Dhru Purohit Show
Why Visceral Fat Is So Dangerous and 3 Strategies To Tackle It For Good
Mon, 23 Dec 2024
This episode is brought to you by Fatty15, Lifeforce, and Levels, As we age, signs like swollen joints, puffiness, lethargy, and reduced sharpness may indicate chronic inflammation tied to visceral fat, the “hidden fat” deep in our organs. Focusing solely on visible subcutaneous fat can overlook metabolic dysfunction in lean individuals. Addressing visceral fat reveals key drivers of health, paving the way for longevity and optimal well-being. Today on The Dhru Purohit Show, we bring you a special compilation episode featuring Dhru's conversations with experts on the dangers of visceral fat. Dr. Sean O’Mara delves into the risks associated with visceral fat, the foods and lifestyle factors that contribute to its production, and actionable steps to lower visceral fat levels to prevent chronic disease and extend lifespan. Dr. Ana Claudia Rosa highlights the lifestyle factors that increase visceral fat and offers strategies to reverse its percentage in the body. Dr. Manickam Palaniappan (Dr. Pal) discusses the unique challenges of belly fat and visceral fat within the South Asian population, explaining why individuals in this group should be cautious—even if they have a "normal" lipid profile and are not classified as obese by traditional standards. If you're seeking a deep dive into visceral fat and practical ways to reduce your risk of chronic disease, this episode is for you. Dr. Sean O’Mara works with business executives, professional performers, and athletes who are motivated to optimize their biology through innovative performance-enhancement techniques. Dr. Ana Claudia Rosa is a physician, radiologist, and medical doctor affiliated with the VA healthcare system. Dr. Rosa is an expert on visceral fat, emphasizing its significance in detection and detailed reporting. Dr. Manickam Palaniappan is a renowned gastroenterologist recognized for his expertise in digestive health and innovative treatment approaches. Dr. Palaniappan is highly respected for his skill in managing complex gastrointestinal disorders, including inflammatory bowel disease, liver diseases, and colorectal cancer. In this episode, Dhru and his guests dive into: What is visceral fat, and why it's dangerous (1:12) Top drivers of visceral fat and why there is such an explosion (9:37) How subcutaneous fat differs from visceral fat (24:37) Accumulation of excess levels of visceral fat (32:37) How Dr. Ana implements these strategies in her own life (37:53) Tracking visceral fat and optimal testing (43:53) How belly fat translates to chronic disease (50:50) Dr. Pal's personal story (53:33) Why visceral fat develops (59:17) Lifestyle vs Genetics or both (1:04:33) Also mentioned: Full episode with Dr. Sean O'Mara Full episode with Dr. Ana Claudia Rosa Full episode with Dr. Pal This episode is brought to you by Fatty15, Lifeforce, and Levels. Fatty15 is offering an additional 15% off its 90-day subscription Starter Kit. Go to fatty15.com/dhru and use code DHRU to replenish your C15 levels for long-term health. Right now, you can save $250 on your first diagnostic and get personalized suggestions. Optimize your longevity and track your progress; go to mylifeforce.com/dhru! Right now, Levels is offering my listeners an additional 2 FREE months of the Levels annual Membership when you use my link, levels.link/DHRU. Make moves on your metabolic health with Levels today. Learn more about your ad choices. Visit megaphone.fm/adchoices
Chapter 1: What is visceral fat and why is it a concern?
Yes, visceral fat. It's wreaking havoc on our health. It's acting as a silent killer behind the surface. And as mentioned in today's episode, we have three fantastic educators who are talking to us about this subject and the dangers of visceral fat. We have Dr. Sean O'Mara, Dr. Ana Claudia Rosa and Dr. Pal.
And they're here to talk to us about how identifying and lowering visceral fat levels could be a canary in the coal mine for reducing inflammation and promoting overall health and longevity. Now, let's tune into my conversation with Dr. Sean O'Mara as he explains what visceral fat is and shares what he believes to be the top five causes of visceral fat. I want to talk about visceral fat.
Help us understand what is it and give us a few reasons why it's so dangerous inside the body.
Yeah. So a good name, because people hear about visceral fat, it's often described other ways like deep belly fat, but some cool names that I like to refer to it as invisible obesity, because it's the kind of fat that you don't know about. So it's invisible, it's deep in your abdomen. Another term that I've heard that is I'll give credit to is Carl Lenore's superhuman radio.
He calls it radioactive fat. And so it's this fat from the concept that it actually has inflammatory properties. It's not really radioactive, but it's the notion that it has the ability to influence tissues outside of itself. And the way it does that, Drew, is through inflammatory molecules. that it's constantly leaking and producing and sending throughout the body.
So it's a proximity to the vascular system that allows it to be distributed throughout the body. And then it has this untoward inflammatory effect in all the tissues. So keep in mind, chronic disease we hear about the common pathway of chronic disease is inflammation. And it's my clinical experience that visceral fat is behind all of that.
I mean, it's got this association or causality yet to be proven in many cases to virtually every form of chronic disease. So one of the interesting things I like to let people think about when it comes to visceral fat is if you have a malady, a certain form of chronic disease, just go on Google or AI and put in the search term, whatever you have, comma, and then list visceral fat.
The other technical term for it is visceral adipose tissue. Adipose means fat. So a variety of terms are used to describe visceral fat, but it is a really bad player because of its influence throughout your body. So I think that's a pretty good introduction to its association with chronic disease.
And then anecdotally, I would like to share that I studied it for seven years for the National Science Foundation, a grant that we received. And during that time, we looked at in 6,000 people, their chronic disease, things that they identified as forms of chronic disease they were suffering. And as we focused on eliminating visceral fat in those individuals,
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Chapter 2: What are the top drivers contributing to visceral fat?
all of their forms of chronic disease either got better or completely reversed. It was amazing as they got rid of visceral fat and to the extent they did. So symptomatology and conditions reverse better if you eliminate more of that visceral fat and only partially improve if you just eliminate to a little bit. So that was absolutely shocking.
to see that something as profoundly connected to pathology and disease was never shared with me in medical school. We only learned about it through this study. But there's a lot of studies. If you Google visceral fat, and just like I invited people to go on Google or AI and look at its association with whatever condition they might be afflicted with, It's connected with so many conditions.
It's been very well researched, but the problem is I've never seen something so valuable in the research lane kept from practitioners, physicians. It's inexplicable how something as powerful as this biomarker is kept from medical schools. The curriculums in medical schools are standardized. I went to both a law school, I'm an attorney as well as a physician.
And I remember there are good law schools and bad law schools. But in the United States, there is no bad medical school. And that's because all the curriculum is set and they're very, very good professional schools. The downside to that is because that curriculum is set and standardized, We don't have really good curriculum and not so good curriculum. So it's all kind of cookie cutter.
And ubiquitous in all these medical schools is a lack of awareness about visceral fat and some of the other biomarkers that we learned about in our study for the National Science Foundation in addition to visceral fat.
Let's talk about the basics. What are the top drivers of visceral fat and why is it such an explosion of visceral fat in our modern day society? This episode is brought to you by Fatty 15. I am so excited to share with you guys about an incredible scientific breakthrough to support our long-term health and wellness.
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Chapter 3: How does subcutaneous fat differ from visceral fat?
In other words, we didn't do medications, we didn't do exercise, we didn't have this individual do a sauna, we didn't have them fast or anything else other than simply eliminate processed foods, processed carbohydrates in particular.
And just to be clear, we're talking about ultra-processed foods? Or we're talking about, because you know, processed foods is a term can be kind of confusing to people. Some people will say guacamole is processed, right? But you're talking about first and foremost, ultra processed foods.
But then also it sounds like you're talking about some minimally processed foods, especially when it comes to certain carbohydrates, right? Like, are you talking about like pastas and other things like that?
Yeah, that would be included. So anything that really changes the form if it's not a natural process. So if you simply take an avocado and squash it and turn it into guacamole, that's a pretty natural process. But if you were to take something like wheat, grind it up, add some oils, and cook it, that would be a lot more processing.
So our guidance to individuals during the National Science Foundation was to only use natural kind of processed foods, squashing, changing the form with some kind of mechanical event as opposed to cooking or adding other ingredients into it. So we instructed this individual to eat food in whole form. So It would be meat and vegetables in non-processed form that he was allowed to eat.
And he did that, and he had this amount of visceral fat on his baseline, meaning when he first got started.
Yeah, and so you, just to describe again for the people that are listening on the podcast, You have a basically a series of six images and they go from week zero all the way to week 35. So this is a sequential imagery and the visceral fat here is this sort of yellow whitish
imaging that's there and you go week by week you go week 0 to 2 to 5 to 15 to 25 and 35 so you sequentially see and then next to it you talk about how much the amount of visceral fat is and is that in the total body or is that in the abdomen region? Like week zero, it says 5.6 pounds. Is that the total body or is that just in that area?
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Chapter 4: What lifestyle changes can reduce visceral fat?
Just in the abdominal cavity. So the visceral fat would roughly correspond, include fat outside the abdomen around the heart. So that's organ fat too. But it's quantified in this particular image through software that was captured and limited just within the abdomen. So this pinkish red color in the middle is your visceral fat. Your sub-Q fat is the yellow.
We tracked and paid attention to the visceral fat because that is the more harmful substance. And yeah, sorry about that.
I got it wrong. The pinkish was the visceral fat.
Yeah.
My apologies.
Yeah, just adding some clarity to it. So you can see from in just two weeks, even though you are not a radiologist and many who are watching this and able to see that, they can visualize that the visceral fat, the pinkish substance has been reduced. And so that's an important observation to be aware of. And that happened just by this individual cutting out processed foods.
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Chapter 5: How do we track and measure visceral fat?
But as you rightfully point out, over 35 weeks, this guy goes from having a dad body, 68 years old, and he also has muscle with
fat infiltrating the muscle we call that adverse muscle composition or myosteatosis the technical term for it where fat starts depositing within the muscle of your your your body and by the time 35 weeks are up this guy goes from a dad bod to looking like a collegiate swimmer look he looks like somebody in his 20s he's reduces visceral fat that much and uh he actually uh
improved his musculature, and he did so without any exercise. So the elimination of visceral fat was profoundly facilitated by the elimination of processed carbohydrates in food. So you ask what causes visceral fat, that's a big one. And then I don't have an image of it, but a second one we get into is is alcohol.
So somebody that drinks, the more you drink, and you could, I could throw, have you start pounding, become this heavy, heavy drinker. We're not going to see visceral fat for a while, but the more you drink, the more your metabolism is burdened and your capacity to have a healthy response to the caloric intake becomes compromised. So
And is that generally because people who are drinking more are sort of also drinking their calories, right? So they're also getting just total excess extra calories and that's contributing to visceral fat?
Well, the calories do make a contribution, but it's really more of its metabolic impact. Alcohol, when it's ingested, behaves differently because of its biochemical composition than any other forms of calories. So if you're ingesting fruit or rice or protein or meat or some other form, it's not going to have as much impact on your metabolism as alcohol.
So we have our clients eliminate, we recommend that they either cut back, scale back on alcohol or completely eliminate it. And those that eliminate it completely have better results in eliminating visceral fat than those that continue to drink. And to the extent that you continue to drink you become more resistant to the elimination of visceral fat.
So somebody who comes back and has disappointing results between their scans, we will ask them about alcohol use. But for the most part, what's really interesting is people, when they get scanned, really are very, like I said earlier, very open to changing their lives more than any other time.
Because they see it firsthand.
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Chapter 6: What personal stories highlight the dangers of visceral fat?
They see this huge amount of visceral fat that they have inside of them. And so with that awareness, suddenly they start going to bed earlier. They start cutting out all the stimulation and other things. And that we could do months of shows on sleep. But suffice it to say that impaired sleeping has a major contribution to visceral fat. The fourth one... surprises people.
And it was a very interesting conversation that you had with Dr. Lustig. It's about stress. So stress causes through the mediation of cortisol. the contribution and composition and deposition of visceral fat within the abdomen.
And so individuals who unknowingly have stress in their lives or who have stress in their lives but simply tolerate or put up with it will be unfortunately accumulating unnecessarily a visceral fat inside of them to the extent that they have it. Now everybody's body is a little bit different and some people respond to stress a little bit different.
But to the extent that you can eliminate stress, you will eliminate the composition or deposition of visceral fat inside of people. So it's really an important discussion for people to be aware of. And then the final point that we see is, believe it or not, and it came as a surprise, is durational exercise, where we simply exercise too much.
And so we see that people that are runners, and I'll pull up a nice scan of this. Here's an MRI of somebody who's a marathoner who had run eight to 10 marathons. a year, he had a lot of this visceral fat within him. And he had this very small amount of subcutaneous fat. So we call these people with low subcutaneous fat on the outside, TOFIs. So they're thin outside, and fat inside.
So this marathoner was filled with a lot of visceral fat. So we see, and it's probably two things. One, it contributes to visceral fat when you overexercise and the exact mechanism is not clear. But my theory is it's probably through elevated reactive oxygen species, ROSs that go around that are associated with exercise. If you exercise too long and too much,
you enhance these ROSs from being produced. And so another example of this happening is a really nice before and after scan in a 58-year-old executive of a company who came in and he was having his repeat abdominal scan, his MRI.
So for the audience that's listening, you have a before and after. It looks like they're taking about two months apart, right? Correct. And so on the left-hand side, for this individual that you mentioned, go ahead, you can describe it.
Yeah, so on the left side is an MRI scan. image of his abdomen and he's got a substantial amount of visceral fat within his abdomen. His muscles look pretty good and he was a pretty healthy guy. He was doing a lot of healthy things, 58-year-old executive. And this was a repeat itself. I don't have the MRI before it, but it was disappointing and alarming.
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Chapter 7: Is it lifestyle, genetics, or both that affect visceral fat?
distance running, like marathon runners, et cetera.
They just stop running. They don't do any more jogging. We recommend that they just simply do sprinting. It's a completely different form of exercise. I mean, it's hard to do. I'm a former distance runner. I ran cross country in school. I love distance running. I could not stop. I will admit to anybody in the audience today, I was addicted, in my belief, I was addicted to running. I loved it.
And I loved the endorphins it produced. And I would run 70 to 90 minutes every single day. I could not stop doing this. And many people are like that. So for me, I stopped doing distance running. I started springing. I get my clients, patients that work with me to do the same thing and dramatic improvement in the reduction of visceral fat when they start doing so.
Next up on today's episode, I speak with Dr. Ana Claudia Rosa, who further breaks down how visceral fat is different from subcutaneous fat and how visceral fat drives the chronic diseases that we're seeing in our population today based on her beliefs. Dr. Rosa also shares about her own efforts to reduce visceral fat and make sustainable lifestyle changes.
Understanding what visceral fat is and how it develops in the body is important, but I love how Dr. Rosa takes that information and has connected it to inform her on her own personal daily habits for overall health. there's a lot of confusion about the different fats that are there. And not all the fats are created equally, right? Visceral fat is the most dangerous.
We're going to come back to that in a second. So the subcutaneous fat, which would be part of what would be included if you got an in-body scan or a DEXA scan, to look at your body composition, which we highly recommend that people get. It's a good idea to tell you how much fat you have, and also, do you have appropriate amounts of muscle, which we'll come back to.
And bone.
And bone as well, right? People look at it often to measure their body composition, but also, as individuals are aging, they might look at it to see if they're at risk of osteoporosis, if you're trying to make fitness goals. There could be a lot of reasons why you're doing these imaging scans. So subcutaneous fat, that's the fat, as I understand, please correct me if I'm wrong.
It's the fat that we can pinch and that we sort of see. And that the fat that often when people look in the mirror, they're thinking like, this is the fat that I'm not excited about. And it's sort of like the vanity fat that's there, right? Can you share a little bit more about that?
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