Why Belly Fat is Deadly Fat

Don’t be surprised if your next physical includes a tape measure around your waist in addition to a check of your height and weight.

That’s right, assessing potential health risks is not only about how much you weigh but where you carry those pounds, especially if you have a “spare tire.”

Recent guidelines from the American Heart Association (AHA) suggest that carrying extra belly fat is a sign that you may have too much visceral adipose tissue — in other words, too much fat along the inner belly wall.¹ Let’s take a closer look at why excess belly fat has health experts worried.

Of course, we all know that excess fat won’t do your health any favors. But researchers now believe that those saddlebags are not as worrisome as a bulging belly.

You see, just like real estate, when it comes to fat it’s all about location, location, location.

According to Harvard Health, in most people, about 90 percent of body fat is subcutaneous, meaning it lies in a layer just beneath the skin.² Give yourself a poke in the old breadbasket. That fat you’re feeling is subcutaneous fat.

But the remaining ten percent of fat, called visceral fat, dwells far out of reach, beneath the firm abdominal wall. This fat surrounds the heart, liver, intestines, and other organs. So even though it’s a small percentage of your total body fat, visceral fat is a culprit in a variety of health problems.

Visceral Fat Leads to Heart Problems

When you pack on excess visceral fat, it can lead to inflammation and higher blood cholesterol levels.

Laura den Hartigh, PhD, a research associate professor at the Diabetes Institute at the University of Washington School of Medicine in Seattle, offers some insight.

She explains that both inflammation and high cholesterol levels can contribute to the development of atherosclerosis, the accumulation of plaque in artery walls that can block blood flow and lead to cardiovascular events like heart attacks and strokes.

She notes that visceral fat carries this risk, but the subcutaneous layer of fat right under the skin does not.³ So, this may explain why some people who have a healthy weight based on their BMI are still metabolically unhealthy with high blood cholesterol levels, inflammation, and elevated blood pressure and blood sugar.

In other words, excess visceral fat around the belly can result in your being metabolically unhealthy even when your BMI suggests that your cardiovascular disease risk is low.

Increased Risk of Heart Attack

Previously, researchers determined that excess belly fat increases the risk of having a first heart attack.⁴ Equally concerning, a 2020 study in Sweden found a link between abdominal obesity and repeat heart attacks.⁵ “In our study, patients with increasing levels of abdominal obesity still had a raised risk for recurrent events despite being on therapies that lower traditional risk factors connected with abdominal obesity — such as anti-hypertensives, diabetes medication, and lipid lowering drugs,” says Dr. Hanieh Mohammadi, author of the study.

What is the take-home message here? All the medications in the world can’t replace wise lifestyle choices, such as regular exercise, a healthy diet, and weight loss, if necessary.

While heart disease is of particular concern, it’s not the only health issue that’s linked to excess belly fat.

Higher Risk of Dementia

Researchers at Kaiser Permanente found people with larger stomachs in their 40s are more likely to have dementia when they reach their 70s.⁶ According to the study, having a large abdomen increased the risk of dementia regardless of whether the people were of normal BMI, overweight, or obese, and regardless of existing health conditions, including diabetes, stroke, and cardiovascular disease.

Interestingly, when researchers analyzed fat measurements for other areas of the body, such as increased thigh size, dementia was not associated with these other fat stores.

How to Banish Belly Fat

At the top of the list is exercise, of course. Experts suggest a two-prong approach to tackling visceral fat that combines aerobic activity (such as brisk walking) and strength training.⁷ To give belly fat the boot, opt for a balanced diet that helps you get down to a healthy weight and stay there.

Avoid those foods that encourage belly fat deposition, especially simple sugars like fructose-sweetened foods and beverages. Instead, up your fiber game, as soluble fiber can help fight belly fat.

Also, mind your stress levels. Stress may promote fat gain around your waist, especially in women. Research shows that stress-induced high cortisol levels increase appetite and drive abdominal fat storage.⁸ Equally troubling, this appears to be a vicious cycle. Women with large waistlines tend to produce more cortisol in response to stress.⁹ In conclusion, take aim at belly fat like your quality of life depends on it, because it does!