The Hidden Dangers of Abdominal Fat—and How to Get Rid of It

Prepare yourself for a fascinating exploration into the depths of body fat and its varying health implications. We promise you'll walk away with a new comprehension of fat distribution and how it can impact your life. Not all fat is equal; differences abound between abdominal visceral, ectopic, and subcutaneous fat. We navigate these variations and their unique health implications, shedding light on why abdominal visceral fat can be particularly harmful.

What if you could reduce abdominal visceral fat and ectopic fat stores with simple dietary adjustments? And what if these changes could minimize your need for conventional health care? This episode is a treasure trove of vital information around this subject. We delve into the tragic health implications of weight and muscle loss due to calorie reduction and discuss the best ways to maintain a healthier balance. In a deep dive into ectopic fat, we examine how its accumulation in organs can cause severe health complications.

Brace yourself for a groundbreaking revelation: the key to controlling your health and appearance lies in the right combination of diet, nutrients, and supplements. We passionately share how a strategic blend of these can help you reduce abdominal visceral fat, subcutaneous fat, and increase lean muscle mass. Join us in our movement of self-empowerment and health to minimize your need for conventional health care. Get ready to revolutionize your understanding of body fat and its profound implications on your health.


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*Dr. Davis and his staff are financially compensated for promoting BiotiQuest and Paleovalley products.

Transcript

William Davis, MD: 0:06

It's a simple fact. Not all body fat is the same, that is, there are differences in the kinds of fat you have in your body. Of course, fat can be a good thing, as it is a form of energy storage that your body can access during periods of food deprivation or extended physical exertion. The problem in the modern world, of course, is that most of us have now developed excess fat. The most problematic forms of fat in the human body are abdominal, visceral fat, that is, fat that encircles the abdominal organs that you cannot see from the outside, and, more recently, ectopic fat Fat that involves organs such as the heart, knees, pancreas, with unique health implications beyond that of abdominal visceral fat. This is in contrast to so-called subcutaneous fat or the fat found in the buttocks, thighs, calves, arms, etc. That it has little health implications beyond stress on weight-bearing joints and, of course, aesthetics. So in this episode of Defiant Health, let's focus on abdominal, visceral and ectopic fat, then talk about what you can do to erase the excess health problems associated with these forms of fat. Later in the podcast, let's talk about Defiant Health's sponsors that include Paleo Valley, who provides fermented grass-fed beef sticks, bone broth, protein rich in collagen, organic supergreens and low-carb superfood bars and now 100% grass-fed and finished pastured meats. And Biotiquest, who provides unique probiotics such as sugar shift to support healthy blood sugars and simple slumber to assist in obtaining healthy sleep probiotics crafted with the unique property of combining synergistic microbes. It's no news to anyone, but being overweight, increased weight, has become a major problem both in the US as well as worldwide, but it's also taught us some new lessons about being overweight. You've likely noticed that different people gain weight in different ways. This has led to such labels as the apple shape or pear shape apple being weight that is gained in the abdomen. Pear shape weight being gained in the buttocks and thighs. That is, lower body. Also, labels like Android, once again the abdominal fat type of pattern and Gynoid fat in the buttocks and thighs. This suggests that men tend to develop this Android type of fat, while women tend to develop this Gynoid. That's a generalization. That's not always true, but it can sometimes be true, the point being different people gain weight in different ways, storing fat in different body parts.

William Davis, MD: 2:50

It's also become clear that fat in certain locations is far more important for health than fat in other locations, specifically, fat in the abdomen, that is, fat that surrounds the abdominal organs such as the intestines, liver and pancreas, has greater health implications than fat that's in the so-called subcutaneous area, that is, the fat just below the skin surface, so-called subcutaneous fat, that's the fat you tend to accumulate in your buttocks, thighs, calves, arms and chest. That has far less health implications. Yes, it's not an aesthetically appealing location, perhaps, and it does add to stress on weight bearing joints, but it doesn't have the same metabolic complications that abdominal visceral fat has. Because abdominal visceral fat is unique, it's different. It is inflamed itself. That is, if you looked at abdominal visceral fat, you would see it is itself inflamed. It's filled with white blood cells reflecting inflammation. Abdominal visceral fat also is a factory, a producer of inflammatory cytokines or inflammatory mediators that enter the bloodstream, such as various interleukins and tumor necrosis factor alpha. These are inflammatory mediators that export inflammation from the abdominal visceral fat to other parts of the body, and it has numerous implications for increased risk for heart disease, dementia and cognitive impairment, breast cancer, hypertension, type 2 diabetes and numerous other conditions.

William Davis, MD: 4:18

Abdominal visceral fat is also the source for insulin resistance, that is, your body's inability to respond to insulin. So muscle, brain, liver don't properly respond to insulin, so your pancreas compensates by producing massive amounts of insulin 10 times more, 30 times more, 100 times more insulin. That degree of insulin resistance causes weight gain. So it's a vicious cycle. Abdominal visceral fat leads to insulin resistance. Insulin resistance causes an expansion of abdominal visceral fat and the increase in insulin. Insulin resistance also leads to all those health conditions, increased risk for all those health conditions like heart disease, dementia and breast cancer.

William Davis, MD: 5:01

For many years the prevailing way to assess someone's weight was to use body mass indexer, or BMI, that is, body surface area divided by weight, and semi-arbitrary cutoffs were established, such as 25, a BMI of 25, or lower being normal, 25 to 30, being overweight, above 30, obese, above 40, super obese. The problem with BMI is that it assumes that fat is distributed uniformly throughout the body, which of course is not true. So BMI is kind of falling away as the leading way to assess the implications of being overweight. Various other measures have emerged, such as waist hip ratio or a simple waist circumference, but the same problem applies here these measures cannot distinguish subcutaneous from visceral fat. So if you were to measure your waistline, for instance, you can't tell if your waistline is large. You can't tell that fat is in the subcutaneous compartment that is below the skin or whether it's in the abdominal cavity surrounding abdominal organs, thereby causing body-wide inflammation and insulin resistance. You just can't tell the difference. So some of the more important insights into fat distribution subcutaneous versus subdominal visceral has come from cross-sectional CAT scans, ct scans and MRI, typically performed at the fourth or fifth lumbar vertebra level, and then the area of visceral fat can be calculated. And the area of subcutaneous can be calculated, because those appear very distinctly in different locations, by cross-sectional CT or MRI. And these measurements have made it crystal clear that the source of health problems is not subcutaneous fat but abdominal visceral fat. By the way, improvements have been made in so-called bioimpedance devices. These are scales that measure your weight and then break down fat weight, muscle weight, and some devices have added a visceral fat calculation. Unfortunately we're still waiting for validation of those measures. It's not quite clear how accurate they are, but know that some devices are able to add a visceral fat calculation.

William Davis, MD: 7:06

Another recent development that has appeared on the scene because of the increasing weight gain by Americans is the idea of ectopic fat, that is, the body essentially runs out of places to store fat and so it starts to deposit excess fat into various organs that include the heart, so-called epichartial fat, the pancreas, kidney, liver and even joints, and in each of these instances that fat deposited in those specific organs carries additional health implications beyond that of just abdominal visceral fat. For instance, epichartial fat is fat that occurs on the surface of the heart, that can be seen on an echocardiogram as well as CT and MRI, and that fat inflames the coronary arteries and that increases risk for heart attack even more so than just abdominal visceral fat. That epichartial fat also impairs the heart muscle, the left ventricle. It can weaken and cause changes in the heart muscle and can lead to something called cardiomyopathy that is, impaired heart muscle performance, which is a very serious issue. So that's epichartial fat, pancreatic fat, that is, fat and pancreas damages the beta cells that produce insulin. It can lead a type 2 diabetic to becoming a type 1 diabetic. Fat in the kidney impairs kidney function and can lead to kidney disease. Fat in the liver of course leads to cirrhosis over time, which is a very serious condition. Fat in joints, especially the knee, can cause knee pain that mimics arthritis and also accelerates arthritis, because that fat in the knee space amplifies inflammation that damages joint cartilage and accelerates the development of arthritis. Ectopic fat can also accumulate in muscle, where it impairs strength and contraction and can accelerate the path to such things as frailty, weakness, falls and fractures and loss of independence. To understand all these issues, it helps to remind yourself that fat consists of triglycerides, that is, the fat in fat cells are triglycerides.

William Davis, MD: 9:06

But don't think that eating fat will raise triglycerides. It does so only transiently and only to a modest degree. The real source of triglycerides, that is, triglycerides that are in the bloodstream and then stored in fat cells, is the liver. The human liver has an enormous capacity for producing triglycerides, and it does so from carbohydrates, carbohydrates and sugars. So whenever you eat grains, wheat and grains that contain the amylopectin A carbohydrate, or you consume sugars, whether it's sucrose, glucose or fructose, the liver is very good at converting those carbohydrates and sugars to triglycerides.

William Davis, MD: 9:43

Now, triglycerides cannot float freely in the bloodstream because the blood is an aqueous or water-based environment, and fats like triglycerides cannot float freely because they would coalesce and occlude arteries and cause damage. And so the only way that triglycerides can float in the bloodstream is if they're attached to a water-soluble protein or a collection of proteins. That's why triglycerides occur in the bloodstream as lipoproteins, fat-carrying proteins, but specifically very low-density lipoproteins, or VLDL, recall that fat is very low density and that's why oil floats on top of water in your salad dressing, and so when triglycerides are in the bloodstream, they occur as the very low density lipoproteins. Vldl particles then deliver these triglycerides to fat cells as well as, by the way, causing coronary disease. Vldl particles are a direct cause for coronary disease, but VLDL delivers triglycerides to your fat cells. Fat cells also deliver triglycerides into VLDL particles and other lipoproteins, and so the triglyceride level in your bloodstream is a very handy index of how much visceral fat you have.

William Davis, MD: 10:54

The higher your triglycerides, the more it reflects an increase in visceral fat stores as well as ectopic fat stores. For this reason, some researchers have suggested that we label people with larger waistlines hypertriglyceridemic waist, and some people have identified an increase in waist circumference of 33 inches or more in females, 35 inches or more in males. That corresponds to fasting triglycerides of 133 milligrams per deciliter in females, 177 in males. I think this is wrong. I think this dramatically underestimates visceral fat and it's implications. So I would not use those cutoffs because, for instance, if you had a waist of 32 inches as a female and a fasting triglyceride level of 120, both below those cutoffs, you can still have tons of abdominal visceral fat inflammation, insulin resistance. So I think those kinds of measures are just too lax. They underestimate the severity of abdominal fat and implications.

William Davis, MD: 11:54

As you can see, it's not an easy thing to really know how much abdominal visceral fat you have If you use a bioimpedance device. Maybe it's accurate, maybe it's not. We need better validation. No one's going to get cross-sectional CT or MRI and most of the places that do these tests do not have the software to make these calculations. So we're kind of left into dark with crude measures such as waist circumference and BMI, but we don't have cutoffs to tell us exactly where you're safe.

William Davis, MD: 12:22

I can tell you, however, that if we subscribe to this idea that fasting triglyceride blood levels are an easy and accessible index of visceral fat, I would aim for a fasting triglyceride level of 60 milligrams per deciliter or less, because that's the level at which virtually all the phenomena of those who have abdominal visceral fat are minimized or completely gone, and you'll see this reflected in addition to the low triglyceride level. You'll see this as excellent. Fasting glucose of no more than 90 milligrams per deciliter. Low fasting insulin of no more than four micro units per liter. Higher HDL typically above 60 milligrams per deciliter, minimization of small allele particles, lower blood pressure, lower C-reactive protein and other measures. In other words, use that triglyceride level fasting triglyceride level as your index. That's the best way to track the implications of excess abdominal visceral fat. Now, maybe in future those bio-impedance devices become validated against cross-sectional CT and MRI. Maybe we can use the visceral fat calculation as a handy index. But until then, the best measure of whether you have too much abdominal visceral fat and thereby implications for your health is to look at your fasting triglyceride level.

William Davis, MD: 13:38

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William Davis, MD: 15:09

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William Davis, MD: 16:34

So we've established that the source of most of the problems in people who are overweight or obese is abdominal visceral fat and ectopic fat. Not so much subcutaneous fat, but something that occurs in parallel is loss of muscle, insulin resistance and inflammation that arises principally from abdominal visceral fat also degrades muscle and reduces strength. It's also not uncommon to have muscle actually infiltrated by fat, so-called myosteatosis. People are often told, in order to reduce fat, to cut their calories, move more, eat less or take a pharmacologic agent to lose weight, like the GLP-1 agonist, such as Wegovy or Ozempic, or even undergo a bariatric procedure, such as LAPBand or other means of reducing stomach volume, such as gastric bypass. These are all variations on the same theme. They're all reductions in calories and we know with good evidence. We know with confidence that any method of weight loss or fat loss that involves reducing calories leads to muscle loss, inevitable muscle loss.

William Davis, MD: 17:43

About 25 to 30% of all weight lost is muscle. So if you lost 30 pounds, say, maybe you paid $15,000 for one of those drugs over a year's time and lose 30 pounds. Of those 30 pounds, about 10 pounds is muscle and muscle is the principal determinant of your basal metabolic rate, or BMR. That's the rate of calorie burn. You have just to maintain the work of living, to breathe, to digest foods, to walk about, to sleep, all the things that require some amount of energy. That contributes to your basal metabolic rate. Where your basal metabolic rate drops 15, 20, 25% when you lose weight by reducing calories, regardless of the method used to reduce calories, that means, let's say, you stop the drug after a year because most people can't afford the 12 to $1,500 per month for that drug. They stop the drug and they regain 24 to 27 pounds.

William Davis, MD: 18:42

Most of it is fat, much of it in the abdomen, and you are more insulin resistant, more inflamed, have higher blood sugars, have greater insulin resistance. You are higher at risk for heart disease, dementia, cognitive impairment, breast cancer, type 2 diabetes, hypertension and other conditions driven by both insulin resistance and inflammation. You're worse off at the end than you were at the beginning and your abdominal visceral fat and perhaps ecopic fat have expanded despite what you went through. So you can see that cutting calories, regardless of the method, is an awful way to try to gain control over this whole process. What's a better way? Well, those of you who've been following these conversations know that my programs are meant are designed to reduce abdominal visceral fat. Don't worry about the subcutaneous fat, that will follow, but it's the abdominal visceral fat that drives insulin resistance and inflammation that when addressed first. You reduce abdominal visceral fat and ectopic fat stores and the subcutaneous fat will follow. So focus on getting rid of the abdominal visceral fat.

William Davis, MD: 19:52

We do that by avoiding the foods, eliminating the foods that raise blood sugar and insulin, because when you raise blood sugar and insulin, it causes insulin resistance. So the worst foods for raising blood sugar and insulin wheat, grains and sugar. We take them out. Now, a corollary to this is we also reject the idea of producing fat intake. We take all the fat you want half bacon, add butter to your foods, use coconut milk, use all the extra virgin olive oil you want, buy fatty cuts of meat, eat the fat and, if you're so inclined, buy organ meats.

William Davis, MD: 20:26

The dietary changes alone are huge. We tend to gravitate towards unprocessed foods rather than processed foods. Processed foods just have too many landmines of additives like food preservatives, colorings and synthetic sweeteners that also impact on weight and disrupt your microbiome, and so we go for unprocessed foods, foods in their natural state, such as an avocado, an egg, a steak, a piece of salmon, spinach, but not box dried, prepared, microwavable foods. We also restore nutrients that are lacking in modern life, that, when restored, they synergize to further reduce insulin resistance and inflammation. Very simply, vitamin D, magnesium, omega-3 fatty acids that can only come from fish oil, not from any other source, and iodine to address your thyroid status.

William Davis, MD: 21:18

Lastly, we take basic steps to bring back order into your disrupted microbiome, gastrointestinal microbiome. Fortunately, everybody has had massive disruptions of their gastrointestinal microbiome due to such factors as repeated exposure to antibiotics, glyphosate, the herbicide that is also an antibiotic, preservatives, emulsifying agents in ice cream, salad dressing, other common foods, stomach acid blocking drugs, non-steroidal anti-inflammatory drugs, other drugs. In other words, many factors have disrupted the gastrointestinal microbiome and part of the effect is weight gain because a disrupted microbiome leads to insulin resistance. So we take basic steps to restore a healthier microbiome. We avoid all those things that disrupted it. Like we minimize our exposure to antibiotics. We avoid foods that have pesticides and herbicides and choose organic instead. Filter our drinking water, avoid processed foods with all those additives.

William Davis, MD: 22:14

We also add back fermented foods so easy and so delicious and so much better for you, in that fermentation of, say, vegetables, mobilizes many of the nutrients and make them more bioavailable to you, including vitamin C and phytonutrients. So we ferment tomatoes and cucumbers, we could call it sauerkraut, we could call it kimchi, kefiers, yogurts or just veggies. You ferment on your kitchen counter, so easy to do. If you don't know what I'm talking about, see my other podcast, see my DR Davis Infinite Health dot com blog, or see the many recipes I've posted in the inner circle within the DR Davis Infinite Health dot com website. Or, of course, see my super gut book that has lots of recipes on fermenting foods. Or see my friend Donna Schwanks website, cultured Food for Life, and she's got tons of fermented food recipes.

William Davis, MD: 23:08

Fermented foods are important because the microbes that ferment food don't actually take up residence in the GI tract. They support the proliferation of truly healthy species, species like acrimacia and fecalobacterium. So you eat fermented foods rich in fermenting species like pediacoccus and leuconostoc. They don't take up residence. They feed and encourage healthy microbes like those ones I mentioned acrimacia, fecalobacterium and plenty of others. We also ferment specific keystone microbes like lactobacillus reuteri and lactobacillus gasseri and others, and we can also choose those microbes to achieve specific effects. If you want smoother skin and better sleep, let's ferment lactobacillus reuteri. If you want to have a healthier child at birth, let's ferment bifidobacteria infantis. The child has less bowel movements, less diaper change from mom and dad, more likely to sleep through the night and has better neurological maturation and a higher IQ. If you want to have better immunity, let's ferment lactobacillus casei. If you don't know what I'm talking about, once again refer to those resources, especially the SuperGut book, my DrDavisInfiniteHealth. com inner circle, for the recipes and how to restore those keystone microbes.

William Davis, MD: 24:23

Many people think that taking a commercial probiotic alone is all you need to do. That's not true. Commercial probiotics can be helpful, especially if one has collection microbes that are synergistic, such as the BioDiquest Sugar Shift product a full disclosure. They're sponsor of this podcast but I also do believe in their products because they were crafted by a microbiologist who paid attention to metabolites shared by various microbes in a synergistic fashion. So that's a good choice, but you need to do more than that. Now in my programs we go even farther. So just the basic programs, that is, the diet, the nutrients that synergize to minimize insulin resistance and inflammation and your efforts to recultivate a healthy GI microbiome. Those alone are very powerful, but we can go even further.

William Davis, MD: 25:11

We restore factors largely lost from modern diets. So because we were told, wrongly, that we need to avoid fat and saturated fat to reduce cardiovascular risk which is complete, utter nonsense there never was any evidence to that effect. There was very poor studies conducted in the 1950s and 1960s before clinical trial design was understood, and there since have been other trials that show that limiting saturated fat and total fat does not reduce cardiovascular risk. In fact, it disrupts things. It causes a rise in triglycerides, it causes a rise in donovus or fat hypertension, c-reactive protein, all the things you're seeing that people around you.

William Davis, MD: 25:49

This is largely a product of misguided dietary guidelines, dietary advice. So we're going to do the opposite. We don't limit fat, we eat no wheat, grains or sugars, we avoid processed foods and we add back factors lacking because the mistaken notion of cutting fat in the diet, two of the most important collagen and hyaluronic acid. Now, if you were to go back to old ways and when you killed an animal and ate its brain, tongue, heart, liver, kidneys, stomach, intestines, skin, etc. You would get tons of collagen and hyaluronic acid, and both collagen and hyaluronic acid add to the loss of abdominal visceral fat and the increase in muscle.

William Davis, MD: 26:34

Now put all this together the diet nutrients, the efforts at correcting your microbiome restoration, especially lactobacillus rotari and lactobacillus gasari.

William Davis, MD: 26:45

Combined with these missing nutrients, collagen, peptides and hyaluronic acid, the combination is extremely powerful for losing abdominal visceral fat, followed of course, by subcutaneous fat, and for increase, restoration or increase of lean muscle mass. What this does is puts you in control over the way you look, the way you feel, how young you look and feel. In other words, it doesn't leave you unhealthy and helpless like conventional efforts do, such as pharmaceuticals and bariatric procedures or simply cutting calories in your diet. Now, if you want to know the details on how to do all this with dose of college, and what form is best, what form of hyaluronic acid, details of the diet, these are in all my books, of course, from the wheat belly books, especially the revised expanded edition, also in the Super Gut book, as well as my drdavisinfinitehealthcom website, especially the Inner Circle, which isa membership website, where we have two-way discussions, typically once a week for a couple of hours.

William Davis, MD: 27:47

There's also this podcast, of course, and my blog that has several thousand posts on it, several thousand articles. I have drdavisinfinitehealthcom blog. Now, if you learned something from this episode of the Defiant Health podcast, I invite you to tell your friends. Post your review, join the movement of self-empowerment and health to minimize your need for the exploitative products and services of conventional health care. Thanks for listening.