With this word we usually associate a few extra kilos that have accumulated around the stomach and hips, making it harder to fit into last year’s trousers.
This is called subcutaneous fat. Fat in the abdominal region is called visceral fat. Simply put, this is when belly fat is starts to hang over the belt.
Only few people know, that it is especially the fat in the abdominal region, i.e. visceral fat, which is dangerous for our health. This is fat that lies beneath the abdominal muscles, around the intestines and in organs such as liver (fatty liver) and pancreas (lipomatosis of the pancreas). Excessive abdominal fat increases the risk of cardiovascular disease and diabetes. Vascular diseases and metabolic disorders occur only slightly more frequently with people that have fat accumulations in the buttocks, hips and thighs than with people with normal weight. So body weight alone is not enough to determine the risk for the heart and blood circulation, more important is the distribution of fat.
With the so-called apple type, fat accumulates mainly on the abdomen, back, sides and the internal organs (stomach, intestine, liver). The main risk factor here is the fat on and in the internal organs, which can be measured by the abdominal girth, among other things. Approximately 80% of men and women in older age are affected.
The pear type is characterised by the fact that the fat cells accumulate mainly in the area of the hips, buttocks and thighs. The varying health risks associated with different fat accumulations are due to their distinct metabolic activity.
In the past, fatty tissue was thought to be an inactive mass. Today we know that visceral fat actively influences the metabolism. By releasing hormones and inflammatory mediators, they trigger biochemical, hormonal and molecular biological processes and have an unfavourable effect on our fat metabolism.
It is assumed that the abdominal fat forms more than 200 messenger substances and thus belongs to the largest glandular organs of the body. The more fat we have, the more certain messenger substances are produced. In theory, an excess of these substances can have a negative effect.
In addition, these fat cells can enlarge and eventually affect the organs around the heart (primarily the liver and pancreas as well as the heart muscles). The fatty liver cells in particular are responsible for insulin resistance/diabetes and hypercholesterolemia. This type of fat is the most dangerous because it has a distinct metabolism that releases the hormones into the bloodstream and distributes them throughout the body.
The best-known hormones produced from fat are the saturation hormone leptin and the inflammatory mediator adiponectin, which stimulate the inflammatory processes in the body without us really noticing. If we add obesity to the equation, we have what physicians call the “deadly quartet”. Obesity in combination with elevated blood sugar, altered metabolic values and high blood pressure result in the so-called metabolic syndrome. If three of these parameters are above the limit values, the risk of a stroke and/or heart attack is massively increased.
Although there is a higher tendency of men accumulating abdominal fat, women after the menopause are at increased risk. An increased abdominal girth is the externally visible sign of too much abdominal fat, so abdominal girth measurement is considered a simple method to detect excessive internal abdominal fat. More than 88 cm abdominal girth in women and 102 cm in men significantly increase the risk of cardiovascular disease and diabetes. This guideline defined by the World Health Organization (WHO) is important because people of the same weight can be exposed to a different risk of metabolic diseases due to their fat distribution.
You want to test where you fit in? Everyone can measure their own waist circumference: Simply place a measuring tape between the lower rib arch and the iliac crest. Pull the tape in a straight line between the two points around the abdomen, exhale and see what it says. In case of uncertainties and dimensions above these values, we recommend that you consult your doctor.
In the long term, fat can only be reduced with a healthy, balanced diet, little stress, sufficient sleep and regular training. This requires constant motivation and a willingness to make a change to one's lifestyle. The secret of a healthy diet is variety. Make sure to eat fresh vegetables, fruit, good fats, high-quality carbohydrates, a sufficient protein intake and drink enough water. With a moderate weight loss - reduction of the body weight by 5 - 10% - and the thus reduced abdominal girth, the inner abdominal fat melts by about 30%. Interval fasting can also help to reduce weight.
All endurance sports are helpful for losing weight, as they successfully stimulate the metabolism. In addition, a moderate full-body muscle training, which is advisable 1-2 times a week. It prevents the age-related loss of muscle mass and thus maintains the strength and coordination ability of the skeletal muscles. But don't expect too much at the beginning, because it takes a few months before a consistent willingness to persevere pays off.
Important: If you have visceral fat, we recommend a low-car diet, i.e. carbohydrates (sugar, especially fructose) should be avoided wherever possible. You should also refrain from alcohol consumption. Unfortunately fructose is found in almost every food product and is the real reason for the overweight pandemic, because it can only be metabolised in the liver. The unfavourable metabolites produced in the liver during fructose digestion are the real reason for fatty liver. By the way, there are also many people (mostly men) with normal weight and still an increased proportion of visceral fat. It is therefore assumed that certain genetic variants can also lead to a premature fatty degeneration of the organs. A possible explanation is an impaired fat storage in the tissue.