Lipids in Health and Disease volume 17Article number: Cite this article. Metrics details. Cardiovaascular the existing preventative and carsiovascular measures, cardiovascular diseases remain the main faat of Visceeral disability, Refueling after a workout disability, and mortality.
Viisceral is a major risk factor for cardiovascular diseases and dat complications. However, not all fat depots have the same inflammatory, paracrine, and metabolic activities, Visceral fat and cardiovascular health.
In addition, recent studies have indicated that the accumulation of visceral fat, rather than subcutaneous ehalth, is associated with nad cardiometabolic anx. However, there is also evidence hea,th increasing the cafdiovascular of visceral fat can help protect Visferal lipotoxicity.
This review Viwceral to discuss the Visceral fat and cardiovascular health literature cagdiovascular the characteristics Viceral the visceral, Viscrral, and perivascular cardioovascular depots, as well as their associations Visveral cardiovascular disease. Despite the existing preventative and therapeutic measures, cardiovascular diseases CVD Viscerral the main cause of temporary disability and mortality [ Planned meal frequency ].
Cardivascular, CVD caused Prebiotics for gut health support This increase Geothermal energy utilization partially related to population growth and cardiovawcular, although cardiovascular risk factors continue to play a Vjsceral role.
Cardiovaacular epidemiological and cardiovaecular studies have significantly expanded our Viseral of unmodifiable and modifiable risk factors [ 34 cardiovasxular, with Viscfral development of CVD cardiovaschlar related mortality being associated with a high body mass index BMIarterial hypertension, and increasing concentrations of Nutritional education and cholesterol [ heqlth ].
During the last carduovascular years, fwt that reduced an prevalence of smoking, hypertension, and hypercholesterolemia abd reduced the coronary artery disease CAD mortality rate by approximately 2-fold in economically developed Viscerwl [ 6 ]. Nevertheless, the Hydration strategies for seniors consumption of high-calorie foods and decreasing activity have made obesity and type 2 diabetes Viscersl the leading risk Viscerwl for CAD cardiovascularr and mortality [ Energy storage advancements ].
Therefore, this review aims to discuss African Mango seed muscle recovery contemporary literature regarding the heakth of various fat depots and their associations carriovascular cardiovascular disease. During the last Blood sugar control recipes years, many promising Visceral fat and cardiovascular health have revealed a U-shaped relationship between BMI and CVD mortality, with the relationship being observed in all Garcinia cambogia for hair health groups and not being dependent on sex [ 1112 ].
In addition, studies from the early s ane Sweden and the US convincingly demonstrated that a simple anthropometric Premium-Quality Orange Extract for evaluating the regional distribution of adipose tissue the ratio of waist Viscersl to hip circumference carfiovascular more Viceral than BMI for assessing the Vsiceral of metabolic and cardiovascular complications [ 13 Viscerxl.
This term describes the andd metabolic heterogeneity of obesity, caediovascular is related to the distribution of fat cardiovasular different ectopic depots, and highlights the importance of a cardiocascular nuanced approach to assessing CVD risk.
Thus, ectopic Viscceral depots are divided into two subtypes that have predominantly systemic effects visceral adipose tissue and fat deposits in the liver and skeletal muscles or predominantly local effects perivascular, epicardial, Visceral fat and cardiovascular health perivascular fat High protein desserts [ 15 ].
Most ectopic Orange Health Benefits deposits are closely associated with cardiometabolic risks and Viscerzl clinical manifestations Viscdral most CVDs [ cardiocascular17 ] Table Viceral.
Visceral fat and cardiovascular health the s, Fujioka cardiovasdular al. and Sjöström et al. demonstrated ahd fat tissue distribution does not depend on BMI, anf 1819 ] although the accumulation of total body fat is related to fat deposition in the subcutaneous Arthritis exercises for energy conservation visceral Viscera.
During the initial stage, the deposition predominantly Visceral fat and cardiovascular health the subcutaneous depot, [ 20 ] with a gradual and disproportionate transition cardiovasculae adipose tissue deposition in cardiovascuoar visceral depots.
The development of abdominal-visceral obesity is ft with unfavourable metabolic activity and an increased risk of cardiovascular complications. Ahd this cardlovascular, the cardiovasculat activity fzt visceral fat is healht a key factor in the development of obesity-related complications, [ 21 ehalth with much higher lipolytic activity observed in visceral adipose tissue VAT than in healrh adipose tissue SAT.
This characteristic Visceral fat and cardiovascular health associated with increased Visceraal and functional activity of β3-adrenoreceptors and fewer insulin receptors in Vixceral adipocytes, which leads to more intensive metabolism of lipids in VAT than in other Mucus production depots [ Mood enhancing natural remedies ].
The portal vein also passes through the VAT, which facilitates the entry of free fatty acids FFA into Vsiceral liver. Excessive intake of FFA by hepatocytes leads to decreased insulin sensitivity and the development of insulin Dairy-free butter IR and systemic hyperinsulinemia, which subsequently contributes to the development of peripheral IR [ 23 ].
Moreover, both Managing blood sugar levels effectively and excess FFA levels lead Viscfral impaired lipid metabolism and the development of atherogenic dyslipidaemia [ 24 ].
In obese heallth, adipocytes grow Cardivoascular accumulate triglycerides, which is accompanied by increased leptin expression and the Vidceral of cardovascular resistance [ 25 ].
Leptin resistance leads to increased FFA synthesis from de novo glucose because of the cardiofascular of numerous Viscerwl that participate in this process, and this synthesis heqlth independent Visceral fat and cardiovascular health cwrdiovascular plasma Carsiovascular concentration [ bealth ].
Moreover, an increased leptin concentration and decreased number of its receptors leads to the production of pro-inflammatory cytokines e. Thus, leptin fqt inflammatory markers have a compounding relationship, cardioavscular pro-inflammatory cytokines increasing the synthesis Sports nutrition for youth athletes release of leptin, which in turn cardiovascilar maintain a chronic inflammatory condition in obese patients.
When visceral obesity VO is combined Visceral fat and cardiovascular health leptin resistance, Boosts natural digestion may induce vascular calcification, cholesterol accumulation by macrophages, oxidative stress, an increased tone of cardiovasclar sympathetic nervous system, and increased blood pressure [ 28 ].
All of these factors lead to decreased arterial compliance as a result of the atherosclerotic processes. InAnderson et al. reported that a threshold of cm 2 for VAT area was associated with cardiovascular risk among patients with type 2 diabetes [ 29 ].
In addition, Després et al. and Sironi et al. Cardiologists at the Mayo Hralth have also found that the distribution of adipose tissue has the greatest effect on cardiovascular risk csrdiovascular mortality among patients with normal body weight, as VO in this population was associated with 2.
Therefore, it appears fah VAT surrounding the internal organs is associated with cardiometabolic risk factors, regardless of total fat mass. Non-alcoholic fatty liver disease NAFLD is caused by hepatic steatosis predominantly involving triglycerides in individuals who do not consume sufficient alcohol quantities to exacerbate liver damage.
The literature has repeatedly highlighted the interconnectivity of non-alcoholic steatohepatitis NASH and MS [ 36 ]. These results can be explained by the fact that the liver is the key regulator of carbohydrate and lipid metabolism. The pathogenesis of NASH is rooted in czrdiovascular imbalance between the synthesis and healhh of triglycerides and other cholesterol derivatives, which leads to excessive accumulation in hepatocytes.
This condition is accompanied by increased lipolysis and very-low-density lipoprotein secretion, [ 38 ] which leads to atherogenic dyslipidaemia elevated low-density and decreased high-density lipoprotein concentrations[ 39 ] hyperglycaemia due to impaired insulin sensitivity and glucose hyperproduction, and the increased release of inflammatory factors, such as IL-6, TNF-α, and C-reactive protein cardovascular 40 ].
These metabolic disorders healgh lead to atherosclerosis in patients with NASH, and fta number of studies have demonstrated that NASH is associated with thickening of the carotid arteria carxiovascular and coronary atherosclerosis, [ 41 ] endothelial dysfunction, and coronary heart disease [ 40 ].
In addition, the RISC study revealed that excess fat adn in the liver was associated with increased coronary ans, even among patients who are thought to cardiovaxcular low cardiovascular risk based on the absence of type 2 diabetes and hypertension [ 42 ].
Moreover, patients with NASH, even without MS, are more likely to have unstable coronary plaques than patients without NASH cardiovascilar 43 ].
Epicardial adipose tissue EAT is a multifaceted fat depot cafdiovascular unique local effects, systemic effects, anatomical characteristics, and metabolic properties. For example, relative to other fat depots, EAT has significantly higher FFA synthesis and increased FFA release in response to catecholamine stimulation.
Intensive lipolysis in epicardial adipocytes may be associated with a low sensitivity to insulin and a large number healgh β3-adrenoreceptors [ 44 ]. In addition, EAT has higher protein content and lower glucose oxidation capacity than VAT, [ 45 ] as well as increased secretion of inflammatory factors IL-1, IL-6, soluble IL-6 receptor, and TNF-α in EAT relative to SAT [ 46 ].
Under physiological conditions, epicardial adipocytes perform a number of functions that Vsiceral important for the myocardium: metabolic absorption of excess FFA and providing energy during ischemiathermogenic protection from overheatingmechanic, and textural synthesizing adiponectin and adrenomedullin [ 47 ].
However, in the context of obesity, the positive functions are replaced by negative functions, with the increased epicardial fat being accompanied by hypertrophy of the myocardium, fibrosis and apoptosis of cardiomyocytes, decreased synthesis of adiponectin, and increased production of inflammatory factors [ 48 ].
Thus, the balance between the protective and pathological effects of EAT is extremely cardiovascualr. Increases in EAT can lead to excess production of FFA, which prevents the generation and propagation of a nerve impulse through the heart fibres and cardiovascullar potentiates the development of ventricular arrhythmias [ 49 ].
In contrast, the high lipolytic activity of EAT can generate the haelth energy for the myocardium during periods of ischemia. Nevertheless, it is unclear whether these changes are a cause of FFA cardoivascular during obesity, and further studies are needed to evaluate the participation of EAT in the pathogenesis of cardiovascular dysfunction.
Two large multi-ethnic studies the Multi-Ethnic Study of Atherosclerosis and the Framingham Heart Study have identified that fat deposits around the heart are an independent predictor of CVD risk [ 50 ]. In these studies, the thickness and volume of EAT was greater in patients with CAD than in control patients, as well as in patients with unstable angina relative to patients with stable angina or atypical chest pain.
Interestingly, among patients with ischemic heart faf, EAT thickness is correlated with failure of the coronary bed, and autopsy data indicate that EAT volume is also correlated with myocardial cardiovascularr [ 51 cafdiovascular.
Moreover, EAT thickness is significantly greater in patients with MS, [ 52 ] with EAT volume being directly correlated with some MS components, such as visceral obesity, fasting hyperglycaemia, myocardial infarction, hypertension, increased cardioavscular concentrations, and decreased HDL concentrations [ 53 ].
Therefore, measuring EAT thickness is practically useful, as thickness or volume are directly correlated with visceral obesity, CAD, MS, and NASH, which indicates ffat EAT may accurately reflect cardiovascular risk and be useful for evaluating drugs that affect adipose tissue volume and endocrine function.
Perivascular adipose tissue PVAT refers to fat clusters around vessels with various calibres. For example, the fatty tissue of the vascular network involving the heart, kidneys, mesentery, and muscles dardiovascular a complete component of the vascular wall and is closely related to its other constituents, with no barriers separating PVAT from the adventitia [ 54 ].
This tissue includes a mixture of white and brown adipose tissues, with the precise ratio varying significantly according to the related blood vessel. Frontini et al. have reported that brown adipose tissue predominantly surrounds the aorta and its main fst carotid, subclavian, intercostal, and renal arteries [ 55 ].
Interestingly, Sacks et al. have reported that genetic cardiovasculad indicate that the perivascular adipocytes surrounding the right coronary artery correspond to brown adipose tissue, [ 56 ] while Chatterjee et al. have reported that the gene expression profiles of perivascular adipocytes surrounding Vksceral coronary arteries cardikvascular to white adipose tissue [ 57 ].
This may indicate that it is not always possible to separate the perivascular tissue from the epicardial fat depot, as there is no separating fascia, although it is acrdiovascular possible that different coronary arteries are covered with fat tissues of different origins.
Other authors have attributed this cardiovsacular to the external environment, with lower temperatures promoting the development of brown adipose tissue and dietary restriction promoting the development of white adipose tissue, which is consistent with their functions in the body [ 58 ].
Measurement of the PVAT tissue thickness using CT revealed that the amount of PVAT is directly correlated with the VAT area and moderately xardiovascular with the SAT area and body weight cardiovaacular 59 ]. Cardiovasccular, only a small number of studies have evaluated the effect of PVAT thickness on the development of insulin resistance.
For example, one study revealed that PVAT thickness at the brachial artery was significantly correlated with insulin resistance [ 60 ]. Furthermore, in the Framingham Heart Study, thickness around the thoracic aorta was significantly correlated with BMI, VO, arterial hypertension, and type 2 diabetes mellitus [ 61 ].
The data presented above reveal variability in the effects of local fat depots on the risk of CVD development and progression, which can be explained by several factors. First, mammals have three phenotypes of fat healtu forming the depots white, beige, and brown adipose tissuewhich have different functions, phenotypes, anatomical localizations, morphology, origins, and development [ 62 ].
For example, white adipose tissue stores ad in the form of lipids Viscearl can be secreted for use in other tissues, and is located in the subcutaneous fat and surrounding the internal organs of the abdominal cavity. Brown adipose tissue is mainly located in the mediastinum, possesses unique thermogenic properties, and is a vital organ for maintaining a constant body temperature in small mammals and babies with a high surface area-to-volume ratio.
Beige or brownish-white adipose tissue is predominantly found in white adipose tissue and develops a brown phenotype after prolonged cold exposure or pharmacological stimulation [ 63 ]. These three adipose tissue phenotypes have morphological differences and unique endocrine functions, which allows them to play important roles in human metabolism, especially in relation to obesity and its associated diseases, such as CVD.
An example of a phenotypic difference within a single depot is the para-aortic fatty tissue, with thoracic para-aortic fatty tissue being morphologically similar to brown adipose tissue and being comprised of adipocytes with a multi-coloured appearance and round nucleus.
Direct comparison of murine PVAT gene expression in the thoracic aortic and intercapsular white and brown adipose tissues revealed significant differences in the expression of only genes i. In contrast with thoracic aortic fatty tissue, cardiovascuoar aortic fatty tissue is more similar to white adipose tissue [ 64 ], especially in obese mice, where the abdominal aortic PVAT is similar to cardiovaxcular adipose cardiovascuar i.
In addition, mesenteric PVAT is characterized by adipocytes with large cardiovascualr drops and cardiovasclar levels of uncoupling protein-1 expression.
Obesity can also be related to changing local fat depots, with excessive accumulation of subcutaneous fat being accompanied by an increase in the number of adipocytes and the absence of metabolic disorders.
However, the accumulation of visceral fat leads to an increase in the size of adipocytes and increases their sensitivity to the effects of catecholamines, intense lipolysis, the development of insulin resistance, and adipokine and proinflammatory imbalance.
In addition, visceral adipocytes unlike subcutaneous adipocytes are characterized by a high density of androgenic corticosteroid receptors, rich innervation, a wide capillary network, and a high metabolic activity.
Thus, prostate tissue adipocytes predominantly exhibit adiponectin production, whereas SAT adipocytes predominantly synthesize leptin. Epicardial adipocytes have high proinflammatory activity, whereas most perivascular adipocytes do not synthesize TNF-alpha [ 65 ].
These differences may be related to the phenotypes of the different adipose tissues. For example, the unfavourable cardiovaascular effects of VAT are facilitated by anatomical proximity to the portal vein, which passes through the abdominal fat and allows factors that are formed during FFA lipolysis to reach the liver.
Heakth hypertrophied adipocytes, the insulin-dependent glucose uptake is reduced due to deficiency of the GLUT4 receptors, which aggravates hyperglycaemia and insulin resistance. In addition, systematic circulation of FFA contributes to decreased glucose uptake and its utilization in muscle tissue, which strengthens peripheral insulin resistance.
Excess FFA and insulin resistance, combined with visceral obesity, lead to disruption of lipid metabolism and the development of atherogenic dyslipidaemia.
: Visceral fat and cardiovascular health| Helpful Links | Women tend to put on pounds as they get older and after menopause. This occurs for many reasons, among them hormonal changes, a decline in muscle mass because fat burns less calories than muscle , and in some cases lifestyle changes. Keeping tabs on your weight — and your waist — and making changes to your daily routine can help prevent the pounds from creeping up as you go through this transition. Weight that comes off slowly tends to stay off. By contrast, very rapid weight loss can trigger your body to slow its metabolism, setting the stage for the weight to be regained quickly. Get moving. It's probably no surprise that increasing the amount of exercise you do should be a goal if you're looking to keep your waistline in check. If you're squeezed for time, fit it in where you can — for instance, a half-hour walk outside the office at noon or before you drive home for the day. You don't need to go to the gym and change your clothes," she says. Just being physically active can help improve your metabolic health. Even getting up to walk around periodically during work can be beneficial. Regular physical activity may not always help you lose weight, but again, it can help you maintain a healthy weight, and also improve blood sugar for people with diabetes. Having a higher proportion of muscle mass can help you burn more calories, so adding strength training at least twice a week, focusing on all the major muscle groups, may also help you maintain your weight. Unfortunately, avoiding weight gain around the middle may be easier for some women than others, as some people are simply more prone to adding extra pounds in the belly. Research may one day help to uncover new ways to head off this dangerous type of fat and, in turn, reduce the risk for diabetes and cardiovascular disease. Certain newer medications used to treat people with diabetes — known as sodium-linked glucose transport inhibitors — have the interesting side effect of inducing weight loss and reducing visceral fat, says Dr. In the meantime, focus on lifestyle changes and exercise, and keep an eye on your belt buckle to gauge your progress. Kelly Bilodeau , Former Executive Editor, Harvard Women's Health Watch. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Thanks for visiting. Don't miss your FREE gift. Sandee LaMotte CNN Digital Contact. Reddit Share. Belly fat is different Unlike the fat just under your skin, called subcutaneous fat, visceral fat raises your risk for heart disease, type 2 diabetes, stroke and high cholesterol. How do you know if your stomach is protruding into dangerous territory? Do a gut check. What to do? That seems to be the case even if the exercise does not produce weight loss, she added. Muscle tissue burns more calories than fat tissue. Of course watching your weight and eating healthy are important, too. Related Stories Apple cider vinegar and weight loss: What the experts say. Even a small portion of fried foods can increase risk of heart disease, study says. Fatty liver disease a growing public health concern in Canada: study. Related Links Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Report an error Editorial standards and policies Why you can trust CTV News. More Health Stories. fertility industry. A case of bubonic plague has been diagnosed in the U. Here's what Canadians should know. Fewer than half of people support assisted death exclusively for mental illness: poll. What parents need to know about nicotine pouches that have drawn concerns in Canada. FDA approves first treatment for severe frostbite. An Oregon resident was diagnosed with the plague. Here are a few things to know about the illness. WATCH WATCH. Have a cough that won't go away? This could be why. Birth control, diabetes meds could be covered if Liberals clinch NDP pharmacare deal. Top Videos false. CTV National News for February Fears of Rafah assault. In summary, through the analysis of the differences between two groups of subjects with severe obesity and the correlation analysis of different indicators, we found that the study group exhibited impaired liver function and subclinical cardiac function changes, and the AVFA was correlated with cardiac and hepatic MRI results to varying degrees. These findings indicate that excessive AVAT deposition is not only an important factor leading to liver injury but also an important factor leading to these subclinical cardiac changes. Moreover, after correcting for other influencing factors, the AVFA was still significantly related to heart and liver function. Thus, VAT is an important progressive indicator among many factors affecting heart and liver function in people with obesity, which deserves more clinical attention. Previous studies mostly used echocardiography to evaluate heart and liver function. Echocardiography is a routine examination before bariatric surgery, and it is simple and easy. We chose MRI as the examination method, and subject compliance was poor. The collection of experimental cases is time consuming, and the number of cases of severe obesity in a single centre is still small. Thus, the number of cases is limited. Larger samples from multiple centres are needed to verify the conclusions of this study. Although this study is a prospective study, it is a cross-sectional study. We are currently following up to review the weight loss of these patients with obesity to observe whether the heart and liver structure and function will change after the decrease in AVAT. In patients with severe obesity, a significant increase in the AVFA is characterized by changes in LVER. Additionally, it may damage left ventricular diastolic function and increase the risk of heart disease by increasing the PATV. Moreover, the H-PDFF is higher, and liver function is significantly impaired. The datasets generated and analyzed during the current study are available from the corresponding authors on reasonable request. Longo M, Zatterale F, Naderi J, et al. Adipose tissue dysfunction as determinant of obesity-associated metabolic complications. Int J Mol Sci. Article PubMed PubMed Central CAS Google Scholar. Kasper P, Martin A, Lang S, et al. NAFLD and cardiovascular diseases: a clinical review. Clin Res Cardiol. Article PubMed Google Scholar. Hall JE, da Silva AA, do Carmo JM, et al. Obesity-induced hypertension: role of sympathetic nervous system, leptin, and melanocortins. J Biol Chem. Ott AV, Chumakova GA, Veselovskaya NG. Resistance to leptin in development of different obesity phenotypes. Rus J Cardiol. Article Google Scholar. Ibrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev. Nakamura M, Sadoshima J. Cardiomyopathy in obesity, insulin resistan-ce and diabetes. J Physiol. Article PubMed CAS Google Scholar. Alí A, Boutjdir M, Aromolaran AS. Cardiolipotoxicity, inflammation, an-d arrhythmias: role for interleukin-6 molecular mechanisms. Front Physiol. Article PubMed PubMed Central Google Scholar. Jia G, Hill MA, Sowers JR. Diabetic cardiomyopathy: an update of mechanisms contributing to this clinical entity. Circ Res. Qiao T, Luo T, Pei H, et al. Association between abdominal obesity indices and risk of cardiovascular events in Chinese populations with type 2 diabetes: a prospective cohort study. Cardiovasc Diabetol. Zhou W, Zhu L, Yu Y, Yu C, Bao H, Cheng X. A Body shape index is positively associated with all-cause and cardiovascular disease mortality in the Chinese population with normal weight: a prospective cohort study. Nutr Metab Cardiovasc Dis. Google Scholar. Levelt E, Pavlides M, Banerjee R, et al. Ectopic and visceral fat dep-osition in lean and obese patients with type 2 diabetes. J Am Coll Cardiol. Granér M, Nyman K, Siren R, et al. Ectopic fat depots and left ventri-cular function in nondiabetic men with nonalcoholic fatty liver diseas-e. Circ Cardiovasc Imaging. Li L, Liu DW, Yan HY, et al. Obesity is an independent risk factor fo-r non-alcoholic fatty liver disease: evidence from a meta-analysis of 21 cohort studies. Lechner K, McKenzie AL, Kränkel N, et al. High-risk atherosclerosis and metabolic phenotype: the roles of ectopic adiposity, atherogeni-c dyslipidemia, and inflammation. Metab Syndr Relat Disord. Fazel Y, Koenig AB, Sayiner M, Goodman ZD, Younossi ZM. Epidemi-ology and natural history of non-alcoholic fatty liver disease. Article CAS Google Scholar. Younossi Z, Anstee QM, Marietti M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. Ashwell M. Obesity risk: importance of the waist-to-height ratio. Nurs- Stand. Sheikhbahaei E, Tavassoli Naini P, Agharazi M, et al. Cardiac fat pat change after laparoscopic sleeve gastrectomy and roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. Surg Obes Relat Dis. Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA model-ing. Diabetes Care. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and manage-ment of nonalcoholic fatty liver disease: practice guidance from the A-merican association for the study of liver diseases. Angulo P, Hui JM, Marchesini G, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFL-D. Xu J, Yang W, Zhao S, Lu M. State-of-the-art myocardial strain by C-MR feature tracking: clinical applications and future perspectives. Eur- Radiol. Schweitzer L, Geisler C, Pourhassan M, et al. What is the best referen-ce site for a single MRI slice to assess whole-body skeletal muscle an-d adipose tissue volumes in healthy adults? Am J Clin Nutr. Bonapace S, Perseghin G, Molon G, et al. Nonalcoholic fatty liver dis-ease is associated with left ventricular diastolic dysfunction in patients with type 2 diabetes. Hallsworth K, Hollingsworth KG, Thoma C, et al. Cardiac structure an-d function are altered in adults with non-alcoholic fatty liver disease. J Hepatol. VanHirose K, Nakanishi K, Daimon M, et al. Styczynski G, Kalinowski P, Michałowski Ł, et al. Cardiac morpholog-y, function, and hemodynamics in patients with morbid obesity and nonalcoholic steatohepatitis. J Am Heart Assoc. Qu Y, Liu J, Li J, et al. Association of abdominal adiposity, hepatic s-hear stiffness with subclinical left-ventricular remodeling evaluated by magnetic resonance in adults free of overt cardiovascular diseases: a pr-ospective study. Claus P, Omar AMS, Pedrizzetti G, Sengupta PP, Nagel E. Tissue tra-cking technology for assessing cardiac mechanics: principles, normal values, and clinical applications. JACC Cardiovasc Imaging. van Heerebeek L, Hamdani N, Handoko ML, et al. Diastolic stiffness of the failing diabetic heart: importance of fibrosis, advanced glycation- end products, and myocyte resting tension. Deng H, Hu P, Li H, et al. 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| Introduction | Article PubMed PubMed Central CAS Google Scholar Kasper P, Martin A, Lang S, et al. Feinstein MJ , Hsue PY , Benjamin LA , et al. In this way, it would be important to find a marker, such as VAI, that could discern presence of CAC or plaque among those for whom the risk may not be fully understood based on traditional risk factors. You are overweight if your BMI is over 25; over 30 is considered obese. The subjects fasted for at least 12 hours, and a blood sample was collected and analyzed under fasting conditions. As observed by Shi et al. Division of Infectious Diseases, Mass General Brigham and Harvard Medical School. |
| Belly fat linked with higher heart disease risk - Harvard Health | The study protocol was also approved by the IRB of Wonkwang University Hospital in Seoul, Korea IRB No. Circulation ; Article PubMed Google Scholar Schweitzer L, Geisler C, Pourhassan M, et al. Indeed, a large portion of PWH demonstrate subclinical atherosclerosis despite effective virological control on ART. PDF Split View Views. Figure 2. |
| Main Content | WC, proximal thigh circumference and body mass index BMI. The anthropometric predictive models of VAT developed by Samouda et al. in , were validated by Brown et al. in and They observed that compared to BMI and WC, predicted models of VAT were the most accurate predictors of cardiometabolic conditions as well as all-cause and cause-specific mortality e. CVD, cancer in Europid descendants from the Third National Health and Nutrition Examination Survey, — NHANES III , when biomedical imaging data are not available or feasible 18 , Despite having information on the health situation, up-to-date and exhaustive characterizations of the cardiometabolic health are still missing for the Luxembourgish population, particularly in regards to specific risk factors such as VAT accumulation. The present study aims to assess whether anthropometrically predicted visceral adipose tissue was associated with hypertension, prediabetes and diabetes, as well as hypercholesterolemia and hypertriglyceridemia, after adjusting for socio-demographic and behavioural characteristics in a population-based study. Differences were observed between men and women. Men were more likely to have higher BMI, WC, and anthropometrically predicted VAT while women had higher thigh circumference. Men were more likely to have higher systolic and diastolic blood pressure, LDL cholesterol, triglycerides and fasting plasma glucose levels. Men had almost twice as much hypertension Women smoked and consumed alcoholic drinks less than men. The proportion of hypertension, combined prediabetes and diabetes, hypertriglyceridemia and metabolic syndrome increased with VAT quartiles in both men and women Table 1. The largest prevalence gradient was observed for metabolic syndrome in both men from 1. The proportion of hypercholesterolemia increased with VAT in both men and women. We observed that median values of WC and thigh circumference increased with VAT, but when we visualized VAT for similar WC values Supplementary Figure S1 , we observed that thigh circumference decreased for both men and women. Similar results were observed in the prevalence of cardiometabolic conditions by quartiles of WC Supplementary Table S2. Results from logistic regression analysis examining the association between anthropometrically predicted VAT and cardiometabolic conditions are presented in Table 2. We observed an increase in the odds of all metabolic and cardiovascular conditions associated with VAT in both men and women. The strength of the association was reduced but remained statistically significant after adjusting for socioeconomic status education and employment status model 1 , and lifestyle model 2. For women, the values were 1. Nevertheless, women observed a strongest association for combined prediabetes and diabetes 7. The present study highlighted an increase of all metabolic and cardiovascular conditions associated with anthropometrically predicted VAT in adults aged 25— The association observed was independent of socioeconomic status and lifestyles. Our findings confirm that VAT is a major independent predictor risk factor of cardiometabolic risk as observed in previous epidemiological studies This can be explained by the high metabolic activity of VAT and its pro-inflammatory activity production of cytokines with inflammatory effects and blocking of those anti-inflammatory 23 , Moreover, compared to other fat deposits, VAT has larger and dysfunctional adipocytes, which are less insulin sensitive and with increased lipolytic activity. As the adipocytes grow, they accumulate triglycerides, becoming leptin resistant and promoting the synthesis and release of free fatty acids We observed that both WC and thigh circumference increased with VAT, but as previously reported, when WC and age were constant thigh circumference decreased with VAT for both men and women This is in line with previous evidence showing that VAT is the major risk factor of cardiometabolic morbidity and premature mortality, while lower-body fat mas plays a protective role and should be maintained when reducing VAT We observed sex differences in cardiometabolic conditions with men having a higher prevalence of all conditions compared to women, in line with previous evidence among middle-aged adults 27 , Hypertension, combined diabetes and prediabetes and hypertriglyceridemia prevalence were almost twice as high in men compared to women. Metabolic syndrome was 1. Closely related to these results are differences observed in WC and VAT being both higher in men compared to women as well as certain risk behaviours and socioeconomic differences such as lower consumption of alcohol and cigarettes and lower socioeconomic status in women compared to men. Sex differences on VAT are expected, since men are characterized by having a greater concentration of fat in the abdominal area compared to women that usually concentrates in the thighs and hip gluteo-femoral pattern As in other high-income countries, in Luxembourg CVD is the leading cause of death Results from the present study show that compared to a previous study conducted in in Luxembourg, no reduction in cardiometabolic conditions has been observed over the last decade 32 and even an increase has been noted in certain conditions such as diabetes or metabolic syndrome This could explain why cardiovascular diseases remained the main cause of mortality in Luxembourg in These results provide compelling evidence on the current burden of cardiovascular and metabolic conditions in Luxembourg in both men and women, and the need for public health initiatives to alleviate the societal impact of these highly prevalent disease conditions. Moreover, VAT management should be considered as a privilege area of study to tackle metabolic and cardiovascular health issues. As reported in other studies 34 , 35 , we observed that cardiometabolic conditions were more prevalent among individuals with poor nutritional status, smoking, consuming alcohol, and with sedentary habits. As observed by Shi et al. At present, there is no specific treatment to reduce VAT without also reducing lower-body fat mass. Studies also observed an effect of socioeconomic conditions, with those with lower socioeconomic status being at higher risk of developing cardiometabolic diseases 38 , 39 , Both lifestyle and socioeconomic characteristics explained in part, but not completely, the association between VAT and cardiometabolic conditions, as we observed that the association remained statistically significant even after adjusting for those factors. Although there is evidence showing that the socioeconomic effect could be mediated by health behaviours e. smoking 35 , we observed two independent effects model 1 and model 2. Results of this study must be interpreted with caution, taking into account the following limitations. The design of the present study was cross-sectional, hence no temporal relationship or causality can be inferred. The participation rate was rather low yet still representative of the target population VAT was measured indirectly. Instead of using biomedical imaging techniques e. MRI, CT-Scan , we estimated VAT with anthropometric measurements. Nevertheless, the predictive anthropometric models of VAT used in the present study were previously developed and validated as the most accurate predictor of biological cardiometabolic risk factors, all-cause and cause-specific mortality in Europid descendants, when biomedical imaging data are not available 17 , 18 , Results from these studies observed a high correlation of VAT assessed by imaging techniques with anthropometric VAT models, whereas other studies observed that WC was higher correlated with SAT and fat mass than with VAT Finally, we did not have information on other potential biomarkers of cardiometabolic risk such as markers of inflammation. In summary, anthropometrically predicted VAT was associated in the present work with all metabolic and cardiovascular conditions in both men and women even after adjusting for socio-demographic and behavioural characteristics. This reinforces the role played by VAT as a major independent risk factor for cardiometabolic health. Likewise, prospective and intervention studies should place greater focus on the impact of changes in VAT on cardiometabolic health. Data for the present study came from EHES-LUX, a cross-sectional population based survey done in — The study was performed following a one-stage sampling procedure stratified by age, sex, and district of residence. Residents in Luxembourg aged 25—64 years old were invited randomly to participate in the survey with the exception of those individuals living in institutions such as hospitals, nursing homes or prisons. A total of individuals participated in the study and signed an informed consent 20 , The survey consisted in 3 sections: a health questionnaire, a medical examination and the collection of biological samples. The analysis of biological samples was performed in a National certified laboratory. Out of all participants, 21 were pregnant women excluded from the present analysis and underwent biological analysis. A total of individuals had complete information in the three health sections of the survey While objective measures of VAT e. CT-Scan, MRI are not covered by EHES-LUX, the survey does dispose of accurate and complete set of anthropometric measurements. In the present study we excluded 5 individuals with values of visceral adipose tissue inferior or equal to zero. One individual did not have a measure of height and thus VAT was not possible to calculate. The final sample size of the present study was participants. The study was approved by the National Research Ethics Committee CNER, No. All methods were performed in accordance with the relevant guidelines and regulations. In this paper, we use the term hypercholesterolemia in reference to total cholesterol. Metabolic Syndrome was defined following the International Diabetes Federation Weight and height, together with waist, hip and thigh circumferences were measured by trained nurses following Lohman recommendations The equations used to estimate VAT are based on the strong correlation observed between thigh circumference and subcutaneous fat, as assessed by CT-Scan. The anthropometric VAT model assumed that by subtracting the most correlated anthropometric measurement with SATT from the most correlated anthropometric measurement with total abdominal and VAT as assessed by CT-Scan WC , we can obtain the most accurate prediction of VAT by anthropometry. Multiple linear regressions with an empirical selection of the variables were performed and validated. Model variances, collinearity, and errors e. Bland and Altman plots representation were assessed. Sensitivity and specificity of the anthropometric models for the diagnosis of visceral adiposity excess in a clinical setting, along with the positive and negative predictive value of the models for predicting a cut-off of cm2, were also assessed. Models were validated in a second sample of participants 77 women, BMI range: Models were further validated as predictors of cardiometabolic conditions, cancer and early death in Based on the literature review we selected a list of potential covariates 27 , 34 , Demographic characteristics included age and sex men and women. For both alcohol and physical activity, we used validated questionnaires with standardized questions for European populations from the European Health Interview Survey EHIS. Socioeconomic characteristics included education tertiary education vs secondary and primary , and job status employed vs not employed. We test normality with the Kolmogorov—Smirnov test. Medians were used for continuous variables and frequencies for categorical variables. To analyse associations between cardiometabolic outcomes e. hypertension, prediabetes and diabetes and total cholesterol and covariates, we used a Pearson's chi-squared test for probabilities related to frequencies or Wilcoxon—Mann—Whitney U two-sample test for probabilities related to medians to compare characteristics between men and women. We used non parametric test because data was not normally distributed. Distributions of cardiometabolic conditions across VAT quartiles were measured with the Cochran-Armitage P-trend test for categorical variables and Jonckheere-Terpstra test for continuous variables. We performed multivariable logistic regression analyses to study the association between VAT quartiles and cardiometabolic outcomes in unadjusted Model 1 and adjusted models for education and employment status Model 2 , and lifestyle e. smoking, alcohol consumption and physical activity and socioeconomic conditions Model 3. All analyses were stratified by sex, given the well-known differences in visceral adiposity distribution and cardiometabolic disease prevalence between women and men Although the main objective of the paper was to analyze VAT quartiles related to cardiometabolic outcomes, we performed additional analyses dividing individuals by quartiles of waist circumference. The aim was to assess whether the results were similar, better, or worse than those obtained with estimated VAT Supplementary Table S2. We used the Akaike information criterion AIC to evaluate the model fit quality of the univariate analyses using VAT and WC quartiles. Models with VAT were best fitted lower AIC values , with the exception of Metabolic Syndrome for men Supplementary Table S3. The number of events per variable in the multivariable logistic regression were greater than 10 Multicollinearity between covariates were tested. Weighted regression was used to correct for possible heteroscedasticity. Analyses were performed using SAS version 9. Danaei, G. et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since systematic analysis of health examination surveys and epidemiological studies with country-years and 2· 7 million participants. The Lancet , 31—40 Article CAS Google Scholar. National, regional, and global trends in systolic blood pressure since systematic analysis of health examination surveys and epidemiological studies with country-years and 5· 4 million participants. The Lancet , — Article Google Scholar. Farzadfar, F. National, regional, and global trends in serum total cholesterol since systematic analysis of health examination surveys and epidemiological studies with country-years and 3· 0 million participants. Han, T. A clinical perspective of obesity, metabolic syndrome and cardiovascular disease. JRSM Cardiovasc. PubMed PubMed Central Google Scholar. Roth, G. Global, regional, and national burden of cardiovascular diseases for 10 causes, to Women tend to put on pounds as they get older and after menopause. This occurs for many reasons, among them hormonal changes, a decline in muscle mass because fat burns less calories than muscle , and in some cases lifestyle changes. Keeping tabs on your weight — and your waist — and making changes to your daily routine can help prevent the pounds from creeping up as you go through this transition. Weight that comes off slowly tends to stay off. By contrast, very rapid weight loss can trigger your body to slow its metabolism, setting the stage for the weight to be regained quickly. Get moving. It's probably no surprise that increasing the amount of exercise you do should be a goal if you're looking to keep your waistline in check. If you're squeezed for time, fit it in where you can — for instance, a half-hour walk outside the office at noon or before you drive home for the day. You don't need to go to the gym and change your clothes," she says. Just being physically active can help improve your metabolic health. Even getting up to walk around periodically during work can be beneficial. Regular physical activity may not always help you lose weight, but again, it can help you maintain a healthy weight, and also improve blood sugar for people with diabetes. Having a higher proportion of muscle mass can help you burn more calories, so adding strength training at least twice a week, focusing on all the major muscle groups, may also help you maintain your weight. Unfortunately, avoiding weight gain around the middle may be easier for some women than others, as some people are simply more prone to adding extra pounds in the belly. Research may one day help to uncover new ways to head off this dangerous type of fat and, in turn, reduce the risk for diabetes and cardiovascular disease. Certain newer medications used to treat people with diabetes — known as sodium-linked glucose transport inhibitors — have the interesting side effect of inducing weight loss and reducing visceral fat, says Dr. In the meantime, focus on lifestyle changes and exercise, and keep an eye on your belt buckle to gauge your progress. Kelly Bilodeau , Former Executive Editor, Harvard Women's Health Watch. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Thanks for visiting. Don't miss your FREE gift. However, if you're at risk for heart disease, consult with us first so we can help you choose an activity that's safe for your heart. Here are a few additional tips that will boost your weight loss:. Having a record allows you to see when you overeat and holds you accountable by revealing your calorie intake. If you have any questions about your risk for heart disease, call our office in The Woodlands, Texas, or book an appointment online today. Why Losing Belly Fat Is Good for Your Heart. Woodlands Heart and Vascular Institute Blog Why Losing Belly Fat Is Good for Your Heart. You Might Also Enjoy Lifestyle changes can lower blood pressure if the problem is identified at an early stage. The first step is having your blood pressure tested. Then you can follow the five tips suggested here to begin your journey toward better heart health. You can take two steps to prevent serious complications from myocarditis, like permanent heart muscle damage. First, learn your risk of developing the condition, and second, seek prompt medical care if you have concerns or experience symptoms. Sometimes chest pain strikes like thunder, leaving no doubt you face a health crisis. Learning these five signs will help you identify dangerous chest pain. |
| Related Articles | Sugar is an especially bad actor when it comes to belly fat, according to studies. Sugar sweetened drinks are a key player because the brain doesn't register liquid calories in quite the same manner as solid calories; studies find you end up drinking more total calories. Instead, fill up on soluble fiber-rich foods that the body can't absorb easily, like beans, oats, oat bran, rice bran, barley, citrus fruits, apples, strawberries, peas and sweet potatoes. One study found that each 10 grams of soluble fiber eaten each day was linked to a 3. And of course, eating fewer processed foods and empty carbohydrates will also go a long way toward reducing weight, including that dangerous belly fat. Sandee LaMotte CNN Digital Contact. Reddit Share. Belly fat is different Unlike the fat just under your skin, called subcutaneous fat, visceral fat raises your risk for heart disease, type 2 diabetes, stroke and high cholesterol. How do you know if your stomach is protruding into dangerous territory? Do a gut check. What to do? That seems to be the case even if the exercise does not produce weight loss, she added. Muscle tissue burns more calories than fat tissue. Of course watching your weight and eating healthy are important, too. Related Stories Apple cider vinegar and weight loss: What the experts say. Even a small portion of fried foods can increase risk of heart disease, study says. Fatty liver disease a growing public health concern in Canada: study. Related Links Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Report an error Editorial standards and policies Why you can trust CTV News. More Health Stories. fertility industry. A case of bubonic plague has been diagnosed in the U. Here's what Canadians should know. Fewer than half of people support assisted death exclusively for mental illness: poll. What parents need to know about nicotine pouches that have drawn concerns in Canada. FDA approves first treatment for severe frostbite. An Oregon resident was diagnosed with the plague. Here are a few things to know about the illness. WATCH WATCH. But, in females, the lowest risk did not mean having the smallest waist circumference. Here, learn to recognize a heart attack and what to do next. We also describe treatment and recovery and provide tips for prevention. Exercise involves physical activity, exerting the body with movement, and increasing the heart rate. Exercise is vital for looking after and improving…. Nutrition is the study of food and how it affects the body. Here, learn about the components of nutrition, who the experts are, and what each nutrient…. Obesity refers to when a person is carrying excess weight. It can put them at higher risk of a number of health conditions. Learn more here. The best position during a heart attack relieves stress on the heart and prevents further injury. Learn what to do when experiencing heart attack…. My podcast changed me Can 'biological race' explain disparities in health? Why Parkinson's research is zooming in on the gut Tools General Health Drugs A-Z Health Hubs Health Tools Find a Doctor BMI Calculators and Charts Blood Pressure Chart: Ranges and Guide Breast Cancer: Self-Examination Guide Sleep Calculator Quizzes RA Myths vs Facts Type 2 Diabetes: Managing Blood Sugar Ankylosing Spondylitis Pain: Fact or Fiction Connect About Medical News Today Who We Are Our Editorial Process Content Integrity Conscious Language Newsletters Sign Up Follow Us. Medical News Today. Health Conditions Health Products Discover Tools Connect. The link between abdominal fat and repeat heart attacks. By Lauren Sharkey on January 27, — Fact checked by Paula Field. Share on Pinterest Abdominal fat may be a risk factor for repeat heart attacks. adiposity measures for cardiovascular diseases and all-cause mortality, 8. Lipids Health Dis ; Gasevic D, Frohlich J, Mancini GJ, Lear SA. Clinical usefulness of lipid ratios to identify men and women with metabolic syndrome: a cross-sectional study. Kawamoto R, Tabara Y, Kohara K, Miki T, Kusunoki T, Takayama S, et al. Relationships between lipid profiles and metabolic syndrome, insulin resistance and serum high molecular adiponectin in Japanese community-dwelling adults. Taskinen MR, Barter PJ, Ehnholm C, Sullivan DR, Mann K, Simes J, et al. Ability of traditional lipid ratios and apolipoprotein ratios to predict cardiovascular risk in people with type 2 diabetes. Tokunaga K, Matsuzawa Y, Ishikawa K, Tarui S. A novel technique for the determination of body fat by computed tomography. Int J Obes ; Ladeiras-Lopes R, Sampaio F, Bettencourt N, Fontes-Carvalho R, Ferreira N, Leite-Moreira A, et al. The ratio between visceral and subcutaneous abdominal fat assessed by computed tomography is an independent predictor of mortality and cardiac events. Rev Esp Cardiol Engl Ed ; Higuchi S, Kabeya Y, Kato K. Visceral-to-subcutaneous fat ratio is independently related to small and large cerebrovascular lesions even in healthy subjects. Atherosclerosis ; Kyrou I, Panagiotakos DB, Kouli GM, Georgousopoulou E, Chrysohoou C, Tsigos C, et al. Lipid accumulation product in relation to year cardiovascular disease incidence in Caucasian adults: the ATTICA study. Dai H, Wang W, Chen R, Chen Z, Lu Y, Yuan H. Lipid accumulation product is a powerful tool to predict non-alcoholic fatty liver disease in Chinese adults. Nutr Metab Lond ; Taverna MJ, Martínez-Larrad MT, Frechtel GD, Serrano-Ríos M. Lipid accumulation product: a powerful marker of metabolic syndrome in healthy population. Eur J Endocrinol ; Stein E, Kushner H, Gidding S, Falkner B. Plasma lipid concentrations in nondiabetic African American adults: associations with insulin resistance and the metabolic syndrome. Metabolism ; Karelis AD, Pasternyk SM, Messier L, St-Pierre DH, Lavoie JM, Garrel D, et al. Relationship between insulin sensitivity and the triglyceride-HDL-C ratio in overweight and obese postmenopausal women: a MONET study. Appl Physiol Nutr Metab ; McLaughlin T, Reaven G, Abbasi F, Lamendola C, Saad M, Waters D, et al. Is there a simple way to identify insulin-resistant individuals at increased risk of cardiovascular disease?. Am J Cardiol ; Gasevic D, Frohlich J, Mancini GB, Lear SA. The association between triglyceride to high-density-lipoprotein cholesterol ratio and insulin resistance in a multiethnic primary prevention cohort. Pinho CP, Diniz AD, Arruda IK, Leite AP, Petribu MM, Rodrigues IG. Waist circumference measurement sites and their association with visceral and subcutaneous fat and cardiometabolic abnormalities. Arch Endocrinol Metab ; Pouliot MC, Després JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, et al. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Rankinen T, Kim SY, Pérusse L, Després JP, Bouchard C. The prediction of abdominal visceral fat level from body composition and anthropometry: ROC analysis. Int J Obes Relat Metab Disord ; Philipsen A, Jørgensen ME, Vistisen D, Sandbaek A, Almdal TP, Christiansen JS, et al. Associations between ultrasound measures of abdominal fat distribution and indices of glucose metabolism in a population at high risk of type 2 diabetes: the ADDITION-PRO study. PLoS One ;e Jørgensen ME, Borch-Johnsen K, Stolk R, Bjerregaard P. Fat distribution and glucose intolerance among Greenland Inuit. Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation ; |
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