Central abdominal obesity.

Metabolic syndrome.

Why the visceral fat is important.

A few weeks i finally got to meet up with a friend who is a qualified personal trainer and sports nutritionist and who has the basic equipment that can calculate , reasonably well, the percentages of lean mass overall fat and visceral fat that i’m at right now.  I say ‘reasonably’ accurate because the only truly accurate ways of measuring those things involve very high-tech scanners that have a much more important medical use than merely giving me an estimate of how ‘fat’ i am.    I’m not doing too badly now with my overall ‘fatness’ visibly being a lot less than when i started out but i’m still above an ideal/acceptable level of visceral fat and i definitely need to keep working away at that : today, as i write i’m into day 2 of my now routine practice of a 2 day fast, once a week and definitely in ketosis so i should be metabolising some of that fat right now !

Central abdominal obesity. (CAO). 

We can reasonably define CAO in men from a simple measurement of waist circumference a and calculation of waist to hip ratio : in an ‘average’ adult man a waist circumference of over 94cm (80 cm in women) and/or a waist-hip ratio of greater than 0.9 are both positive indicators of central abdominal obesity which in turn is strongly associated with high levels of visceral (between organ) fat and usually strongly predictors of metabolic disease such as Type 2 Diabetes, hypertension, heart disease, stroke and cancer.    One small caveat here is that the numbers and percentages do differ between people and notably that lower ‘numbers’ of measured obesity in asian men for example correlate with higher incidence of disease : the numbers i have quoted refer to European males.

Man with large beer gut holding pint glass full of beer
Man with large beer gut holding pint glass full of beer (Photo by Universal Images Group via Getty Images)

Metabolic syndrome.

We can define metabolic syndrome as a cluster of other measurements : abdominal obesity, hypertension, high blood sugar, high triglycerides and high LDL, some physicians define metabolic syndrome as when any 3 of those measurements occur in one case.   In my example i had abdominal obesity and high blood pressure, i have no idea what my blood sugar or HbA1C was or what my lipid profile was before i started my own LCHF diet so i can’t claim to have been already in metabolic syndrome although i did have other related signs that are suggestive of the pro-inflammatory state that goes with metabolic syndrome.

Visceral fat.

In 2020 we have both a very visibly obese population and an extreme national anxiety about the Covid 19 virus pandemic, the 2 being strongly related.  Once again we have a government that to some extent is taking an interest in obesity and public health again but that interest just doesn’t seem to be filtering down to the public : rather that the public, fueled by the media and social media are in a great state of agitation about masks and vaccines !.    For the main part of this piece i want to explore why central abdominal obesity (CAO) and it’s associated high levels of visceral fat are strongly implicated in diseases….all the way from ‘simple’ diseases such as hypertension and T2DM right up to many forms of cancer and even dementia.

How and why.

How and why the visceral fat gets there and why it’s so important (to get rid of).    Ok, so this is the clinical science-y part.

The most likely mechanism here is this : with a hyper-abundance of energy dense and carbohydrate rich foodstuffs , coupled with some 50 % of the human population having some degree of insulin resistance the body’s physiological responses are high blood sugar matched by high circulating insulin.   The excess carbohydrates are converted to fat (triglcerides)and, under the action of insulin transported across fat-cell membranes and stored there ; notably in and around the soft organs….so this can include fat actually in the liver (NAFLD) and the classic ‘fat apple’ shape of CAO.

While blood sugar and insulin levels remain elevated it is impossible for the body to metabolise the stored fat as this can only happen in a low/normal insulin state.

Visceral fat is then a multiple problem….the key point here is that it is not now just an inert store of fat and available fuel but highly active in metabolic terms : the problem with the active visceral fat is what it is directly secreting which include the pro-inflammatory factors ( cytokines) pro-coagulation factors , pro cancer factors and hormones and a tumour necrosis factor (TNF) which is strongly associated with many diseases.    All of these factors in combination are the direct chemical/hormonal drive that creates or accelerates nearly all of the diseases we now have in the developed world : from Type2 DM, through fatty-liver (NAFLD) heart disease and stroke, hypertension, arthritis, inflammatory bowel disease, cancer and dementia.

Practical stuff and experience.

My own measurement came out as 11% visceral fat and the best reasonable recommendation that a safe/normal level should be below 10 % so i still have some work to do.  Most sites that look at the causes and effects of visceral fat also say that reducing insulin is the key to starting to metabolise that fat….that can be enhanced and increased by fasting and using a combination of both slow/aerobic, and short period/high intensity exercise.    In my own case, doing what i have done so far seems to have completely reversed my hypertension and my arthritic pain , on top of that and although highly subjective i seem to have more energy to do physical work and better focus in my writing and blogging work.



  1. congratulations. My wife and I have been on keto for nearly two years. Well done on your quest for better health

    “There is magic in the feel of a paddle and the movement of a canoe, a magic compounded of distance, adventure, solitude, and peace.” -Sigurd Olson


    1. Thankyou, i’m wondering now how to use my new knowledge and experience to help other people in the same way….the blog is one method obviously but only seems to reach people already looking at the problem.


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