Visceral Fat
The deep abdominal fat — source of chronic inflammation and insulin resistance
Definition
Visceral fat (VAT, Visceral Adipose Tissue) is the adipose tissue located within the abdominal cavity, surrounding organs such as the liver, intestines, and pancreas. Unlike subcutaneous fat (beneath the skin, relatively metabolically inert), visceral fat is a very active endocrine and immune organ: it secretes pro-inflammatory cytokines (IL-6, TNF-α, MCP-1), dysregulated adipokines (high leptin, low adiponectin), and free fatty acids that reach the liver directly via the portal vein, causing steatosis and insulin resistance.
Detailed explanation
Measurement methods ordered by precision:
Segmental DEXA (accessible gold standard): quantifies VAT in cm² or grams. Risk thresholds: <100 cm² optimal; 100-130 cm² intermediate; >130 cm² high cardiometabolic risk. Abdominal MRI/CT: the true gold standard, but high cost and radiation (CT). Advanced bioimpedance (InBody 970, Tanita MC-980): estimates VAT via segments; moderate correlation with DEXA. Waist-to-height ratio: simple and useful; value <0.5 healthy. Waist-to-hip ratio: traditional; >0.90 men and >0.85 women = increased risk.
The increase of visceral fat with age is a central factor in metabolic ageing: it secretes chronic inflammaging, triggers insulinaemia, contributes to sarcopenia (muscle catabolism), and predicts cardiovascular events and mortality better than total BMI.
Interventions that specifically reduce VAT: Mediterranean diet with moderate caloric deficit, structured 16:8 intermittent fasting, Zone 2 aerobic exercise (3-4×/week), HIIT (very potent effect on VAT), strength training (improves body composition independently of weight), specific reduction of free fructose and alcohol, sleep improvement (sleep deprivation increases VAT). In selected profiles, GLP-1 analogues (semaglutide) reduce VAT very potently.
Scientific sources
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