Rapid urbanisation and sedentary lifestyles have been key factors that have triggered the obesity crisis. It is believed that more than 13% of the world’s adult population is obese (BMI greater than 30). A report by the World Health Organization (WHO) in 2019 indicated that around 38.2 million children became overweight or obese even before they reached 5 years of age.
While generalized obesity is considered a public health issue, several studies have shown that people with excess abdominal fat are more prone to develop diabetes later in life. Abdominal fat, also known as visceral fat or central obesity, is associated with insulin resistance (body not absorbing insulin), high glucose levels and hyperinsulinemia (high insulin levels in the body), which ultimately results in diabetes.
What is abdominal fat?
Abdominal fat is the fat present around the tummy region giving the body the shape of an apple. Since this fat is stored within the abdominal cavity, it surrounds a number of vital organs such as the liver, pancreas and intestines. The excess fat present in the abdominal region is classified into three types:
- Visceral fat: This fat accumulates around the organs. It cannot be felt as it is stored deep within and is firm.
- Subcutaneous fat: This fat accumulates under the skin. It can be felt easily and is soft.
- Ectopic fat: This fat not only accumulates in the fat tissues but also in regions where fat is generally present in small quantities, such as muscles, heart, liver and pancreas.
Amongst all these, visceral fat is known to have a significant impact on diabetes-related risk factors. Studies have shown that visceral fat releases a protein called retinol-binding protein 4, which increases insulin resistance in the body. Insulin resistance in the body causes increased sugar levels in the blood, eventually causing diabetes.
Who is more likely to gain abdominal fat?
People with an imbalance between calories consumed and calories spent are more likely to be obese or overweight. Increased intake of calorie-rich foods and diets high in fat and sugars are the primary culprits of obesity, alongside other lifestyle habits such as physical inactivity.
It has also been noticed that although women have a higher percentage of fat than men, the latter are more prone to gaining central obesity (abdominal fat), while women exhibit more deposition of gynoid fat (fat around the pelvic region).
How is abdominal fat linked with diabetes?
There are several studies that highlight the relationship of abdominal fat with diabetes, some of which include:
- A meta-analysis published in the journal Hindawi included 41 studies in which scientists examined the effect of fat tissues in non-diabetic people and in those diagnosed with diabetes or prediabetes. The results of the study showed that diabetes was more prevalent in people with visceral fat as compared to those with subcutaneous fat.
- Another study conducted in Shanghai, China in 2018 included 4658 diabetic participants who underwent several tests such as blood pressure, glucose, lipid profile, and urine culture and measurements such as height, weight, waist circumference, neck circumference and hip circumference. The results of the study showed that people with high visceral fat were prone to diabetic kidney disease, cardiovascular disease and cerebrovascular disease (related to the brain).
- A research conducted by Dr Mohans’ Diabetes Specialities Centre & Madras Diabetes Research Foundation, Chennai, included 26000 subjects to determine the effect of visceral and subcutaneous fat (abdominal fat) on insulin resistance in people with no history of diabetes. The result of the study showed that people with visceral fat showed they were more at risk of developing metabolic syndrome irrespective of their age, gender, generalized obesity and glycemic control.
What can be done to manage central obesity?
There are certain things that can help in combating abdominal fat, thereby reducing the risk of diabetes.
- Exercise regularly for at least 30 to 60 minutes a day to control weight and lose belly fat. One can practice moderate-intensity physical activities such as swimming, brisk walking, cycling and yoga.
- Practice strength training, such as lifting weights, to cut down abdominal fat.
- Avoid simple carbohydrates such as white bread, polished rice and grains, and carbonated drinks. Instead, add complex carbohydrates such as whole grains, vegetables, fruits and lean protein to your diet. While maintaining a healthy diet, lay emphasis on controlling the portion size.
- Consume healthy fats such as flax seeds, sunflower seeds, olive oil, nuts and nut butter.
- Significantly cut down and limit the consumption of alcohol, to an occasional drink.
- Sleep for at least 7 hours a day.
- Check the blood sugar levels routinely, especially if you have a family history of diabetes.
It is a well-known fact that obesity is a risk factor for a number of diseases including hypertension, diabetes, heart diseases and stroke. Abdominal fat is not only dangerous for people with a family history of diabetes but can also increase the risk of developing diabetes in healthy people. Scientists are trying to develop drug treatments that would target abdominal fat. Meanwhile, eating healthy, exercising and quitting a sedentary lifestyle would help people fight abdominal (visceral) fat.