I often get a lot of questions and concerns about what kind of fat clients have around their midsection. It comes mostly from the wives of my mail clients. The concern is whether or not the extra inches around their waist is visceral (dangerous fat) or subcutaneous (less dangerous).
Subcutaneous fat – Can be grasped with a pinching action by the fingers and pulled away from the body. It’s softer.
Visceral fat – is intertwined in the organs of the body, deeper and harder to touch and harder to grab with a finger pinch.
The big reason visceral fat is so dangerous relies on the concept of lipotoxicity. Unlike Subcutaneous fat, visceral fat cells release their metabolic products directly into the portal circulation, which carries blood straight to the liver. As a result, visceral fat cells that are enlarged and stuffed with excess triglycerides pour free fatty acids into the liver. Free fatty acids also accumulate in the pancreas, heart, and other organs. In all these locations, the free fatty acids accumulate in cells that are not engineered to store fat. The result is organ dysfunction, which produces impaired regulation of insulin, blood sugar, and cholesterol, as well as abnormal heart function.
The good news is that visceral fat yields fairly easily to exercise and diet, with benefits ranging from lower blood pressure to more favorable cholesterol levels. Subcutaneous fat located at the waist — the pinchable stuff — can be frustratingly difficult to budge, but in normal-weight people, it’s generally not considered as much of a health threat as visceral fat is.
MEASURING YOUR LEVEL OF RISK
The most accurate method is to use computed tomography (CT) or magnetic resonance imaging (MRI) to measure the amount of visceral fat. But they’re expensive and require sophisticated equipment.
A far simpler method is to determine the waist-to-hip ratio. With your abdomen relaxed, measure your waist at the navel. Next, measure your hips at their widest point, usually at the bony prominences. Finally, divide your waist size by your hip size:Â Waist (in inches) / Hips (in inches) = ratio
How does your ratio translate into health risk? The chance of suffering a heart attack or stroke increases steadily as a man’s ratio rises above 0.95; for women, risk begins to rise above 0.85.
The waist-to-hip ratio is a very useful tool. But many experts are now turning to an even simpler technique: waist circumference. Because it involves one measurement instead of two, it’s more accurate and reproducible than the waist-to-hip ratio.
To measure your waist circumference properly, take your shoes off and stand with your feet together. Be sure your belly is bare. Relax and exhale. Using a cloth measuring tape that can’t be stretched, not the stiff metal tape from your toolbox, measure your waist at the navel. Be sure to keep the tape parallel to the ground. Record the measurement to the nearest one-tenth of an inch.
Table 2: Interpreting your waist circumference
|
|
Men |
Women |
| Low risk |
37 inches and below |
31.5 inches and below |
| Intermediate risk |
37.1–39.9 inches |
31.6–34.9 inches |
| High risk |
40 inches and above |
35 inches and above |
Measuring your waist to learn if you have abdominal obesity and excess
visceral fat is easy — but doing something about it is much harder.
Remember the basics. The only way to reduce visceral fat is to lose weight —
and the only way to do that is to burn up more calories with exercise than you
take in from food. Sustained weight loss requires both caloric restriction and
increased exercise
The BMI is more complex, but waist measurement is more prone to errors than
measuring height and weight. So for the time being, you should use both
standards. Your BMI will give you the best estimate of your total body fatness,
while your waist measurement will give you the best estimate of your visceral
fat and risk of obesity-related disease.
RESOURCES:
http://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch/2010/August/taking-aim-at-belly-fat