Reduce and track abdominal visceral fat for improved health

Abdominal visceral fat, i.e., fat within the abdominal cavity that surrounds abdominal organs, is unique and the source of so many common health problems. While people who are overweight with a protuberant abdomen almost always have an excess of abdomen visceral fat, it can also occur with a flat abdomen. 

You can reduce and track the amount of abdominal visceral fat with home bioimpedance devices. Here are some unconventional but effective ways to reduce/minimize this form of fat while also tracking your results. 

Chapters

• 0:00 Why Visceral Fat Is Dangerous
• 2:46 Ectopic Fat In Organs And Joints
• 6:30 Muscle Loss And Myosteatosis
• 9:20 Measuring Visceral Fat At Home
• 14:10 Insulin Resistance Vicious Cycle

Transcript

William Davis, MD: 0:00

You've likely heard that the various locations that your body can store fat in, the most problematic, the most dangerous form is the fat that accumulates in the abdomen, inside the abdominal cavity, that is, fat that surrounds abdominal organs like intestines, pancreas, liver, etc. Because that fat is inflamed, itself is inflamed, and also exports inflammation to other parts of the body. If you were to biopsy that abdominal visceral fat, you'd see it's filled with white blood cells, with inflammatory white blood cells. It itself is inflamed. And it also sends inflammatory mediators to other parts of the body, which drives all kinds of diseases like coronary disease, dementia, breast cancer, and other forms of cancer, hypertension, and other conditions. So it's very bad to have an excess of abdominal visceral fat. There's another process that accompanies abdominal visceral fat, and that is the accumulation of what's called ectopic fat. The more abdominal visceral fat you have, the more you start to implant fat in other organs. It could be in the liver, fatty liver, it could be in the pancreas, where that fat tends to damage the beta cells that produce insulin, and it can convert over time a type 2 diabetic into a type 1 diabetic, making that person relying on insulin for a lifetime. There's also fat that accumulates in knees and hips. You can actually see this on an MRI or CAT scan of a joint. You can see globules of fat. And when that happens, it accelerates the deterioration, the degradation of cartilage, taking you closer to bone-on-bone arthritis. You can also develop fat around the heart, epicardial or pericardial fat, that accelerates heart disease, especially coronary disease, coronary atherosclerosis, bringing you closer to such things as heart attack, sudden cardiac death, or the need for heart procedures. And there's accumulation of fat in muscle. So the accumulation of abdominal visceral fat encourages the deposition of fat in muscle, so-called myosteatosis. People who have excessive abdominal fat also tend to lose muscle, and the implantation of fat in muscle, myosteatosis, accelerates that process. And this is bad. We don't want to lose muscle as we age, because you're already losing muscle just by aging. About 30% of your muscle is lost from after age 30 to age 70 or so, and having abdominal visceral fat accelerates that process. And that means a future of disability, frailty, increased risk for dementia, loss of independence, and even early death. So we do not want to lose muscle. So minimizing your abdominal visceral fat is important. Now here's the problem: if you've got a big protuberant abdomen, you're overweight, it's obvious you have a lot of abdominal visceral fat. Even though you really can't tell the difference on the surface, how much is subcutaneous, that is just below the skin's surface, and how much is intra-abdominal. You really need a CAT scan or MRI to really tell the difference and accurately dissect apart how much is subcutaneous and how much is abdominal visceral fat. But it's that kind of experience, CAT scans and MRIs that have helped us understand just how to deal with this abdominal visceral fat. The downside with those tests, of course, is that you can't do them repeatedly to track what's happening to your abdominal visceral fat. You can do repeated DEXA scans. There's some cost involved, it's kind of logistically difficult, but some people do that. And that's an excellent way to track abdominal visceral fat and dissect it apart from subcutaneous fat. But us everyday people who don't want to go to the hospital all the time or a clinic don't want to spend a lot of money, there are now bioimpedance scales, so-called smart scales, especially ones made by three companies in particular, Tanita, Withings, and Omron have done a very good job in developing visceral fat scoring. So they're not really quantitative, they're more qualitative. They give you a score, and each device has a different scoring scale. So you have to look at the scale that each device has been uh has been using. And what they did was they used the cutoff of 100 square centimeters of abdominal visceral fat measured by CT skin or MRI, cross-sectional CT scan or MRI, because that seems to be the cutoff. When you have more than 100 square centimeters of abdominal visceral fat, it's much more likely to lead to all those health problems like heart disease, dementia, and cancer. Below 100, it's less likely. Now, that's not entirely true. You can still have lots of problems at 90, but it gives you some kind of a number to correlate the bioimpedance scales. So if your device says your scale is uh on, let's say 0 to 12 scale, let's say your number is 7, and they say that's high, it probably means you're above 100 square centimeters of abdominal visceral fat uh surface area. And so you want to get that number down. So even though the bioimpedance scales are not truly quantitative, they do give you an idea. So if you're seven, you're gonna work to try to get it down. Six, five, four, maybe three, something like that. Well, how do you do that, by the way? Well, it's very easy. So it's it's ironic. An excess of abdominal visceral fat drives the process not just of inflammation, but also insulin resistance. And all that means is your brain, muscle, liver don't properly respond to insulin, so your pancreas compensates by producing huge amounts of insulin. Someone who is insulin sensitive will typically have a fasting insulin blood level of one or three, or no more than four microunits per liter. A person who's insulin resistant because they have abdominal visceral fat in excess can have a level of 40, 90, 150 microunits per liter. In other words, it's not a little bit worse, it's not 10% worse, it's tenfold worse, 30-fold worse, a hundredfold worse. So that high level of insulin is very destructive to your health. It drives risk for all those conditions like dementia and heart disease. And the odd thing about that is the more insulin resistance you have, the more it encourages the growth, your expansion of abdominal visceral fat. So it's a vicious cycle, right? Visceral fat encourages insulin resistance, which encourages visceral fat, which encourages insulin resistance round and around and around. And it gets worse and worse and worse. And that's why people end up with dementia, cancer, heart disease, and other conditions. So, how do we get rid of abdominal visceral fat? So let's say you score high on your bioimpedance scale and you want to get that abdominal visceral fat down. Well, how do you do that? Well, we're gonna change our diets so that you're not provoking insulin. Very easy. What foods are flagrant triggers for insulin? Wheat, grains, and sugars. Simple. Not saturated fat, not pork, not olive oil, not butter, wheat, grains, and sugars. Wheat and grains, because the amylopectin A carbohydrate, unique to grains, is a flagrant trigger for blood glucose. And when you trigger blood glucose, you trigger blood insulin. And so this repeated cycle of high blood glucose, high blood insulin that comes, say, from eating pasta or bread or a bagel or anything made of wheat grains or sugar, that repeated cycle of high blood glucose, high blood insulin expands abdominal visceral fat. So we're going to eliminate those foods very easily, very easy to do. But we don't limit calories, we don't limit fat, we don't limit saturated fat. We eat whole unprocessed foods, eggs, beef, pork, green vegetables, broccoli, asparagus, you know the drill. Salmon, real foods, but no wheat, grains, or sugars that provokes insulin and blood glucose. We're going to address common nutrient deficiencies that apply to virtually everybody because of the quirks of modern life, not the diet, but because of the way we conduct our lives. For instance, you have to filter your drinking water. You have to. You don't have a choice, right? You can't drink from a river, stream, or lake. It's tainted. It's filthy, it's got sewage and other things. So we're going to filter our water, but water filtration removes all magnesium. And modern produce is very low in magnesium because of the farming methods and the degradation of soil quality. So we supplement magnesium. Vitamin D, we live indoors, we wear clothing. As you age, you lose the capacity to activate vitamin D in the skin with sun exposure. We supplement vitamin D. Iodine, because all the iodine in the world is in the ocean. If you live inland, away from the ocean, you don't get access to iodine in your food. And so we supplement iodine. Lastly, omega-3 fatty acids. We're supposed to get it from eating organ meats like brain, but no one wants to do that anymore. We can't eat all the fish we'd like because fish is contaminated with mercury and now microplastics. So we get it from omega-3 fatty acid supplements. Now, those four things, magnesium, vitamin D, iodine, omega-3 fatty acids, when put together, synergize to minimize insulin resistance, accelerating the loss of abdominal visceral fat. Now, another very important phenomenon is to address your disrupted gastrointestinal microbiome. Because we've all been exposed to so many factors that disrupt the composition of the microbes in our gastrointestinal tract, but especially repeated courses of antibiotics. Antibiotics are peculiar in that they're very good at killing probiotic species, beneficial species like lactobacillus species, biophytobacteria, fecalobacterium, acromancia, and many others. But they're not very good at killing pathogens and fecal microbes. These are species like E. coli, salmonella, campylobacter. And so your repeated exposure to antibiotics, whether it was a prescription antibiotic for an upper respiratory infection or urinary tract infection, or sometimes antibiotic residues in your food and water, they kill off beneficial microbes, are less effective in killing off fecal microbes. So what's happened in most modern people's gastrointestinal microbiomes is there's been an excessive proliferation of fecal microbes in the colon first, where they belong, where they started, that then ascend into the small intestine, into the 24 feet of small intestine. So that process is called small intestinal bacterial overgrowth. We say SIBO, SIBO. Now, the small intestine is ill-equipped to deal with trillions of invading fecal microbes in the 24 feet of small intestine. Small intestine is where we absorb nutrients like amino acids and vitamins and minerals. So it's by design very permeable, unlike the colon, which is not so permeable. Now, when you have trillions of microbes that only live for a few hours at a time, they're living and dying rapidly, shedding their components, and their breakdown products enter the bloodstream. That's called endotoxemia, a major driver of insulin resistance and expansion of abdominal fat. Now, how do you get rid of it? Well, there's a number of ways. My way is to cultivate three microbes, chosen specifically for their ability to colonize the small intestine. Most beneficial species, microbial species, don't colonize the small intestine, they colonize the colon. But I've chosen three species that are known to colonize in this small intestine and produce bacteriocins. Bacteriocins are natural antibiotics that are smarter than prescription antibiotics because bactericins specifically kill fecal microbes, not beneficial microbes. So I chose three species: a strain of lactobacillus rotori, a strain of lactobacillus gastri, and a strain of bacillus subtillis. They all colonize or germinate in the case of subtlus in the small intestine and produce bacteriocins. For instance, I recently DNA sequenced a strain of Bacillus subtlis I have, and it has seven genes for bacteriocin production. That subtilus I have is a magnificent producer. And so far, this has been incredibly effective in eradicating or normalizing SIBO, but we do it as something that looks and smells like yogurt. I call it SIBO yogurt. We're going to use my method of prolonged fermentation, typically 36 hours at human body temperature. These are microbes meant to colonize humans, not silly microbes that you get in a store-bought yogurt. That's something different. I call this yogurt because it looks and smells like yogurt. It's not yogurt. It's a fermented dairy product made from human-sourced microbes. Okay. Using extended fermentation, I add prebiotic fibers to encourage growth, like adding cow manure to your tomato garden. You're going to get bigger tomatoes, right? More tomatoes. So that recipe, by the way, is in my super gut book. It's in my super body book. And by the way, my new super body book is the book that articulates what this is all about. How we specifically target loss of abdominal visceral fat, how we preserve or increase lean muscle. And don't hear going to the gym for hours every week. That's not what I'm talking about. I'm talking about ways to correct your physiology to regain control over what I call shape and body composition, that includes minimizing and losing and tracking abdominal visceral fat. So the diet where we eliminate foods that provoke insulin, glucose, and insulin, nutrients lacking that, when put together synergize to minimize insulin resistance, and then we address the microbiome. If you want to follow my way with SIBO yogurt because of the colonization of small intestine and the production of bacteria cells, we go even further. There's two components of your diet that are lacking because we were told, right, to cut saturated fat and cholesterol. Many people did that, and most people abandoned consumption of organ meats like pancreas, stomach, skin, heart, brain, and two nutrients fell to the wayside that no longer part of most people's diet: collagen and hyaluronic acid. And those two things have major influences on abdominal visceral fat and muscle. So collagen, very important. And you know what? Those two things also consumed orally, not topically, orally, also improve skin. You lose wrinkles from both those things. You improve the location of muscle and fat. And you get other benefits. Hyaluronic acid, for instance, is a component of the glycocalyx that lines your arteries. So hyaluronic acid is probably one of the most important things you can do to preserve arterial and cardiovascular health. So we also supplement now you could eat organ meats, but most modern people don't want to do that. So we supplement collagen, for instance, 20 grams per day of a bovine source of collagen, which is the most common source, and 120 milligrams of hyaluronic acid as a powder. You could eat skin and brain, but most people don't want to. So we use it, we supplement as a powder. So though that's the formula I've been using to reshape your body, to reduce fat, and to restore or maintain muscle. That's what we want. That's how you maintain youthfulness, vigor, and probably longevity also. And you can track, you can track abdominal visceral fat if you get yourself one of those bioimpedance scales that has a visceral. So if you do purchase one of those things, make sure it has a visceral fat score function. Not all bioimpedance scales have that. So it's the Withings, OMRON, or TANITA devices that typically have, and not all their devices have it, so you want to specifically choose one that have the bioimpedance visceral fat score, and you can track it. So if this kind of conversation interests you, join my conversations in my membership program, my blog, my uh William DavisMD.com blog, as well as my Defiant Health podcast, and of course my YouTube channel.