Why You Need to Avoid High Visceral Fat

While some fat is normal and essential for protecting the body, too much of certain types of fat can negatively influence healthspan. The body has multiple types of fat, two of which are subcutaneous and visceral fat. Subcutaneous fat is found just beneath the skin—it is the most dominant form of fat in the body, and you can squeeze or pinch it. Conversely, visceral fat is found deep within your abdomen. Excessive visceral fat content can be detrimental to health due to its association with chronic diseases, namely cardiovascular disease, cancer, Alzheimer’s disease, type 2 diabetes, and stroke. But the good news is that lifestyle habits can both influence the amount of visceral fat in the body—and help reduce it if present.

Here, we discuss visceral fat, how to measure it, its association with health, and what you can do to reduce visceral fat mass.

What is visceral fat?

Visceral fat is a type of fat in the abdomen surrounding organs and is referred to as “hidden fat” given that it’s often not visible on the body. While some visceral fat is necessary to protect organs, excess visceral fat is considered harmful due to its association with numerous chronic health conditions like cardiovascular disease, type 2 diabetes, Alzheimer’s disease, stroke, and some cancers.

How visceral fat mass is measured

Dual-energy X-ray absorptiometry, or DEXA scans, measure body composition including bone density, fat, and muscle mass. They are considered a clinical gold standard for measuring visceral fat mass along with computer tomography (CT) and magnetic resonance imaging (MRI). A more accessible and inexpensive measurement for most people is waist circumference, which serves as a suitable proxy. This measurement can be taken by aligning the bottom edge of a tape measure with the top of the hip bone and wrapping the tape measure around the body. When using waist circumference as a proxy for visceral fat, its interpretation should also consider other markers of metabolic health, such as cholesterol levels, blood pressure, BMI, or waist-to-hip ratio. [1]

How much visceral fat is normal?

Visceral fat generally comprises about 10% of a person’s body fat. Compared to females, males have about twice as much visceral fat as a proportion of total fat, regardless of obesity status. Women tend not to have significant visceral fat levels without obesity. [2]

Guidelines from the International Atherosclerosis Society and International Chair on Cardiometabolic Risk Working Group on Visceral Obesity recommend a waist circumference measurement below 102 centimeters (40 inches) for men and 88 centimeters (35 inches) for women to reduce health risks associated with visceral fat mass. [3] Waist circumference and visceral fat thresholds also vary depending on body mass index (BMI) class and ethnicity.

Why is visceral fat so harmful for your healthspan?

Visceral fat is harmful because higher amounts are associated with several health risks like poor metabolic health, a cycle of weight gain, hormone imbalances, and inflammation.

Insulin resistance

Visceral fat is associated with insulin resistance, a sign of metabolic dysfunction and a risk factor for type 2 diabetes, weight gain, and metabolic syndrome. Fat accumulation around the organs impacts the effect of insulin, a hormone that helps regulate metabolism and energy availability and storage. The presence of inflammatory molecules in adipose tissue can also affect insulin signaling, contributing to insulin resistance. [1,4]

One study found that waist circumference could predict decreases in insulin sensitivity in people with normal weight and blood sugar levels. Changes in insulin sensitivity are a risk factor for type 2 diabetes and can pre-exist a diagnosis. [5]

Weight gain

Research on the relationship between visceral fat and weight gain is evolving and likely multifactorial, involving the influence of chronic stress and appetite-related hormones like leptin.

Chronic stress can contribute to shifts in fat distribution. Take cortisol—a hormone responsible for the “fight or flight” response to stress—for example. Cortisol and visceral fat are linked: increased cortisol production in adipose tissue contributes to greater visceral fat accumulation. [3] Cortisol also redistributes adipose tissue to the abdomen from other places in the body, increasing visceral fat mass.

Chronic stress can also affect appetite and food choices, leading to a cycle of weight gain that may exacerbate visceral fat mass. Chronic stress can provoke eating more highly-palatable foods (often high in sugar and fat), increasing waist circumference and the risk of metabolic diseases. [6] Additionally, stress may affect hormones involved in appetite regulation. In particular, the hormone leptin—produced in adipose tissue and triggers satiety (normal and higher levels reduce food intake)—decreases following acute stress, with the magnitude of this change varying depending on an individual’s weight [7,8].

Hormone imbalance

Like cortisol, the sex hormones estrogen and testosterone can influence body fat distribution. However, it is low levels of these hormones that are associated with higher visceral fat content.

Menopause is characterized by significant hormonal changes, including decreases in estrogen, increases in testosterone, and a shift in the location of hormone production from the gonads to predominantly adipose tissue. These changes are associated with visceral fat accumulation and contribute to why postmenopausal women struggle with weight and body composition. Changes in estrogen signaling can also influence body composition and visceral fat in men. [1,9,10]

Inflammation

Adipose tissue is an active endocrine organ. Macrophages, specialized cells that can be pro- or anti-inflammatory, can invade visceral fat beyond normal levels, contributing to metabolic dysfunction and inflammation. In visceral fat, macrophages release pro-inflammatory cytokines that can lead to a state of chronic, low-grade inflammation and increase the risk of cardiovascular disease and type 2 diabetes. [1]

What are the chronic disease risks associated with high visceral fat content?

Visceral fat is considered metabolically active since it produces different hormones, many of which participate in inflammatory processes that increase the risk of chronic diseases, such as cardiovascular disease, Alzheimer’s disease, stroke, and cancer. [11]

Cardiovascular disease

Assessing visceral fat content can be a reliable method for evaluating the risk of cardiovascular disease, as it is associated with heart failure and cardiovascular events like heart attacks. [12] One meta-analysis of over one million people found an increased risk of heart failure among people with higher visceral fat content. And for every 10-centimeter increase in waist circumference, the risk of heart failure increased by 28%. [13]

The association between visceral fat and cardiovascular disease is multifactorial. Dyslipidemia—particularly low high-density lipoproteins (HDL) and elevated small low-density lipoproteins (LDL) and triglyceride levels—often accompanies high visceral fat content. It can lead to atherosclerosis and is considered a significant risk factor for cardiovascular disease. High visceral fat content is also associated with hypertension (high blood pressure), another risk factor for cardiovascular disease. [1]

Alzheimer’s disease

Increases in visceral fat mass cause a greater release of inflammatory molecules from adipose tissue, which may affect the brain, contributing to Alzheimer’s disease. One study of older participants with none to varying degrees of cognitive impairment found that visceral fat activity was positively associated with increased amyloid-B plaques, characteristic of Alzheimer’s disease. [14] Other health risks affiliated with visceral fat (like inflammation and insulin resistance) may also contribute to cognitive decline. [15]

Stroke

Dyslipidemia and hypertension—due to visceral fat, particularly around the kidneys that affects renal function and blood pressure regulation—put pressure on arteries, contributing to atherosclerosis and cardiovascular issues, increasing the risk of stroke. [1] One study observed twice the odds of stroke among people in the highest tertile of the visceral adiposity index (VAI) score compared to those in the lowest tertile. [16] VAI is a calculation that uses sex, BMI, waist circumference, HDL cholesterol, and triglyceride data to indirectly measure visceral adiposity and assess an individual’s cardiovascular risk. Notably, visceral fat may also be a significant risk factor for the age of the first stroke. [17]

Cancer

Visceral fat may influence cancer development through its effect on inflammation and hormones [18]. The specific impact of visceral fat on cancer varies depending on gender and the type of cancer — colorectal and breast (postmenopausal) cancers are more strongly linked with visceral fat mass. Greater visceral fat content may also contribute to a worse response to chemotherapy treatment and an increased risk of surgery-related complications. [1]

How does your DNA influence visceral fat?

Genetics play a significant role in determining adipose tissue distribution, and visceral fat content has been shown to be quite heritable. [19,20] One genome-wide association study discovered over 100 novel genetic variants associated with higher visceral fat levels, facilitating the construction of a genetic score that can be used to help predict an individual’s genetically determined baseline for visceral fat mass. Using advanced genomics techniques, researchers also found that visceral fat is a causal risk factor in developing hypertension, heart attack, type 2 diabetes, and hyperlipidemia. [20]

Lifestyle habits to improve visceral fat mass

It is possible to overcome a genetic predisposition for visceral fat mass through lifestyle modifications focusing on nutrition, exercise, stress management, and sleep.

Exercise

Exercise is an important lifestyle habit for reducing visceral fat content and preserving muscle mass. Activating muscles through physical activity induces changes to muscle, stimulating the release of molecules that contribute to increased muscle synthesis, glucose utilization, and reduced chronic inflammation. [21] Regularly using your muscles can alter body composition to favor muscle mass over visceral fat, which helps improve insulin sensitivity and reduce risks of type 2 diabetes, hypertension, and dyslipidemia—factors linked to inflammation and cardiovascular disease. [4,22]

Research suggests both resistance training and aerobic exercise are beneficial for reducing visceral fat and its associated health risks. [23] Resistance training two to three times weekly for 20 minutes appears highly effective for reducing visceral fat mass in particular. [22]

Nutrition

A Mediterranean diet rich in polyphenols (compounds found in plant-based foods with antioxidant and anti-inflammatory benefits) and low in red and processed meats may reduce visceral fat mass. The diet emphasizes high-quality carbohydrates—such as fruits, vegetables, whole grains, and legumes—associated with reduced visceral fat mass. Higher-quality carbohydrates are fiber-rich and confer numerous health benefits, including contributing to satiety and slowing digestion and absorption. [24]

Stress management

Elevated stress can contribute to changes in appetite and visceral fat, so stress management is key for preventing visceral fat accumulation. Stress management techniques can include nutrition and exercise, or focus on cognitive and emotional strategies like meditation and visualization. In particular, practicing mindfulness can attenuate stress levels and may contribute to improved cardiovascular health. [25]

Sleep

Sleep restriction may contribute to increases in visceral fat as inadequate sleep can influence stress levels, energy intake, and food choices. On the other hand, attaining optimal sleep, generally 7 to 9 hours a night, may help prevent visceral fat accumulation. [26]

Key takeaways

Visceral fat is the type in the abdomen surrounding organs. It is associated with numerous health risks, including inflammation, hormone imbalances, and weight gain.
Visceral fat mass is associated with an increased risk of chronic diseases like cardiovascular disease, type 2 diabetes, Alzheimer’s disease, stroke, and cancer.
Certain genetic variants are associated with visceral fat and can be used to better understand the risk of developing certain chronic diseases.
Regular exercise, a healthy diet, stress management, and adequate sleep can help reduce visceral fat mass

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