Dr. Manoj Vithlani,Sr. Consultant Internal Medicine,HCG Hospitals, Ahmedabad
In today’s sedentary lifestyle, weight gain due to desk-bound jobs has become common. But it is not just about how much weight you gain, but what matters is the place where the fats get stored. Visceral fat or the active fat, accumulates deep inside and a layer of soft, cushioning protection around several of your internal organs gets formed. It also has a role to play in how your body stores and utilizes the energy. The visceral fat accumulated around the stomach, and abdomen is often referred to as abdominal or central obesity. Though this fat is called active fats, an excessive amount becomes harmful.
Importance of waistline than your weight
Unlike subcutaneous fats that sits under the skin, this kind of accumulated fat is hidden and more harmful. When present in excess, it leads to central obesity, commonly seen as a protruding “pot belly” or “beer belly.” This pattern is known as an “apple-shaped” body, where fat gets collected around the waist, unlike the “pear-shaped” body and settles on the hips and thighs.
Therefore, abdominal obesity is typically measured using waist circumference rather than body weight alone. For Indians, a waist circumference of more than 90 cm (35-inches) in men and 80 cm (31-inches) in women is considered high risk. This is particularly concerning because many people with normal Body Mass Index (BMI) may still have excess belly fat, putting them at risk without realizing it.
Belly fat & it’s concerns
Abdominal fat surrounds vital organs such as the liver, pancreas and intestines. This visceral fat is metabolically active and releases inflammatory chemicals like cytokines and adipokines, free fatty acids and hormones that directly interfere with normal body functions. And, when these substances enter the bloodstream, they interfere with insulin actions rising chronic inflammation in blood pressure and cholesterol levels all of which are major contributors to heart disease.
Abdominal obesity, and specifically visceral adipose tissue, is associated with increased risk of disease-specific morbidity and mortality, with the primary abdominal obesity-mortality cause being cardio-vascular diseases (CVD). Excess abdominal fat increases “bad” low-density lipoprotein (LDL cholesterol) and triglycerides while lowering “good” high-density lipoprotein (HDL cholesterol). This imbalance accelerates the buildup of plaques in the arteries due to cholesterol deposition in the walls of the arteries, which is known as atherosclerosis. Over time, narrowed and stiffened arteries create hindrance in blood flow to the heart, increasing the risk of heart diseases like attacks and strokes.
Abdominal obesity affecting high blood pressure and diabetes
The inflammatory substances from visceral fat that are cytokines and adipokines affects the kidneys and blood vessels, leading to sodium retention and increased pressure within the arteries. Persistent high blood pressure forces the heart to work harder, gradually weakening it and increasing the risk of heart failure.
At the same time, belly fat plays a central role in the development of type 2 diabetes (T2DM). It impairs glucose metabolism, interferes with the action of insulin, causing blood sugar levels to rise. As we know, diabetes and heart disease often go hand in hand, people with both conditions face a significantly higher risk of cardiovascular complications compared to those without abdominal obesity.
Why Indians are at risk
Indians are particularly vulnerable to abdominal obesity due to genetic predisposition, lower muscle mass and higher tendency to store fat around the waist. Also, a sedentary lifestyle and diets high in refined carbs, sugar, and unhealthy fats, and urbanization makes Indians more vulnerable. Abdominal obesity can also cause knee pain and palpitations. Even normal people can have dangerous belly fat.
There is this term called “Thin outside, fat inside” (TOFI or skinny fat) means you have low muscle mass and high internal fat, which is specially caused due to poor diet, inactivity, high cortisol, and poor sleep, even if you look lean, there are certain risks for heart disease and diabetes. It happens because unused calories get stored as deep fat around organs.
Preventive measures
Well, abdominal obesity is reversible, and one of the measures is by controlling waist size. Regular physical activity is needed of the hour, along with planning a proper diet. Reducing intake of refined sugars, white rice, maida-based foods and processed snacks while increasing intake of whole grains, vegetables, fruits, legumes and healthy fats. Stick to mind-full eating and portion control. Adequate sleep and stress management should not be overlooked, as stress raises cortisol levels and promotes fat accumulation around the abdomen.
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