How can you get rid of visceral fat? Tips from a nutritional expert

"Ugh, I put on so much weight during the holidays." Who hasn't heard someone they know bemoan their Christmas weight gain come January? But did you know that there are two types of fat? To explain which one we're talking about, our nutritional expert, Dr Jean-Michel Lecerf, reveals all.

There are two different types of fat in our bodies: white adipose tissue and brown adipose tissue. Pretty simple so far.

White adipose tissue is composed of adipocytes (adipo whats??). These are cells that store fat in the form of triglycerides. This word might ring a bell if you've recently had a blood test… You now know that too much isn't a good thing!

"White adipose tissue plays two roles: it stores fat, which people tend to know about, and it plays an endocrine role, which is very important and often overlooked," explains Dr Lecerf, our nutritional expert.
Endocrine means that the tissue is metabolically and hormonally active: it produces hormones that are then transported by the blood. So white adipose tissue isn't as bad as we think, given that it plays an important role in keeping our organs working. The problem, then, is excess storage…

We hope you're keeping up, because we're about to take things to the next level. White adipose tissue can be found throughout our bodies, but technically speaking there are two types:
► subcutaneous white tissue: As the name suggests, this type of fat sits just beneath the skin ("Cellulite!" I hear you shout. But hold your horses – we'll get to cellulite in a minute);

  ► ectopic fat. Don't panic: Dr Lecerf is here to explain. "It's a type of fat that sits around all of our organs, such as our intestines, heart, liver, spleen, lungs, pancreas, etc."

Not so complicated after all, eh?

Now let's look at the second type of fat. Brown adipose tissue is composed of mitochondria. The role of these cells is to supply us with ATP (an essential energy source for our bodies. Think of it as being like petrol for your car). It actually contains very little fat.
Seriously? Adipose tissue with very little fat? Don't get too excited. Its only function is to produce heat and regulate body temperature. "This brown fat doesn't play any kind of storage role. It is abundant in newborns, but its levels tend to drop off as we get older. It is reactivated in certain conditions, such as when someone is exposed to the cold."
What a shame! It's not the kind of fat that we put on when we overindulge on our holidays.

Our nutritional expert also points out that, in certain cases, these cells can mix with white adipose tissue to form beige adipose tissue! This third type of tissue is less common and doesn't have anything to do with our visceral fat. Right, let's move on.

If you've followed everything so far, well done! For anyone who dozed off or got lost, here's a quick reminder of what we talked about: visceral fat is an ectopic white adipose tissue. It is also known as perivisceral adipose tissue or intra-abdominal fat. The clue is in the name: it sits inside the abdomen.

Both types of white adipose tissue (subcutaneous and ectopic) play a role in storing fat, but visceral fat also provides energy. "Fat can be released to produce ATP. The distinction is important, because subcutaneous adipose tissue releases much less energy. However, this is the type of fat that we tend to find in the lower body in women, and in the stomach in men."
To sum up what Dr Lecerf is saying, that cellulite that you want to get rid of has nothing to do with visceral fat. So if visceral fat releases energy, why would you want to get rid of it? We'll come to that later.

If you've been keeping up, then you'll know that the difference is where the tissue is located.

More specifically, subcutaneous fat can be found throughout the body, in the stomach, legs, arms, etc. You might know it as saddlebags, love handles or knee fat: all those things we often feel self-conscious about.  

As for visceral fat, it surrounds the organs. Simple! And here, we're talking about every organ that sits in a cavity: the heart, lungs, kidneys, spleen, pancreas, etc. It's not just limited to our digestive organs!

Here's something else that can trip people up: not all subcutaneous fat is cellulite! You know, that orange-peel skin that we're always trying to get rid of...
As Dr Lecerf explains, everyone has subcutaneous white adipose tissue. It's essential for our bodies. But not everybody has cellulite. "Cellulite is when the cells located under the skin are inflamed. It's referred to as gynoid lipodystrophy and is a state rather than a metabolic disease." Do you know the three types of cellulite? In its adipose form, cellulite doesn't really respond to changes in diet, metabolism, physical activity, etc. Thankfully, though, we can do something about aqueous cellulite.
The reason why cellulite is so hard to get rid of is that subcutaneous white adipose tissue's main role is to do with storage and metabolism. The body therefore recruits adipose cellulite far less. "In women, subcutaneous white adipose tissue is used to provide energy during pregnancy and breastfeeding, as well as for ovulation. At other times, it isn't used very much. This explains why, when women reach menopause, fat tends to move to the stomach – because it is no longer needed in the lower body."
As a slight aside, the menopause is an incredibly complex period that's worth learning more about. Here's how to prepare for the major changes your body will experience.

In men, who are less prone to developing cellulite, subcutaneous adipose tissue tends to sit primarily on the stomach. "Evolution explains why storage is a priority. Bear in mind that the body is always trying to replace any fat that is lost, because fat is essential for the survival of the species."

If you try to get rid of your adipose tissue, your body will work harder to store more of it. To illustrate how our bodies are conspiring against us, let's take liposuction as an example. If you undergo liposuction (which involves removing some of these adipose cells), your body will compensate for the fat loss by laying down new fat in the long and/or short term. The effects of your cosmetic surgery will therefore only be temporary. Yep, all that effort for something so fleeting. And the fact that it's so hard to get rid of cellulite is why it's important to avoid building it up in the first place!

Let's get down to the real business: "We can't get rid of fat cells. When you eat less, it's the size of the cells that decreases, rather than the number of cells you have." Well that explains a lot!

There are many things that cause you to build up stomach fat, but the two main ones that can affect it (no surprises here!) are:

► diet
► exercise.

"It's essential to live a healthy lifestyle. Prevention is fundamental. Over time, diets become less effective because your body becomes used to them. And because your body is trying to replace what it has lost, it will resort to other tactics, such as making you feel hungrier."
We've said it before and we'll say it again: we're really not fans of diets!

Another piece of bad news (or maybe not so bad) is that it's impossible to target only stomach fat. The body works as a whole and we can't shed fat to order. Something else that we keep banging on about!
But that doesn't mean you should just give up. If you're carrying a little extra fat around your abdomen, it's not too late to do something about it! Phew!

So, to keep morale high, our expert has two bits of good news:
1-  Studies have shown that, in general, we lose stomach fat faster than subcutaneous fat. 
2- Even when we only lose a little bit of stomach fat, it instantly has a beneficial effect on our health.
Basically, you'll be rewarded for any effort, no matter how small!

When you read Dr Lecerf's list of factors that have been scientifically recognised as causing abdominal fat, you start to get an idea of what we can do about it:

◆ smoking (but if I quit, I'll eat more…!);

◆ stress (stopping stress is easier said than done);

◆ having a low birth weight (yeah, there's nothing you can do about that);

◆ having an unhealthy gut microbiome (hmmm…);

◆ long-term cortisone treatment (basically, steroids make you gain weight);

◆ a diet that's too rich and sugary (I think you can see where I'm coming from).


Ta da! "Looking at this list of factors, you can see that there are a lot of things we can do in terms of diet and physical activity. Exercise in particular is fundamental for weight loss, but it's not enough on its own. In terms of diet, you can stop having sugary drinks, which are toxic, and greatly reduce the amount of glucose and fructose you consume."
It seems that we are what we eat after all...

"In order for fat to form in the body, no matter where, there needs to be a regular imbalance between energy intake and energy expenditure."

This is known as our energy balance. The aim should be to provide the body with the energy it needs to function at rest (the famous basal metabolic rate) and when active (Physical Activity Level, or PAL). But no more than that. So grab your calculator and see whether your energy is balanced!  
If you eat too much for several days in a row without expending this excess energy, your energy balance will be broken.
Your body will then store the excess energy in your fat cells. "The problem with this overstorage is that, if you gain 10 kilos over 5 to 10 years, the fat can become unhealthy."
In a nutshell, it's good to have visceral fat because it releases energy when we need it. But if we eat more than we need, our visceral fat will only release some of the energy and will store the rest.

You won't be surprised to learn that this type of fat is bad for our bodies.
Excess abdominal fat carries a risk of fatty liver disease, diabetes and cardiovascular disease. Ouch...

This affects the entire body, including the muscles, where intramuscular fat can be found. It's formed when fat isn't used by the muscle (due to an absence or lack of activity).
In a healthy body, our muscles contain very little fat, and use it as a fuel during exercise. If there's too much fat, it can infiltrate the muscles.
The reason is simple: when we're overweight, the amount of adipose tissue increases significantly. The number and size of fat cells increases. Since adipose tissue is metabolically active, the cells will both store and release fatty acids into the blood. If too much fatty acid is released, it'll infiltrate the muscles.
The muscle will prioritise fatty acids as a fuel source over sugar, hence blood sugar levels will increase. And this is how the risk of type 2 diabetes increases.

Remember that, the more adipose tissue there is, the more it will release fat, because that is one of its functions. And where does this surplus go? To the closest possible place.

If we follow this logic, in the case of excess visceral fat, the cells reject fat, which then travels to the liver (it's the nearest organ). It literally becomes fat and sends triglycerides and cholesterol into the blood (remember that blood test?). It begins to produce blood sugar, even on an empty stomach. So as well as diabetes, there's a risk of heart disease too. Which is what makes it so bad…

Even with all this information, it's hard to tell the difference between subcutaneous fat underneath the skin on our bellies, and visceral fat located inside the abdomen and, specifically, around the organs.
"There are two ways to measure visceral fat levels: measuring the waist circumference and comparing it to epidemiological data, OR using DEXA (dual-energy x-ray absorptiometry). It's a method for measuring body composition, but is only used in very specific cases."
Which means that you'll need to dig out your sewing tape measure!
Just be aware that your waist circumference can be hard to calculate. Take the measurement just above the top of your hip bones, which you can feel by placing your hands on your hips. Don't use your belly button as a guide, as it isn't very precise.
Our nutritional expert has the following advice:
in Caucasian females, the measurement should be no more than 88 cm;


in Caucasian men, it should be no more than 102 cm.


The level of visceral fat is an estimate based on the averages across entire populations. Hence the importance of specifying ethnicity. "For any given person, the measurement is only useful if it's compared to a group of the same ethnicity. For example, the numbers are much lower for Asians than Europeans."

While it's recognised that an unhealthy microbiome can lead to excess visceral fat, Dr Lecerf recommends making any changes to your diet slowly. There's no point completely changing how you eat if there's a risk of your efforts being wasted.
"Try to change your diet little by little by gradually adopting new habits. Think about whether you could eat a smaller portion of chips at the restaurant, not have a fizzy drink with your meal, stop keeping a box of biscuits in your office drawer, avoid having crisps when sitting on the sofa, take time to savour your meal, and listen to your body's hunger cues."
It's a marathon, not a sprint. Allow yourself some treats and take things one step at a time, rather than doing everything at once and quitting after just a few days or weeks. If you want to make changes to your diet that will last for many years to come, we recommend working with a qualified professional.

Physical activity plays an important role in reducing visceral fat levels. It's essential to exercise regularly. "Sport is essential for a healthy lifestyle. You're not going to achieve a lasting drop in visceral fat without regular exercise."

You don't need to become a high-level athlete or aim for Olympic-style performances; the aim is just to get moving regularly. Pick an activity that you enjoy, start small, and gradually increase your activity levels.

As you start to move more, you'll increase your daily energy needs and your basal metabolic rate, in other words, the energy that your body burns when resting.
If you're new to exercise, you'll see a lot of benefits from walking. Did you know that a 20-minute walk after a meal greatly reduces your blood sugar levels? So why not swap your coffee break for an active break near to your workplace?

Stress stimulates the production of fat cells. It causes the body to secrete cortisol, a hormone that's involved in weight gain.
Once again, the best way to reduce your stress levels is to turn to exercise. When we move regularly, there are many benefits for both our physical and mental health.
Exercise improves blood flow throughout the body, including to the brain. Stimulating the sympathetic and parasympathetic nervous systems increases the body's overall energy levels and leads to better post-effort relaxation.

The more you exercise, the better the body's resistance to stress will be. But even after your first workout, whatever it may be, your stress levels will fall significantly. To retain the effect over time, you'll need to exercise regularly.

And be aware that other techniques exist too, such as sophrology, breathing exercises, meditation and psychotherapy. Give them a try to figure out what works best for you.

Sleep quality has a significant effect on our bodies. A lack of sleep is one of the things that can lead to obesity. When we sleep less, the body's metabolism is disturbed, and this can cause us to eat more.
And without wanting to sound like a broken record, it's worth knowing that exercise will help you sleep better. Another good reason to dust off your trainers!

In his next book, 40 misconceptions about diets, Dr Lecerf explains why, in 90% to 95% of cases, diets result in people gaining more weight than they lost in the first place.
It doesn't matter what type of diet you go on (number of calories, type of food, etc.), they are counter-productive and risk leading to an unhealthy relationship with food. "In the medical jargon, we talk about cognitive restriction. This is when somebody stops using their physical sensations and feelings to control their eating, and only uses their brain. If you try to control your hunger through logic and reasoning alone, you risk developing an eating disorder."  
The best option is to seek the support of a qualified dietician or nutritionist to help you rebalance your eating sustainability.