A recent study published in BMC Medicine has shed light on the distinct health implications of reducing visceral fat, the deep-seated fat surrounding internal organs, versus subcutaneous fat, which lies just beneath the skin. The research indicates that both the absolute amount and the proportion of visceral fat relative to total abdominal fat play crucial roles in influencing cardiometabolic health.
The study analysed data from two 18-month randomised controlled trials, encompassing 572 participants who underwent various dietary interventions. Magnetic resonance imaging (MRI) was utilised to measure changes in both absolute visceral fat and its proportion relative to total abdominal fat.
At the outset, researchers discovered that the proportion of visceral fat was a stronger predictor of elevated triglyceride levels, a significant marker of metabolic dysfunction. Conversely, the absolute amount of visceral fat was more closely associated with chronic inflammation and blood sugar regulation, both key indicators of diabetes risk.
Over the 18-month period, participants experienced an average reduction of 22.5% in their absolute visceral fat area. Both absolute and proportional reductions in visceral fat led to significant improvements in triglyceride levels, blood sugar control, and liver function. However, a decrease in absolute visceral fat was more strongly linked to reductions in leptin levels and insulin resistance, which are critical for preventing metabolic diseases like diabetes.
Professor Iris Shai, the study’s principal investigator from Ben-Gurion University of the Negev, said: “These results offer a new framework for evaluating weight-loss success – one that considers not just how much fat is lost, but what kind of fat is lost and how it affects metabolic health.”
Hadar Klein, RD MSc, a doctoral student and lead author, emphasised the clinical significance: “Two people with the same BMI can have entirely different metabolic risks based on how their visceral fat is distributed.”
Dr Hila Zelicha, RD PhD, co-lead author of the study, underscored the importance of personalised interventions: “Understanding visceral fat dynamics could lead to more effective strategies. People with a high visceral fat proportion may benefit from different dietary and exercise approaches compared to those with a large absolute visceral fat area.”
These findings highlight the necessity of personalised approaches in targeting visceral adiposity for cardiometabolic health improvement. They also suggest that both absolute and proportional reductions in visceral fat are associated with improved metabolic profiles, though they may influence different health markers.
