Dangers of Visceral Fat
Being overweight or obese is associated with a wide range of health conditions, but as we sill see below, it isn't only being fat, it is also about where the fatty tissues are located.
Even relatively slim, non-obese individuals with a higher proportion of visceral fat, are more predisposed to suffer from noncoholic fatty liver disease (NAFLD).
So let's review the different diseases that are linked to abdominal fat, but first we will explain what abdominal fat is:
Visceral and Subcutaneous Fat
Both men and women tend to put on weight as they age, and most of it is stored in the mid section.
There are two types of fat in the abdominal area: visceral fat and subcutaneous fat
Visceral Fat (VAT)
Visceral or Abdominal fat (we will use the abbreviation VAT which stands for Visceral Adipose Tissue) is the fat that is stored inside your abdomen. This fat fills the spaces within the abdominal cavity, surrounding the internal organs that are located there, such as the the intestines, liver and pancreas.
Normally Visceral Fat represents around 10% of the body's total fat stores. But in obese or overweight people fat will accumulate in the abdomen in larger quantities.
Subcutaneous Fat (SAT)
Subcutaneous Fat or SAT (for Subcutaneous Adipose Tissue) is the fat that lies beneath the skin, forming a layer between the muscles beneath it and and the skin above it.
Normally 90% of your body fat is subcutaneous fat (SAT), and its main purpose is isolation, and it keeps your body from loosing internal heat.
It is also a storage area: SAT is stored on thighs, upper arm, neck, hips.
However this fat is far less risky than the fat stored in your middle: Abdominal fat is an indicator of higher health risk.
Now, let's look into these health risks:
Short List of Health Conditions linked to Visceral Fat
Dementia and obesity
A study by Whitmer (2005) ( 1 ) tracked 10,276 men and women over the course of 27 years and found a link between dementia (includen Alzheimer's disease) and obesity in the middle age.
6.9% of the study's participants were diagnosed with Dementia.
Whitmer concluded that "Obesity in middle age increases the risk of future dementia independently of comorbid conditions".
- The risk of dementia was 74% higher in obese people (body mass index or BMI= 30) than in people with normal weight (BMI 18.6 to 24.9)
- In overweight people (BMI 25 to 29.9) the risk increased by 35%
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Obesity and Asthma
Capelo (2006) ( 2 ), studied asthma in a group of 83 women and found that Visceral Fat was negatively associated with asthma control and lung function, meaning that higher visceral fat levels worsened the condition.
Behren (2009) ( 3 ) in a study involving a large group of California teachers found that obese and overweight women with high levels of abdominal fat were at greater risk of severe asthma episodes than slimmer women (with waists narrower than 35 inches). Apparently the inflammation triggered by fatty tissue affects the lungs' airways.
Cancer and its link to visceral fat
Steele (2017) ( 4 ) points out that the cancer statistics of the CDC (Centers for Disease Control and Prevention) record an increase in cancer associated to obesity. These have grown by 7% between 2005 and 2014.
On the other hand, cancers not related to obesity have dropped by 13% during the same period. Clearly the obesity epidemic is becoming a problem.
Dohohoe (2011) ( 5 ) recognizes that the mechanism by which obesity and fatty tissues cause cancer is not fully understood, but the link exists.
The current hypothesis is that the excessive fat causes an increase in the secretion of pro-inflammatory adipokines.
Fatty tissue produces a group of proteins such as hormones, some of which act on the brain, and cytokines (small proteins that regulate the cells of the immune system). These are known collectively as Adipokines.
Some of them promote inflammation, others counter it.
The low grade chronic inflammation, and especially the "inflammed visceral adipose tissue, may influence the tumor microenvironment" (5).
This persistent inflammation alters insulin sensitivity, sex steroid, IGF hormone and immune functions, all of which help to "promote the development and progression of cancer at a cellular level".
Liver, colon, breast and pancreatic cancer are all obesity-related.
A meta-analysis by Ning et al. (2010) ( 6 ) found that an increase in Body Mass Index (or BMI) was proportional to the increase in colon cancer risk.
Jee-Yon Lee et al., (2014) ( 7 ) in a study of South Korean women, found that "visceral fat area is positively associated with the prevalence of Colorectal cancer.", the visceral fat increased the risk by 86% in comparison to leaner subjects.
The study concludes that "This result suggests that visceral adiposity, at least in part, might directly affect carcinogenesis in the gastrointestinal (GI) tract".
Nagrani et al. (2016) ( 8 ) studied Indian women both pre and post menopausal, finding that "Overweight and obese women were at increased Breast Cancer risk [...] Central obesity [...] increased the risk of both premenopausal and postmenopausal Breast Cancers.".
The risk group was that of women with a BMI above 25 and a Waist-to-hip-ratio of 0.95.
We discuss the Waist size and the Waist-to-Hip Ratio in our "Waist Size Matters" webpage:
Read More about waist-to-hip-ratio and obesity:
Lahmann et al., (2004) ( 9 ) analyzed the data from the EPIC study, which involved 73,542 premenopausal and 103,344 postmenopausal women from 9 European countries. They concluded that:
- In premenopausal women, hip circumference was the only measure significantly related to breast cancer.
- In postmenopausal women general obesity is a significant predictor of breast cancer
So a larger waistline, meaning abdominal obesity increases the risk of cancer in premenopausal women.
Bracci (2012) ( 10 ) reports that there is a positive association between "obesity ⁄ high BMI and pancreatic cancer risk", and a large waist-to-hip-ratio was also positively associated with an increased risk of this type of cancer.
Cholesterol, high blood pressure and CVD
Obesity is linked to heart disease (CVD or Cardiovascular Disease), and Visceral Fat causes an increase in total cholesterol, low density LDL cholesterol and triglycerides. It lowers the quantity of protective HDL cholesterol. It increases blood pressure and alters blood sugar (which besides its diabetic effect also impacts on blood pressure).
Veloso and Resende (2015) ( 11 ) studied the link between visceral fat, atherosclerosis and coronary artery disease and find that "Visceral Fat may be a cause of coronary risk factors, which may eventually develop into coronary stenosis". They review several studies that conclude:
- Subjects with visceral obesity had several other coronary risk factors, indicating that they had a high risk of developing coronary arterial lesions.
- The accumulation of Visceral Fat causes arteriosclerosis
- Visceral Fat correlates with diabetes, atherosclerosis and metabolic abnormalities associated with increased risk of atherosclerotic cardiovascular disease
- Visceral Fat is an excellent predictor of cardiovascular risk
Rosito et al., (2008) ( 12 ) analysed data from The Framingham Heart study, and found a significant correlation between visceral adiposity and cardiovascular diseases.
Després (2007) ( 13 ) stresses that the risk of developing cardiovascular disease is increased in individuals with abdominal obesity (VAT is Visceral Adipose Tissue): "excess VAT is accompanied by elevated triglycerides, reduced high-density lipoprotein (HDL) cholesterol, elevated blood pressure."
Matsuzawa (2014) ( 14 ) links "visceral fat accumulation in the development of obesity related diseases ... because visceral fat accumulation causes.... hypertension and dyslipidemia" (dylipidemia is an alteration in blood lipids, i.e. cholesterol and triglycerides).
Lupatelli et al., (2012) ( 15 ) studied 126 subjects with high blood lipids and found that "the amount of visceral fat correlates with cholesterol synthesis", and that "patients with a higher visceral fat area (VFA) had higer levels of lathosterol", lathosterol is a cholesterol-like molecule that is used as an indicator of whole-body cholesterol synthesis. So higher lathosterol levels mean higher cholesterol values.
Visceral fat increases risk of Diabetes
A study by de Lemos (2012) ( 16 ) found that "Having excess visceral fat and insulin resistance - but not being obese in and of itself - appears to put heavier patients at risk for prediabetes and diabetes".
The presence of visceral fat increases the risk by 60% to 268% in comparison to obese people lacking visceral fat.
Matsuzawa (2014) (14) whom we mentioned further up, also associates "visceral fat accumulation causes Type 2 diabetes", as does Despré (2007) (13): "excess Visceral Adipose Tissue is accompanied by.... elevated fasting plasma sugar".
Non Alcoholic Fatty Liver Disease
Fat that accumulates in the abdomen, not only surrounds the vital organs located there, it also seems to promote Non alcoholic Fatty liver (NAFLD): Ha (2015) ( 17 ) reports that "visceral adiposity makes non-obese subjects more susceptible to NAFLD, compared with subcutaneous fat and BMI". This is interesting because these individuals were not obese yet their abdominal fat made them more predisposed to suffer from NAFLD.
Obesity Risk Factors
A high BMI, a wide waist (high waist-to-hip ratio) and, as we have seen above, visceral fat are all obesity risk factors.
The side effects of being overweight and the harmful effects of obesity are serious, ranging from cancer to diabetes and from asthma to dementia.
The dangers of visceral fat are often overlooked, but it is this fat, deeply embeded in the abdomen that is the root cause for many medical conditions.
Adopting a healthy lifestyle, loosing weight (especially abdominal fat), excercising and modifying eating habits can help combat this "big stomach disease" and improve the quality of life and lifespan of overweight individuals.
Our website has many useful pages that can help you shed weight and work towards a more fit and leaner self:
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Cite this article:
A. Whittall. ©2018. Dangers of Belly Fat. Patagonia Wellness, 11 Oct. 2018. http://www.patagoniawellness.com/health/dangers-of-belly-fat.html
Subject: Dangers of Belly Fat. Visceral or abdominal fat increases the risk of many diseases (cancer, dementia, diabetes, etc.)
References and Further Reading
(1) R. Whitmer, E. Gunderson, E. Barrett-Connor, C. Quesenberry, Jr, K. Yaffe, (2005). Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study. BMJ. 2005 Jun 11; 330(7504): 1360. doi: 10.1136/bmj.38446.466238.E0
(2) Capelo AV, et al., (2016). Visceral adiposity is associated with cytokines and decrease in lung function in women with persistent asthma. Rev Port Pneumol 2016 Sep-Oct;22(5):255-61. doi: 10.1016/j.rppnen.2016.02.005. Epub 2016 Mar 29
(3) Julie Von Behren, et al., (2009). Obesity, Waist Size, and Prevalence of Current Asthma in the California Teachers Study Cohort. Thorax. 2009 Oct; 64(10): 889. 2009 Aug 25. doi: 10.1136/thx.2009.114579
(4) Steele CB, Thomas CC, Henley SJ et al., (2017). Vital signs: trends in incidence of cancers associated with overweight and obesity - United States, 2005-2014. MMWR Morb. Mortal. Wkly Rep. (66), 1052-1058 (2017)
(5) C. Donohoe, S. Doyle and J. Reynolds, (2011). Visceral adiposity, insulin resistance and cancer risk. Diabetol Metab Syndr. 2011; 3: 12. 2011 Jun 22. doi: 10.1186/1758-5996-3-12
(6) Ning Y, Wang L, Giovannucci EL. (2010) A quantitative analysis of body mass index and colorectal cancer: findings from 56 observational studies. Obes. Rev. 11(1), 19-30 (2010).
(7) Jee-Yon Lee et al. (2014). Visceral Fat Accumulation Is Associated with Colorectal Cancer in Postmenopausal Women. PLoS One. 2014; 9(11): e110587. 2014 Nov 17. doi: 10.1371/journal.pone.0110587
(8) R. Nagrani et al., (2016). Central obesity increases risk of breast cancer irrespective of menopausal and hormonal receptor status in women of South Asian Ethnicity. Eur J Cancer. 2016 Oct; 66: 153-161. doi: 10.1016/j.ejca.2016.07.022
(9) Lahmann PH, (2004). Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer And Nutrition (EPIC). Int J Cancer. 2004 Sep 20;111(5):762-71
(10) Paige M. Bracci, (2012). Obesity and pancreatic cancer: overview of epidemiologic evidence and biologic mechanisms. Mol Carcinog. 2012 Jan; 51(1): 53-63. doi: 10.1002/mc.20778
(11) Roever L, Veloso FC, Resende ES., (2015). Visceral Fat, Atherosclerosis and Coronary Artery Disease. Intern Med 5:188. doi:10.4172/2165-8048.1000188
(12) Guido A. Rosito et al., (2008). Pericardial Fat, Visceral Abdominal Fat, Cardiovascular Disease Risk Factors, and Vascular Calcification in a Community-Based Sample - The Framingham Heart Study. 22 Jan 2008, Circulation. 2008;117:605-613
(13) Després JP, (2007). Cardiovascular disease under the influence of excess visceral fat. Crit Pathw Cardiol. 2007 Jun;6(2):51-9
(14) Yuji Matsuzawa, (2014). Obesity and metabolic syndrome: the contribution of visceral fat and adiponectin. Diabetes Management (2014) 4(4), 391-401 ISSN 1758-1907 391
(15) Lupattelli G., et al., (2012). Visceral fat positively correlates with cholesterol synthesis in dyslipidaemic patients. Eur J Clin Invest. 2012 Feb;42(2):164-70. doi: 10.1111/j.1365-2362.2011.02572.x. Epub 2011 Jul 27
(16) de Lemos JA, et al. (2012). Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults. JAMA 2012; 308:1150-1159
(17) Ha Y, et al. (2015). Intimate association of visceral obesity with non-alcoholic fatty liver disease in healthy Asians: A case-control study. J Gastroenterol Hepatol. 2015 Nov;30(11):1666-72. doi: 10.1111/jgh.12996