Visceral Fat and Cognition – An Asian Study

Visceral fat, also known as abdominal or intra-abdominal fat, is a type of body fat that is stored deep within the abdominal cavity and around the internal organs such as the liver, pancreas, and intestines. 

Unlike subcutaneous fat, which is located just beneath the skin and is more visible, visceral fat cannot be seen or felt. However, assumptions can be logically made that obese people usually have excessive amounts of visceral fat below their subcutaneous fat layer as well. Traditionally, this condition has been widely associated with an increased risk of developing diabetes, high blood cholesterol, high blood pressure, heart attack and stroke. 

Recently, a study from Nanyang Technological University (NTU) in Singapore was published in the latest edition of Lancet Regional Health. It analysed 8769 participants in Singapore of south-east Asian origin with their metabolic and cognitive data collected between 2018-2021. As first of the kind focusing on the Asian population, the researchers concluded that increased visceral fat mass index, increased waist-to-hip ratio, and reduced high-density lipoprotein are consistently associated with lower general cognitive performance index; blood pressure, HbA1C (blood glucose control index) did not indicate association with cognition. 

How do I know if I have visceral fat?

As mentioned above, visceral fat is invisible, making it hard to tell without extensive medical imaging. However, being overweight and obese almost certainly lead to visceral fat. As per WHO standards, a body mass index (BMI) over 25 is considered overweight, and over 30 is obese. To calculate BMI, use your weight in kilograms divided by the square of your height in metres (kg/m2). For example, an adult who weighs 70 kg and whose height is 1.75 m will have a BMI of 22.9. Even easier, simply put your weight and height into this website. An ideal BMI would fall within 18.5-24.9.

How to lose visceral fat?

Ok, if I found out that my BMI is over 25, and I’m determined to lose weight, what can I do? Overall, a healthy lifestyle is the key: 

1. Increase Physical Activity: Regular exercise can help burn calories and reduce visceral fat. Aim for at least 30 minutes of moderate-intensity exercise at least five days a week. Activities such as walking, cycling, swimming, or strength training can help you burn calories and lose visceral fat.
2. Follow a healthy diet: A healthy diet that includes plenty of fruits, vegetables, whole grains, lean protein, and healthy fats can help reduce visceral fat. Avoid processed foods, sugary drinks, and saturated fats. A dietician can offer professional guidance if you need advice. 
3. Stop smoking: long term smokers are more likely to be overweight or obese while also contributing to increased overall risk of cardiovascular and lung disease. 
4. Limit alcohol intake: limit alcohol intake to 10 standards a week and no more than 4 standards on a single occasion. 1 standard equals to 10 grams of alcohol, that’s roughly 300mL of beer, 100mL of wine or 30mL of spirits.
5. Establish good sleeping habits: Poor sleep can cause an increase in cortisol and insulin resistance, which can lead to visceral fat gain. Aim for 7-8 hours of sleep per night. 

For people with morbid obesity and failed lifestyle intervention, certain medication like liraglutide and orlistat can help with weight reduction. If it still fails to reach the ideal healthy body weight, surgical intervention like gastric bypass (connecting food pipe directly to the small intestine and bypass stomach) or gastric sleeve (reduces stomach size). 

Conclusion

Given the breakthrough result from the study, further research could look into how people from different ethnicity are affected differently, and which aspects of cognition are affected the most. For now, calculate your BMI, and start a healthy lifestyle, it’s never too late.