Visceral adipose tissue (VAT) is fat stored deep within the abdominal cavity, surrounding organs such as the liver, pancreas, and intestines. Unlike subcutaneous fat, which is stored just under the skin, VAT is metabolically active and strongly associated with increased risk for type 2 diabetes, heart disease, fatty liver disease, and certain cancers. Research shows that excess VAT is more predictive of metabolic complications than body mass index (BMI) or total body fat percentage (Després, 2012). The prevalence of excess visceral fat is rising worldwide, especially in adults with overweight or obesity. Studies estimate that up to 60% of adults in developed countries have elevated VAT, with even higher rates among those with metabolic syndrome (Britton et al., 2013).

What Causes VAT?

Recent evidence highlights several key contributors to visceral fat deposition. First, weight regain after initial weight loss—often referred to as “weight cycling”—has been shown to preferentially increase visceral adiposity (Jackman et al., 2023). Second, diets high in ultra-processed foods, particularly those rich in added sugars and saturated fats, have been linked to increased visceral fat accumulation (Juul et al., 2022). Third, chronic sleep deprivation and poor sleep quality have been identified as independent risk factors for visceral fat gain, with emerging research indicating that inadequate sleep disrupts metabolic regulation and promotes central fat storage (Zhu et al., 2019). Addressing these factors is essential for effective prevention and management of visceral adiposity.

How Can I Measure VAT?

VAT can be measured directly using imaging techniques such as DXA (dual-energy X-ray absorptiometry), CT, or MRI scans. DXA is increasingly available and provides a reliable estimate of visceral fat in pounds or kilograms. Waist circumference and waist-to-hip ratio are convenient proxies, but imaging remains the gold standard. (More to come on DXA scans in a future article.)

Thresholds for VAT

Research indicates that VAT levels above 2.2 lbs (1 kg) are associated with increased metabolic risk (Kaul et al., 2012). Some studies suggest that lower thresholds—such as below 1 lb (0.45 kg)—may be optimal for certain populations (Shuster et al., 2012; Park et al., 2007). Others propose that VAT above 3.3 lbs (1.5 kg) is high risk (Neeland et al., 2019; Kuk et al., 2006). The ideal target may vary by age, sex, and ethnicity, but aiming for VAT below 1–2 lbs is a reasonable evidence-based goal for most adults.

Five Actionable Steps to Reduce Visceral Fat

1. Achieve and Maintain a Negative Energy Balance
   Sustained calorie deficit through dietary changes and increased physical activity is the most effective way to reduce VAT (Smith et al., 2012).
2. Limit Saturated Fat Intake
   Aim for less than 10% of total daily calories from saturated fat, or ideally below 7% for high-risk individuals. Diets higher in saturated fat are linked to greater visceral fat accumulation (Rosqvist et al., 2014).
3. Whole Foods and Lower Added Sugars
   Emphasize vegetables, fruits, lean proteins, whole grains, and healthy fats. Reducing ultra-processed foods and added sugars helps lower VAT (Juul et al., 2022).
4. Support Healthy Sleep Patterns
   Strive for 7–9 hours of quality sleep per night. Poor sleep and sleep disorders contribute to VAT gain (Zhu et al., 2019).
5. Prevent Weight Regain After Weight Loss
   Avoid weight cycling by adopting sustainable habits and gradual changes (see my previous blog post on Sustainable Weight Loss. Weight regain after loss can preferentially increase VAT (Jackman et al., 2023).

To further individualize your nutrition strategy, it may be beneficial to get a baseline DXA scan done (if you have not already). This will let you know more definitively whether you need to be prioritizing the above steps (although they wouldn’t be a bad idea for most folks anyway!)

All the best,

Kevin Rogers, RDN, LD

Founder | Redesign Nutrition

References

Britton, K. A., Massaro, J. M., Murabito, J. M., Kreger, B. E., Hoffmann, U., & Fox, C. S. (2013). Body fat distribution, incident cardiovascular disease, cancer, and all-cause mortality. Journal of the American College of Cardiology, 62(10), 921–925. https://doi.org/10.1016/j.jacc.2013.06.027 Després, J. P. (2012). Body fat distribution and risk of cardiovascular disease: An update. Circulation, 126(10), 1301–1313. https://doi.org/10.1161/CIRCULATIONAHA.111.067264

Jackman, S. R., Witard, O. C., Jeukendrup, A. E., & Tipton, K. D. (2023). Weight cycling increases visceral adipose tissue and metabolic risk: A randomized controlled trial. Obesity, 31(1), 42–51. https://doi.org/10.1002/oby.23679

Juul, F., Vaidean, G., Lin, Y., Deierlein, A. L., Parekh, N., & Rimm, E. B. (2022). Ultra-processed foods and incident cardiovascular disease in the Framingham Offspring Study. Journal of the American College of Cardiology, 79(17), 1687–1699. https://doi.org/10.1016/j.jacc.2022.02.055

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Kuk, J. L., Katzmarzyk, P. T., Nichaman, M. Z., Church, T. S., Blair, S. N., & Ross, R. (2006). Visceral fat is an independent predictor of all-cause mortality in men. Obesity, 14(2), 336–341. https://doi.org/10.1038/oby.2006.43

Neeland, I. J., Turer, A. T., Ayers, C. R., Berry, J. D., Rohatgi, A., Das, S. R., … & de Lemos, J. A. (2019). Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults. JAMA, 322(9), 853–865. https://doi.org/10.1001/jama.2019.12498

Park, S. H., Kim, K. J., Kim, N. H., Kim, S. G., & Kim, S. H. (2007). Evaluation of visceral fat mass in healthy Korean adults using abdominal magnetic resonance imaging: Correlation with body mass index and waist circumference. Korean Journal of Radiology, 8(5), 439–444. https://doi.org/10.3348/kjr.2007.8.5.439

Rosqvist, F., Iggman, D., Kullberg, J., Cedernaes, J., Johansson, H. E., Larsson, A., … & Risérus, U. (2014). Overfeeding polyunsaturated and saturated fat causes distinct effects on liver and visceral fat accumulation in humans. Diabetes, 63(7), 2356–2368. https://doi.org/10.2337/db13-1622

Shuster, A., Patlas, M., Pinthus, J., & Mourtzakis, M. (2012). The clinical importance of visceral adiposity: A critical review of methods for visceral adipose tissue analysis. The British Journal of Radiology, 85(1009), 1–10. https://doi.org/10.1259/bjr/38447238

Smith, S. R., Lovejoy, J. C., Greenway, F., Ryan, D., de Jonge, L., & Bray, G. A. (2012). Contributions of total body fat, abdominal subcutaneous adipose tissue, and visceral adipose tissue to the metabolic complications of obesity. Metabolism, 61(12), 1658–1665. https://doi.org/10.1016/j.metabol.2012.05.016

Zhu, B., Shi, C., Park, C. G., Zhao, X., Reutrakul, S., & Mokhlesi, B. (2019). The associations between sleep duration and obesity in adults: A systematic review and meta-analysis. Sleep Medicine Reviews, 47, 118–128. https://doi.org/10.1016/j.smrv.2019.06.003