Visceral fat is the deep fat around your organs. Unlike subcutaneous fat (the kind you can pinch), visceral fat is metabolically active and dangerous. It drives inflammation, insulin resistance, and heart disease even when your weight looks normal.
Why visceral fat is different
Visceral fat sends fatty acids straight to your liver and releases inflammatory signals into your bloodstream. Together they drive insulin resistance, higher triglycerides, lower HDL, and smaller, denser LDL particles that penetrate artery walls more easily.
This is why BMI misses the picture. BMI doesn't distinguish between subcutaneous fat and visceral fat. You can have a normal BMI but dangerous visceral fat. You can also have a high BMI with relatively little visceral fat.
How to measure it
The gold standard is a DEXA scan, which measures body fat distribution precisely. But for practical screening, waist measurements work well:
- Waist-to-height ratio: keep your waist below half your height.
- Waist circumference: under 40 inches (men) or 35 inches (women).
- Waist-to-hip ratio: tracks heart attack risk better than BMI in large studies.
More on waist-to-height ratio in our dedicated guide.
Warning signs
If your waist is above half your height, or your labs show high triglycerides with low HDL, the biology driving plaque may already be active. This pattern often appears before blood sugar rises or HbA1c looks abnormal.
How to reduce visceral fat
- Exercise: both cardio and resistance training reduce visceral fat.
- Diet: cut refined carbs and added sugars. Increase protein and fiber.
- Sleep: aim for 7–8 hours. Poor sleep drives visceral fat accumulation.
- Stress: chronic stress raises cortisol, which promotes visceral fat storage.
The good news: visceral fat responds faster to lifestyle changes than subcutaneous fat. Weight loss preferentially reduces visceral fat first.
The bottom line
Visceral fat is a driver of inflammation and insulin resistance, both of which accelerate plaque buildup. If your waist is above half your height, or your triglycerides are high and HDL is low, these are early warning signs to act on.
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