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Deep Fat May Be Deadly

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How to Get Rid of It

You’ve probably heard that the deep or visceral kind around your internal organs (belly fat) is more dangerous than the outer layer of subcutaneous fat under the skin, the kind that covers your six pack. The fact is that visceral fat is more closely connected with health problems than obesity in general. The explanation often given is simply that the proximity of visceral fat to the intestines makes it easily absorbed into the blood stream, where it often ends up clogging the coronary arteries and can lead to hypertension, diabetes and other metabolic problems. A study published in the February 12, 2008, issue of Circulation, the journal of the American Heart Association, provides specific details and strengthens the visceral fat-heart disease connection.  

Researchers led by Dr. Daniel T. Eitzman transplanted visceral fat from obese mice into healthy, non-obese mice—and the mice developed atherosclerosis or clogged arteries. To determine if the effect was unique to visceral fat, the researchers also transplanted subcutaneous fat into another group of health, non-obese mice. None of those mice developed clogged arteries.

Interestingly, both groups of lean and healthy mice developed a similar degree of fat inflammation. In other words, both the transplanted visceral fat and the transplanted subcutaneous fat caused an inflammatory reaction. “This indicates that the vascular effects of adipose [fat] tissue are not due solely to inflammation but to an interaction between inflammatory cells and visceral [fat deposits],” the researchers wrote. “Visceral adipose-related inflammation accelerates atherosclerosis in mice,” they concluded, “and may represent a link between obesity and vascular disease.”

“This study showed that the inflammation from visceral fat was actually transferred from one mouse to another,” cardiologist Ravi Dave, MD, an associate professor of medicine at UCLA School of Medicine, told the editors of UCLA Healthy/Years. “This accumulation of fat is associated with chronic, low-grade inflammation,” he added. “If it continues…there is a much greater risk of blockage occurring in the heart.”

We’ll discuss what can be done to prevent or get rid of this “bad” fat in a moment. But first, let’s look at another new study reinforcing the link between belly fat and health problems.

 Watch Your Waistline, Ladies (and Gentlemen)

In the second study, also published in Circulation (April 7, 2008), Frank Hu, MD, PhD, (a leader in obesity research) and his team of researchers at Harvard and elsewhere followed 44,636 women for 16 years to determine the connection, if any, between waist size and premature death. They wanted to find out whether belly size is linked to death rates, even if total body weight is normal. In short, is belly fat an independent risk factor?

In terms of person years (over 600,000) and deaths (3,507) monitored, this is one of the largest studies of fatness and mortality, according to the researchers. Here’s what they found.

“Our data indicate that …measures of abdominal adiposity were strongly and positively associated with all-cause, cardiovascular disease, and cancer mortality, independently of body mass index,” the researchers concluded. 

In street language, women with a lot of fat on their belly have an elevated risk of dying early, especially from heart disease and cancer, even if their weight is normal. Specifically, women with waists larger than 35 inches were about twice as likely to die prematurely of heart disease or cancer as women with waists less than 28 inches, regardless of their overall body size. Obese women with big bellies were at greatest risk, the researchers found.

The danger figure for men, according to earlier guidelines, is 40 inches or more. “These guys with small behinds but big ‘beer guts’ are at greater risk than men with higher Body Mass Index, but less fat in the abdominal region,” Rudolph L. Leibel, co-director of the Diabetes Center at Columbia University Medical Center, told Melinda Beck of The Wall Street Journal.

Beyond beefing up the calorie-burning muscle in your butt, what else can we do to keep our waistline under control? We can begin by evaluating the kind of food we eat.

The Whole-Grain Connection

Belly fat can be reduced substantially by eating whole grain products rather than refined, according to a study published in the January 2008 issue of The American Journal of Clinical Nutrition.

Researchers divided 50 obese adults ages 24 to 63 (25 men, 25 women) in half; one group was instructed to avoid whole-grain foods and the other was told to make all grain servings whole grain. Otherwise the diets were the same: balanced with a 500-calorie deficit to cause weight loss.

After 12 weeks, all participants reduced body weight, waist circumference and percent body fat significantly—but the whole-grain group lost about twice as much fat in their abdominal region.

Why did the whole-grain eaters lose more belly fat?

The only explanation offered in the study is that whole grains are less energy dense—more volume and fewer calories—and more satisfying. But Heather Katcher, PhD, a nutritionist at Penn State and the lead author, offered an explanation in comments after the study, which are reported in UCLA Healthy/Years.

Katcher says the exact reason isn’t clear, but one theory is that whole grains “reduce blood sugar levels after a meal because they take longer to digest.”

“This may alter fat metabolism in a way that reduces the amount of abdominal fat a person has,” she continued. “The general message…of this study is that replacing refined grains with whole grains as part of a balanced diet can be beneficial for cardiovascular health and help you lose abdominal fat.”

(You’ll find more about the role of whole foods in keeping blood sugar on an even keel and controlling hunger in our book Challenge Yourself http://www.cbass.com/CHALLENG.HTM )

Exercise also helps to reduce belly fat, but not the type of exercise some might think.

Deep Fat Goes First

Doing hundreds of sit-ups, leg raises and twists will not burn the fat off the abdominal area. It doesn't work that way. There is no such thing as spot reducing. Fat is systemic; it's all over the body. The abdominal muscles are not fueled by the fat that surrounds them. The energy for sit-ups comes from fat deposits all over the body. Moreover, the muscles of the waistline are relatively small and don't use many calories. If you have a layer of fat on your body, your abs will be obscured by fat, no matter how many crunches you do.

The good news is that training the whole body (weights and aerobics) improves insulin sensitivity and burns calories, which helps to get rid of fat all over the body, including visceral fat. The really good news, however, is that deep fat, visceral fat is usually the first to go. (This was confirmed recently by Melina Beck, writing in the Health Journal section of The Wall Street Journal.)

Unfortunately, that doesn’t mean the fat under the skin, subcutaneous fat—which hides even well-developed abs—is the first to go. The abs, especially the lower abs, are often the last muscles to appear. Fat is deposited in a genetically determined way, and comes off the same way. To have a well-defined six pack, you must reduce the fat all over your body.

When you get to that point, health problems caused by visceral fat should no longer be on your radar.

Eat a balanced diet of whole foods and exercise regularly and you’ll soon be rid of unhealthy visceral fat. Keep at it long enough, and you’ll be getting compliments on your six pack.

(The new Tanita (and other) body composition scales allow you to monitor total body fat—and visceral fat: http://www.cbass.com/FAQ6.htm )

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