Battling the Belly Bulge: Visceral Fat, the Stealthy Culprit Behind Your Waistline

The waist circumference reflects your level of visceral fat, which is stored in organs such as the small intestine, large intestine, liver, heart, and kidneys. It is closely related to ectopic fat, which migrates from fat cells to non-typical fat storage sites like the liver and muscles. Ectopic fat has been identified as the primary cause of insulin resistance and metabolic diseases like hypertension, hyperlipidemia, and diabetes. While excess fat stored in fat cells alone does not cause diabetes, an excessive accumulation of ectopic fat disrupts insulin signals, leading to insulin resistance and eventually diabetes.

Visceral and ectopic fat are not externally visible. They can be accurately diagnosed using imaging methods like CT or MRI. Another approximate method is to look at the overall body fat percentage. It is suggested that approximately 10% of body fat is visceral fat [1], meaning higher body fat percentages generally indicate higher visceral fat levels, typically around 10%. Even if someone appears thin with little subcutaneous fat, they could still have a significant amount of visceral fat, which may mask underlying health issues.

Effective Waistline Management with Fewer Calories

Dietary changes have been proven effective in reducing visceral fat and waist circumference. In a human diet intervention study, the low-carbohydrate diet group had a greater reduction in waist circumference than the low-fat diet group during the initial 3 to 6 months. However, by the end of the 12-month trial, the difference in waist circumference reduction between the two groups became less significant. The low-carbohydrate group reduced their waist circumference by 6.7cm, while the low-fat group reduced theirs by 5.0cm [2].

In a 2018 controlled intervention study, participants achieved a reduction in waist circumference of 5.2cm – 6.8cm or 5.4% – 7.0% within 8 weeks by reducing daily calorie intake by approximately 22%-30% (about 500-1000 calories). The obese participants were divided into two groups: regular protein diet (12%-20% protein, 55%-60% carbohydrates, and 20%-30% fat) and high-protein diet (22%-30% protein, 50%-55% carbohydrates, and 20%-25% fat). Both groups significantly reduced their waist circumference, but there was no significant difference between them, suggesting that protein proportion does not play a major role in waist circumference reduction [3].

Mediterranean Diet: Reducing Inflammation and Waist Circumference

Olive oil in the Mediterranean diet effectively improves metabolic indicators and reduces waist circumference. In a double-blind clinical study, participants supplementing with 20g of olive oil for 12 weeks experienced lower blood pressure and reduced waist circumference [4]. Another study with 23 obese participants, consuming 32g of special ultra-pure olive oil rich in “oleocanthal,” reduced waist circumference by 3cm after 2 months [5]. This emphasizes the role of high-quality olive oil with polyphenolic compounds in influencing inflammation and waist circumference.

Nuts, along with olive oil, are emphasized in the Mediterranean diet and can reduce waist circumference. In a study with 7,447 participants, those following the Mediterranean diet with added olive oil showed a 0.46cm reduction, and those with added nuts showed a 0.92cm reduction in waist circumference compared to the control group with reduced fat intake. The study indicates that the Mediterranean diet, without calorie restriction, can help lower waist circumference and prevent obesity [6].

Snack Smart: A Path to Reduced Waistline

Reducing unhealthy snacks can decrease waist circumference. In a 2017 study with 1,430 adolescents aged 12 to 14, reducing snacks led to a 1.68cm reduction in waist circumference compared to the control group after 17 months. However, in the second phase after 11 months, the reduction decreased to 0.84cm, possibly due to inconsistent support from parents and schools [7].

References:

[1] https://www.health.harvard.edu/diabetes/why-is-visceral-fat-a-problem

[2] Bazzano, L. A. et al. (2014). Effects of low-carbohydrate and low-fat diets: a randomized trial. Annals of internal medicine, 161(5), 309–318. https://doi.org/10.7326/M14-0180

[3] Witjaksono, F. et al. (2018). Comparison of low calorie high protein and low calorie standard protein diet on waist circumference of adults with visceral obesity and weight cycling. BMC research notes, 11(1), 674. https://doi.org/10.1186/s13104-018-3781-z

[4] Rezaei, S. et al. (2019). Olive oil lessened fatty liver severity independent of cardiometabolic correction in patients with non-alcoholic fatty liver disease: A randomized clinical trial. Nutrition (Burbank, Los Angeles County, Calif.), 57, 154–161. https://doi.org/10.1016/j.nut.2

[5] Patti, A. M. et al.. (2020). Daily Use of Extra Virgin Olive Oil with High Oleocanthal Concentration Reduced Body Weight, Waist Circumference, Alanine Transaminase, Inflammatory Cytokines and Hepatic Steatosis in Subjects with the Metabolic Syndrome: A 2-Month Intervention Study. Metabolites, 10(10), 392. https://doi.org/10.3390/metabo10100392

[6] Estruch, R. et al. (2019). Effect of a high-fat Mediterranean diet on bodyweight and waist circumference: a prespecified secondary outcomes analysis of the PREDIMED randomised controlled trial. The lancet. Diabetes & endocrinology, 7(5), e6–e17. https://doi.org/10.1016/S2213-8587(19)30074-9

[7] Ochoa-Avilés, A. et al. (2017). A school-based intervention improved dietary intake outcomes and reduced waist circumference in adolescents: a cluster randomized controlled trial. Nutrition journal, 16(1), 79. https://doi.org/10.1186/s12937-