Is Belly Fat the Worst Kind of Fat?

While excess belly fat may allow for a more impressive splash when flopping into the pool, it also packs some not so stellar abilities, like leading to higher cholesterol levels and increased risks for cardiovascular disease. What’s more, belly fat—also known as visceral fat, abdominal fat, or central adiposity—can lead to type 2 diabetes, a disease that causes blood sugar levels to rise dangerously high.

The good news? Some types of midsection weight are less worrisome than others.

Tubby Tummies—Why It Matters

So why aren’t jelly bellies and thunder thighs equally bad? Of course, excess fat anywhere on the body can contribute to cardiovascular disease and diabetes, but not all fat is created equal: Geography mattersAbdominal+visceral+and+subcutaneous+adipose+tissue+compartments:+association+with+metabolic+risk+factors+in+the+Framingham+Heart+Study.+Fox,+C.,+Massaro,+J.,+Hoffman,+U.,+et+al.+National+Heart,+Lung+and+Blood+Institute’s+Framingham+Heart+Study,+Framingham,+Mass,+USA.+Circulation, +2007+Jul+3;116(1):39-48.. Abdominal fat is stored in two different ways. First, there is subcutaneous fat (the pinchable stuff!), which sits between the skin and the abdominal wall. This fat is more of a holding tank for extra calories, and is less of a health threat since it does not directly surround organs and the blood vessels that keep them healthyBeneficial+effects+of+subcutaneous+fat+transplantation+on+metabolism.+Tran,+T.,+Yamamoto,+Y.,+Gesta,+S.+et+al.+Joslin+Diabetes+Center+and+Harvard+Medical+School,+Boston,+MA.+Cell+Metabolism,+2008+May;7(5):410-20.. Visceral fat, however, sits deeper in the stomach and blankets the abdominal organsMetabolic+obesity:+the+paradox+between+visceral+and+subcutaneous+fat.+Hamdy,+O.,+Porramatikul,+S.,+Al-Ozairi,+E.+Joslin+Diabetes+Center,+Harvard+Medical+School,+Boston,+MA,+USA.+Current+Diabetes+Review,+2006+Nov;2(4):367-73..

Now, everyone has some amount of visceral fat, but concerns surface when this inner fat exceeds normal levels. In some cases, the fat can invade the organs themselves (a common occurrence in the liver)Obesity,+Visceral+Fat,+and+NAFLD:+Querying+the+Role+of+Adipokines+in+the+Progression+of+Nonalcoholic+Fatty+Liver+Disease.+Mirza,+M.+SpR+Surgery,+Ninewells+Hospital,+Dundee,+UK.+ISRN+Gastroenterology,+2011;2011:592404.. The organ-swaddling visceral fat negatively affects organ function and integrity by increasing inflammation, clogging blood supplies (which prevents nutrient and oxygen delivery to organs), and eventually causing insulin resistance.

Insulin resistance, a pre-cursor to diabetes, is a condition by which the body’s muscle, fat, and liver no longer respond properly to circulating insulin suppliesBrown+fat+lipoatrophy+and+increased+visceral+adiposity+through+a+concerted+adipocytokines+overexpression+induces+vascular+insulin+resistance+and+dysfunction.+Gomez-Hernandez,+A.,+Otero,+Y.,+de+las+Heras,+N.,+et+al.+Biochemistry+and+Molecular+Biology+Department,+School+of+Pharmacy,+Complutense+University+of+Madrid,+Madrid,+Spain.+Endocrinology,+2012+Mar;153(3):1242-55.. This means that insulin—a hormone made in the pancreas that tells glucose to enter the body’s cells to fulfill their energy needs—can’t do its job. The result? The body’s cells starve while the excess glucose accumulates in the blood, ultimately damaging organs and vessels throughout the body. What’s more, visceral fat cells also produce hormones that regulate weight and appetite, sometimes leading to further weight gain or increased feelings of hungerAdipose+tissue+as+an+endocrine+organ.+Galic,+S.,+Oakhill,+J.,+and+Steinberg,+G.+St.+Vincent’s+Institute+of+Medical+Research+and+Department+of+Medicine,+University+of+Melbourne,+Melbourne,+Victoria,+Australia.+Molecular+and+Cellular+Endocrinology,+2010+Mar+25;316(2):129-39..

Getting Waisted—The Answer/Debate

They say America is a melting pot, but let’s think of it as a fruit basket. Different body shapes are associated with each gender and type of fatA+weight+shape+index+for+assessing+risk+of+disease+in+44,820+women.+Rimm,+A.,+Hartz,+A.,+and+Fischer,+M.+Department+of+Medicine,+Medical+College+of+Wisconsin,+Milwaukee.+Journal+of+Clinical+Epidemiology,+1988;41(5):459-65.. Pear-shaped women have more padding around the butt and thighs (hence, apple bottom jeans—not be confused with apple shape!). These areas harbor mostly subcutaneous fat. Apple-shaped men and women, or those with fat around the middle, have more visceral fat (the dangerous kind). Banana-shaped are relatively thin throughout, or have a more equal distribution of fat. And we can’t forget beer bellies! Beer guzzlers beware—tummies full of Budweiser also count as dangerous visceral fatThe+association+of+lifetime+alcohol+use+with+measures+of+abdominal+and+general+adiposity+in+a+large-scale+European+cohort.+Bergmann,+M.,+Schutze,+M.,+Steffen,+A.,+et+al.+Department+of+Epidemiology,+German+Institute+of+Human+Nutrition+Potsdam-Rehbrücke,+Nuthetal,+Germany.+European+Journal+of+Clinical+Nutrition,+2011+Oct;65(10):1079-87.Relationship+of+abdominal+obesity+with+alcohol+consumption+at+population+scale.+Scroder,+H.,+Morales-Molina,+J.,+Bermejo,+S.,+et+al.+Lipids+and+Cardiovascular+Epidemiology+Research+Unit,+Institut+Municipal+d’Investigació+Mèdica,+Barcelona,+Spain.+European+Journal+of+Nutrition,+2007+Oct;46(7):369-76..

While calculating body mass index (BMI) is a helpful tool to assess the overall health of an individual’s weight, determining a waist-to-hip ratio with a measuring tape is a better method to pinpoint belly fatBody+mass+index,+waist+circumference+and+waist:hip+ratio+as+predictors+of+cardiovascular+risk–a+review+of+the+literature.+Huxley,+R.,+Mendis,+S.,+Zhelezyakov,+E.,+et+al.+Renal+and+Metabolic+Division,+The+George+Institute+for+International+Health,+The+University+of+Sydney,+Sydney,+Australia.+European+Journal+of+Clinical+Nutrition,+2010+Jan;64(1):16-22.. Calculate waist-to-hip ratio by dividing the waist’s circumference at its narrowest point (use the belly button as a guide) by the hips’ circumference at their widest points (near the top of the bony protrusions). Ratios of 0.8 and below are healthy, and those above 0.8 suggest an increased risk for heart disease and diabetes. Some studies have found waist circumference to be a better determinant and to better express the amount of belly fat presentWaist+circumference+in+children+and+adolescents+correlate+with+metabolic+syndrome+and+fat+deposits+in+young+adults.+Spolidoro,+JV,+Pitrez+Filho,+ML,+Vargas+LT,+et+al.+Medical+School+of+the+Pontifficia+Universidade+Catolica+do+RS,+Moinhos+de+Vento+Hospital,+Porto+Alegre,+Brazil.+Clinical+Nutrition,+2012+Jul+28.. Measure waist circumference at the spot right above the hip bones right afer breathing out. Risk for developing obesity-related health problems (like cardiovascular disease) increases in women with waists larger than 35 inches and in men with a circumference larger than 40 inches.

Ready to battle the bulge? Thankfully visceral fat typically surrenders to diet and exercise. Trim the fat with the four pillars of a healthy middle: exercise, diet, sleep, and stress management. While core exercises such as the plank and crunches will firm up abs, they won’t blast the belly fat that lies underneath. Instead, try moderate or vigorous intensity aerobic activity—recent research suggests that sprinting is the best way to lose the love handlesA+systematic+review+and+meta-analysis+of+the+effect+of+aerobic+vs.+resistance+exercise+training+on+visceral+fat.+Ismail,+I.,+Keating,+S.,+Baker,+M.,+et+al.+Discipline+of+Exercise+and+Sport+Science,+University+of+Sydney,+Sydney,+New+South+Wales,+Australia.+Obesity+Reviews,+2012+Jan;13(1):68-91.Effects+of+aerobic+vs.+resistance+training+on+visceral+and+liver+fat+stores,+liver+enzymes,+and+insulin+resistance+by+HOMA+in+overweight+adults+from+STRRIDE+AT/RT.+Slentz,+C.,+Bateman,+L.,+Willis,+L.,+et+al.+Div.+of+Cardiology,+Dept.+of+Medicine,+Duke+Univ.+Medical+Center,+Durham,+NC,+USA.+American+Journal+of+Physiology:+Endocrinology+and+Metabolism,+2011+Nov;301(5):E1033-9.The+effect+of+high-intensity+intermittent+exercise+on+body+composition+of+overweight+young+males.+Heydari,+M.,+Freund,+J.,+Boutcher,+S.H.+School+of+Medical+Sciences,+Faculty+of+Medicine,+University+of+New+South+Wales,+Sydney,+Australia.+Journal+of+Obesity,+2012;2012:480467.. Complement aerobics with diets low in saturated fat, cholesterol, and carbohydrates (beer lovers, beware), and consider protein-rich meals and low-fat snacksRelationship+between+bread+consumption,+body+weight,+and+abdominal+fat+distribution:+evidence+from+epidemiological+studies.+Bautista-Castano,+I.+and+Serra-Marjem,+L.+Department+of+Clinical+Sciences,+University+of+Las+Palmas+de+Gran+Canaria,+Las+Palmas+de+Gran+Canaria,+Spain.+Nutrition+Reviews,+2012+Apr;70(4):218-33.. And don’t forget to manage life stressors and catch plenty of zzzs—increased cortisol levels (the stress hormone) and lack of sleep are both tied to abdominal weight gainStress-induced+cortisol+response+and+fat+distribution+in+women.+Moyer,+A.,+Rodin,+J.,+Grilo,+C.,+et+al.+Department+of+Psychology,+Yale+University,+New+Haven,+CT,+USA.+Obesity+Research,+1994+May;2(3):255-62.Obesity+and+metabolic+syndrome:+Association+with+chronodisruption,+sleep+deprivation,+and+melatonin+suppression.+Reiter,+R.,+Tan,+D.,+Korkmaz,+A.,+et+al.+Department+of+Cellular+and+Structural+Biology,+UT+Health+Science+Center+,+San+Antonio,+Texas+USA.+Annals+of+Medicine,+2011+Jun+13..

The Takeaway

Belly (aka visceral) fat can be more harmful than other types in terms of leading to bigger health issues. The good news? It also surrenders more easily to improved fitness and diet than other types!