy lifestyles that often limit high quality sleep. At least eight hours of sleep per night seems to be optimal for limiting visceral fat accumulation. Even just one hour less of sleep per night is associated with an increase in abdominal fat.³

Improve your sleep quality by reducing light exposure in the evenings, turning off electronic devices at least an hour before bedtime, going to bed around the same time each night, waking around the same time each morning, and avoiding large meals, caffeine, alcohol, and sugar before bedtime. 

5. Consider intermittent fasting

Intermittent fasting (IF) is a strategy that can reduce visceral fat, even without restricting total daily caloric intake. IF involves restricting food intake to a specific time period. The more common plans are 16:8 time-restricted eating, which limits caloric intake to an 8-hour period, and 5:2 eating, which restricts regular eating to five days per week with two days of very low-calorie intake.

One of the biggest benefits of IF is that it helps reduce visceral fat without causing a loss of lean tissues (muscle and bone) that generally occur with weight loss. Choosing an IF strategy focusing on increasing protein and fiber intake while reducing sugar and sodium intake can optimize the benefits of IF.⁴ 

6. Limit alcohol intake

Although the relationship between alcohol intake and cardiometabolic health is a complex one, studies have shown higher alcohol intake is associated with greater accumulation of belly fat.⁵ The Dietary Guidelines for Americans recommends limiting alcohol intake to two drinks per day for men and one drink per day for women.

One thing to keep in mind when reducing alcohol intake is to be careful to avoid replacing alcoholic beverages with high-sugar and/or high-calorie beverages. Sodas might taste great, but they can contribute to increased belly fat even more than some alcoholic beverages. In general, choose a calorie-free beverage like sparkling water or herbal tea, and optimize your daily water intake to stay well-hydrated.

7. Incorporate nutritional supplements

While there are no “magic pill” nutritional supplements that prevent visceral fat accumulation, certain nutritional supplements can help you reach your health goals. Thorne’s Metabolic Health contains two well-researched botanical extracts that can help combat abdominal weight gain.* Thorne’s Berberine helps maintain healthy blood sugar and lipid levels, and the probiotic strains in Thorne’s FloraMend Prime Probiotic help improve waist circumference.*

8. Talk to your health-care practitioner about hormone replacement therapy (HRT)

For aging individuals, changes in hormone production create additional challenges to managing visceral fat accumulation. The connection between the low estrogen production characteristic of menopause and abdominal fat accumulation has already been noted, but men with low testosterone can also struggle to keep visceral fat accumulation down. If you’ve noticed an increase in abdominal fat, particularly as you age, then consult with your health-care practitioner about whether or not HRT could be right for you.

Regardless of your personal health goals regarding visceral fat, Thorne offers multiple resources to support you. From wellness guides to health tests that provide personalized supplement and lifestyle recommendations, we consider ourselves your partner in achieving and maintaining optimal health. 

References

1. Vissers D, Hens W, Taeymans J, et al. The effect of exercise on visceral adipose tissue in overweight adults: a systematic review and meta-analysis. PLoS One 2013;8(2):e56415. doi:10.1371/journal.pone.0056415
2. Maillard F, Pereira B, Boisseau N. Effect of high-intensity interval training on total, abdominal and visceral fat mass: A meta-analysis. Sports Med 2018;48(2):269-288. doi:10.1007/s40279-017-0807-y
3. Giannos P, Prokopidis K, Candow DG, et al. Shorter sleep duration is associated with greater visceral fat mass in US adults: findings from NHANES, 2011-2014. Sleep Med 2023;105:78-84. doi:10.1016/j.sleep.2023.03.013
4. Arciero PJ, Poe M, Mohr AE, et al. Intermittent fasting and protein pacing are superior to caloric restriction for weight and visceral fat loss. Obesity (Silver Spring) 2023;31 Suppl 1(Suppl 1):139-149. doi:10.1002/oby.23660
5. Sumi M, Hisamatsu T, Fujiyoshi A, et al. Association of alcohol consumption with fat deposition in a community-based sample of Japanese men: the Shiga epidemiological study of subclinical atherosclerosis (SESSA). J Epidemiol 2019;29(6):205-212. doi:10.2188/jea.JE20170191