Nutrition Expert Explains How To DESTROY Visceral Belly Fat (Forever)

Belly fat gets harder to lose every year after 40. And most people don't know they're actually fighting 2 different kinds. There's the fat you can grab, and then there's the fat you can't. That hidden layer packed around your liver and your pancreas that drives up your blood sugar, your blood pressure, and the— it's the inflammation behind almost every chronic disease. And in this video, I'm gonna show you how to fix it for good. All right, let's break it down. Visceral fat versus subcutaneous fat. The fat you can pinch and the fat you can't. So subcutaneous fat is that fat directly beneath your skin. It's the one you can pinch. You've got it around your stomach, your hips, your thighs, and your arms. The visceral fat is that deep fat. And actually, you might not be able to pinch very much fat at all, but it's like this firm, very rounded abdomen might even feel hard. Now subcutaneous fat isn't automatically harmless, but visceral fat is the one that has the much stronger association with cardiometabolic disease. Here's what's crazy. 2 people could have the exact same waist size or body weight, but very different distributions of visceral fat and subcutaneous fat. And that can dramatically change their health outcomes. Now, premenopause, before all the perimenopause crazy hormone havoc starts, women store more fat around their hips and their thighs. But then estrogen starts to drop, insulin resistance starts to climb. Cortisol can too, and fat distribution starts to shift, and it shifts away from your thighs and your booty and into your abdomen. And that's why a woman's body shape can change during menopause, even when that scale is barely moving. In fact, my mom had a name for it. She called it shifting sands. So what exactly is visceral adipose tissue, or VAT? The first time I saw this, I was a young exercise physiologist, and I'd been taught to do body fat using Skinfold calipers. We didn't have body impedance back then. And I'll never forget Graziella. Graziella had a very, very hard abdomen. And remember when I went to take her skinfold calipers there, I could barely pinch anything. Now, what I've been taught is like, this person's really lean, but I knew she wasn't lean because you could tell. She barely had any fat on her thighs or her arms. It was all around. Her abdomen inside, right? I couldn't pinch it. And when I did her measurements, this was a woman who's 5'2, so 62 inches tall. Her waist was 38 inches. She would want it to be maybe 34-inch waist, right? And then that 38-inch waist, her hips were 36. And one of the other things is you wanna make sure that your waist is smaller than your hips if you're a woman. If you're a man, 1 to 1's okay, although 0.9 or less is better. If you're a woman, 0.8 is okay, but 0.7 or less is better. So that was Graziella, first time I really started to see it, which led me to go, okay, we actually really need to be able to monitor this visceral adipose tissue. This is the fat that's stored deep inside the abdominal cavity, and it surrounds the internal organs, pancreas, the liver, the intestines. Again, you can't pinch it, and quite often you can't really pinch everything because it's pushing, it's so hard, it's made this really hard, Belly. What's wild is a woman, or anyone actually, can have a relatively normal body mass index. That's why those are not useful and still have way too much unhealthy visceral fat. Or you might have a healthy range of body fat, but you've got too much visceral adipose tissue. And this is important because visceral is not just simply stored energy. This visceral fat is metabolically active tissue that releases fatty acids and hormones and inflammatory signals that can affect the liver, the blood vessels, and your insulin sensitivity. Now, the good news is it's not all bad news here—is that you can change it. It's very responsive to lifestyle changes. It can be reduced. Now, I put in here like we're going to change it forever. Well, that only works as if you change the habits forever too. Okay, so changing this means we're going to give you the tools today, and then these things need to become the way that you live. Consistency is always the most important thing when you're changing health, your health metrics. I've hinted at why I'm so concerned about this. visceral fat, let's go a little deeper. So visceral fat drains fatty acids and inflammatory substances into the portal circulation, which goes directly to the liver. And it is associated with the following: insulin resistance and type 2 diabetes, fatty liver disease, which is a huge undiagnosed problem because we're not looking for it, higher triglycerides, unhealthy cholesterol patterns, high blood pressure, cardiovascular disease, chronic inflammation. And increased all-cause mortality. And it does something really bad because it contributes to a feedback loop. So visceral fat increases insulin resistance, which means the pancreas has to release more insulin to do its job. And then insulin levels, those higher levels of insulin, make getting to your stored fat more difficult, which then makes you hungrier, which then means that you're gonna be eating more, which then means that surplus of calories makes it easier to store more fat. And around and around and around we go. In fact, a systemic review found that greater abdominal visceral fat was associated with greater all-cause mortality risk. This was from the Journal of Frontiers in Endocrinology in August 2022. So the big takeaway is you really need to know about this visceral adipose tissue. What I've always been taught is you want 10% or less of your overall body fat to be from visceral adipose tissue, and you want to be as close to zero as possible. Here's the big challenge: trying to measure it is not The most accurate direct measurements come from either doing a CT scan or MRI imaging. I had to do a CT scan of my abdominal area a couple years ago. I was super happy to find out how low my visceral adipose tissue is, but I wouldn't have done that unless I had to do it for another reason. Now, you can do a DEXA scan. You know I love me those DEXA scans, but really that's going to be for fat mass, fat-free mass, and bone mineral density. It's going to give you an estimate. Of that abdominal or what they'll call android fat, but it's not measuring it like an MRI or a CT does. Then, of course, you can also get this estimated from one of those smart scales, from a bioimpedance scale, but realize it's an algorithm. It's a guesstimate. It really isn't gonna give you the information you're looking for. This, I think, is the best way to do this. And it's the cheapest too. It's called a waist measurement, right? So what I want you to do, and I love the new Bluetooth Tape measures they have. In fact, I've been using the PATH scale and it comes with a Bluetooth tape measure too. You're going to want to measure 2 things, your waist and your hip. You're also going to need to know your height. And if you haven't measured your height for a while, time to do it. Because you know what? It changes as we age. You're going to want to do your waist and do that around the abdomen. And remember, you always want to get to the same place every single time. So super important. Do a normal exhale. Don't suck in your stomach. That's the hardest part. If you are a menstruating woman, do it around the same time every single month. And ideally use a flexible tape. And I like the medical-grade tapes where they have a little hook you put it in so that you can't pull it tight. Really important. You got to keep those conditions. You're also going to do your hips around the widest part with your feet together. So we're going to look at your waist-to-height measurement. We want your waist to be half or less compared to your height. Your waist-to-hip measurement, as a woman, shoot for 0.7. As a man, 0.8. 9. And then also you wanna have just your absolute waist measurement for a man under 40, for a woman under 36. But I really prefer waist to height. So these are all great screening tools. And here's the other piece. If you're losing weight but not losing your waist, you could just be making yourself worse, not better. Let's talk about how this is happening. Why is this happening to you? So what causes visceral adipose tissue? Number one, it's too many calories, long-term energy surplus. That could be not moving enough. Eating too much. Usually it's a combination of both. Genetics, where you're storing your fat. Aging. Insulin resistance. Menopause, estrogen going down, insulin cortisol going up. Speaking of cortisol, poor sleep, chronic stress. Of course, we know poor sleep affects both insulin resistance and cortisol. Alcohol and high fructose diets, especially things like ultra-processed foods, can cause you to lay down more fat there. Being sedentary and losing your muscle. All things we talk about all the time here. So what do you need to do to destroy that visceral fat? Well, you can't really go out and just destroy it. But what you can do is change the conditions that will help you lose it and then keep it off forever. The only way to keep it off forever, though, is to continue to do the things I'm going to talk to you about. So one of the things we talked about was menopause. So what about using menopausal hormone therapy? This can help some because it can help improve that insulin sensitivity, right? In fact, there was a randomized controlled study done that found hormone therapy helped prevent the central redistribution of fat in early menopause women. This was back in 1991, December, in Metabolism. Boy, do we need more research on this. I know I watched this, my mom going through this, and she was one of those poor women that got taken out by the Women's Health Initiative. I never went off. Like, I, I never let myself really suffer during menopause. I started on hormones really early on. But still, you're not at the same level of estrogen as you were when you were younger. So I still could notice some, some shifting sands, which I've done everything here to fight against. So hormones can help here. They might help that whole hormonal environment, but it's not going to do the whole job. You're still going to have to look at nutrition and exercise and sleep. You know, all the things. So let's talk cortisol, shall we? The big thing first with cortisol and insulin is sleep is such an important part of your metabolic health. In fact, there was a randomized crossover trial. That's where women participate in both sides of the trial where they reduced their sleep by 90 minutes per night for 6 weeks. I would never do this, by the way. And they got more insulin resistant even without any other changes. So don't sleep well, you'll get more insulin resistant, which is going to cause problems over time, right, with laying down more visceral adipose tissue. That was in Diabetes Care, January 2024. Bless you women who volunteered for that. Then there was another study that found that sleep restriction reduced whole body insulin sensitivity by approximately 25% and increased stress hormones. That was in Journal of Endocrine Clinical Endocrinology and Metabolism in April 2015. Sleep matters, okay? Like, don't steal from sleep. And I know as progesterone's going down, the 3 o'clock wake-up is a real thing. So again, this is where you find a menopause-trained doc and test out some menopause hormone replacement therapy. Sometimes all you need is a little progesterone. So check that out, because beyond just the insulin and cortisol problems with poor sleep. It also makes you hungrier. We know that you've got elevated ghrelin, you're hungrier. And I always say you're hungrier and it's not for salmon, is it? It's for things like, you know, ultra-processed foods. You need the dopamine hit of them. You're not going to feel like going and doing a big heavy workout and your recovery is going to be reduced. You're not going to be able to build muscle like you used to. And then you tend to eat more at night. Like the whole thing is just this cascading cycle of doom. So I have done multiple videos on sleep. We will link to our sleep videos so you can work on getting your sleep better. But big thing is try to go to bed and wake up at the same time each day. Create a really nice nighttime power-down hour. I learned that from Dr. Michael Breus. Cool that bedroom down. We get ours down to about 68. Don't go hitting a big bottle of wine before bed. And if you notice, if your partner notices, or you check on your Oura Ring and it does not look like you're sleeping quality sleep, go get it checked out. Shout out to Dr. Andy Galpin has A sleep test at home that we can link to in the show notes that could be helpful here. The other side of sleep, of course, is stress. Of course, stress can impact sleep and create problems with sleep, and poor sleep is another stressor. And really, stress can cause the laydown of more fat around the waist. So I always looked at my waistline as kind of a measure of how much stress I was under. And Boy, if I could go back and tell my younger self anything, it would be like, slow it down. Like, come on, throw some meditation or breathwork, or just go outside and play with the dogs. Find your bliss. But it really is important, and it doesn't have to be hours, but just do something that's gonna help manage those stress hormones because they matter. In fact, a stress management meta-analysis found modest effects on cortisol with mindfulness, meditation, and relaxation producing some of the strongest results. And that was the Psychoneuroendocrinology Journal, January 2024. I know it's like just even tapping can reduce cortisol by 27%. Vitamin C can help reduce cortisol. So again, we need cortisol to come up in the morning. That's where you go and look at the sunlight. That can help regulate your nighttime sleep, but you don't want it driving high all day. That's where you get into the trouble. Now we're going to get to my favorite. One of my favorite solutions here is resistance training. Why? Because muscle is where you can throw your sugar. I call it the sugar sponge. It's It's called the glucose sink in the exercise physiology world because this is where you can put those carbohydrates rather than converting them to fat and storing them around your organs, right? It's your biggest place to put your sugar. And when you contract your muscles, you increase glucose uptake. So, and improve insulin sensitivity. So it's super important. Like, this is my favorite thing to do. So when you are doing resistance training, you're going to help build that muscle. You're going to help improve strength. You're going to help improve insulin sensitivity. You're going to reduce inflammation. You're going to teach your body how to handle cortisol better. You're going to reduce your waist circumference and that visceral adipose tissue. So super important. If you haven't checked out my 2x2x2 workout or how to get started on a resistance training program, I have made it easy for you. I've broken it all down. So check that out. I even have a resistance training So, and how you can do this in literally 30 minutes twice a week or 10 minutes a day. So there really are no excuses here. In fact, there was a network meta-analysis of 84 randomized trials that found that resistance training, aerobic training, combined training, and HIIT, high-intensity interval training, all can improve visceral fat-related outcomes. This was Obesity Review, March 2024. But what I'm going to tell you is My vote, move more all throughout the day, add in resistance training at least twice a week, full body, multi-joint, and then your HIIT training, which we'll kind of talk about next. In fact, shout out to Dr. Bill Campbell. He's got a great Instagram and he talks about HIIT training as being the most effective form of exercise for really targeting visceral adipose tissue. So what is HIIT training? HIIT training is doing short bursts of hard, big effort. Followed by recovery bursts. So maybe you sprint for a minute, walk for a minute, maybe you run the stairs for a minute, come back down them for a minute, but it's hard, easy, hard, easy. And the recovery is active. It's not sitting on the couch. Hard, easy, hard, easy. Super time efficient. Really good for improving VO2 max and elevating your lactate. So a study of postmenopausal women with type 2 diabetes found that 16 weeks of HIIT Reduced abdominal fat. And this was in Diabetes Metabolism, December 2016. And then another meta-analysis also found that HIIT can reduce both total and abdominal fat in women before and after menopause. This was in Experimental Physiology, September 2020. Here's one thing though that you'll hear, and I just got to set the record straight on this because you'll hear HIIT raises cortisol, avoid this high intensity. Yes, it does. And that's great. It's gonna temporarily, acutely raise cortisol, actually helps your body handle stress better. So your cortisol will come up, but then it will adjust and come down lower. So here's what you wanna think about with cortisol. You wanna get up in the morning, go see the sunlight, raise your cortisol. That can boost it like 50%. That'll help you sleep better. As I mentioned earlier, you wanna have your cortisol have a normal rhythm, not be chronically elevated. It turns out that high-intensity interval training can actually help your nervous system learn how to regulate itself better. So that's a bonus. Do not fear the cortisol. Fear the chronically elevated cortisol. All right, let's talk about diet. Now, it's not like one diet's going to be specifically great for visceral adipose tissue. There's a couple things that can impact that, which we'll talk about. But the whole thing here is for you to be getting what you need in your diet, the protein, the fiber, the phytonutrients, the vitamins, minerals, protecting your muscle, and if needed, going into a caloric deficit to really target overall body fat. So how do we do this? First, eat protein first. I've talked about this before. You want to make sure you have the essential amino acids from protein to support muscle. Follow next with fiber, lots of plants. A little bit of fruit, lots of different colors of vegetables to get both the fiber and the phytonutrients. You'll also get some from minimally processed carbohydrates or unprocessed carbohydrates. So slightly cooled, cooked and cooled potatoes, wild rice, maybe quinoa, beets, pumpkin, those types of things. And I always say unprocessed or minimally processed there because there's a big difference between a potato and a potato chip, obviously. And then of course, healthy fats round this whole thing out. I go protein first, then fiber, because you're going to be full and it's— you're going to be way less likely to overeat. It gets it way easier to start to rotate in a caloric deficit, which can be super helpful for burning off that fat. A meta-analysis found that both exercise and caloric restriction help reduce visceral fat with a dose-response relationship observed for exercise. This was the British Journal of Sports in Sports Medicine. It was August 2023. There are 2 foods or food categories that can really impact This area. And one is ultra-processed food for a couple reasons. Number one, ultra-processed foods tend to cause overeating. They've got high energy density, very low satiety. You eat them fast and they trigger your reward system. It's a recipe for disaster. In fact, there was an NIH inpatient trial that found that patients eat about 500 more calories a day and gained about 2 pounds in 2 weeks when given ultra-processed foods as the option, and when they were given the minimally processed foods the option, they lost 2 pounds and they ate 500 calories less. This was published in Cell Metabolism, July 2019. It was a very controlled study done in a metabolic ward. So we know that ultra-processed foods make you overeat. But the other piece about ultra-processed foods is they tend to be higher in high fructose corn syrup, which is higher in fructose. Fructose, especially the fructose found in things like sodas, sweetened coffee drinks, energy drinks, juices, and snack foods, can be especially problematic. Fructose can only be metabolized by the liver, and if it can't be stored in the liver as glycogen, guess what? It's turned into fat. Can lead to fatty liver, can lead to insulin resistance. There was a review of 160 169 controlled trials that found that excess energy from sugars, especially from sugar-sweetened beverages, increased body fat. And if you reduce those calories, guess what? You lost it. I don't know why they need studies for some of this stuff. That was the American Journal of Clinical Nutrition, April 2023. So I said there were 2 things that can be problematic, especially problematic. Fructose is one. Alcohol is the other. Here's the thing. When you're drinking alcohol, your body is going to prioritize getting rid of that alcohol. 'Cause it's a toxin. So if you're drinking alcohol, you're not burning fat, right? It's basically gonna stop fat oxidation. But the other couple things that happen when you drink alcohol is you tend to throw your inhibitions out the window. And that can mean inhibitions about what you're eating tends to make you make bad choices, especially late at night. And then your sleep gets messed up. That's another one, which means you're not gonna be able to work out as hard the next day. And if your sleep's not great, then you tend to be hungry the next day too. So just a lot of problems. There are some observational studies out there that associate alcohol intake with greater abdominal or visceral fat. Of course, that has a lot to do with how much you're drinking, when you're drinking. But, you know, beer belly's called beer belly for a reason. And finally, you know, visceral fat definitely has a hormonal component— cortisol, insulin— but it is not controlled by by hormones alone. So there's a whole lot of evidence for how many calories you're eating. Are you getting the protein and fiber in that you need? Are you doing resistance training? Are you doing HIIT training and getting your NEAT, a lot of movement in, you know, not being sedentary? How about great sleep and managing stress, getting rid of the alcohol or lowering it, bumping out those ultra-processed foods, and HRT? Those are all the things that there's evidence that can help. Now, I said something about destroying visceral adipose tissue. Here's the There's not one approach here. It's doing all the things. Of course, all these things I'm talking about are going to make you healthier overall too. So these are all things you want to be doing, right? And when you do them, they're going to help lower visceral adipose tissue, but you got to keep doing them. And I want to make sure too, when you look at what helps people keep things, keep their weight off, I'm going to talk the same about visceral adipose tissue. Do the same things. Get that activity in. Do all the things I just mentioned. But more importantly, also be regular about your tracking. Track your body composition every day, take the average each week, but track your waist measurement and your waist and hip every week too, so that if you start to notice a shift in the wrong direction, you can do something about it. All right, if you've got a friend struggling with belly fat, don't let them suffer. Share this episode with them. And if you have found something useful here, I'd love to hear it in the comments. What are you starting with? What was an aha for you? All right, I'll see you next time. Thanks for tuning in.