It used to be if you could "pinch and inch" around your middle, you could be pretty sure you needed to lose a few pounds. Back then, we viewed belly fat as the same as any other kind of fat. As it turns out, visceral belly fat can be a much more serious risk factor than other fat.

Fat comes in two forms: subcutaneous and visceral. Subcutaneous fat is the layer you can pinch just under the skin. Visceral fat is deep in the body; you can’t pinch it.

Recent research has revealed that visceral fat is bad for you for two reasons. Visceral belly fat is situated in the region of the body near the portal vein, a major vessel that feeds the liver. Since visceral fat cells release harmful fatty acids, they can access the portal vein and set off a chain of physiological events that can lead to insulin resistance. Fat cells are known to release good and bad hormonelike substances. The good substances such as Leptin, (helps regulate the appetite by sending a message to the brain that you are full,) and Adiponectin, (helps your body fight insulin resistance) are decreased in the presence of visceral fat. Harmful substances such as Interleukin-6 and Tumor necrosis factor-alpha can worsen insulin resistance and cause low-level inflammation in the body.

These recent studies on visceral fat help explain a well-established fact: that having a Pear shape is more healthful than having an Apple shape. The Pear shape is caused by subcutaneous fat resting just under the skin. The Apple shape is caused by deep, visceral fat. Although both body types — Apple and Pear — can be overweight, what this means is, the one with the most health risks is the Apple. Even people with normal weight who have an Apple shape can be at a higher health risk without knowing it.

The evidence against visceral fat is so strong that some health experts are suggesting we focus on our waists and "inch loss" instead of using our scales and monitoring our weight. The good news is, moderate exercise makes a big difference when it comes to reducing belly fat. A 2001 study published in the American Journal of Clinical Nutrition showed that women on a diet-and-exercise program lost between 37% and 41% of their visceral fat, with a total weight loss of 15%. Another study in Obesity Research found that those who exercise tend to lose more visceral fat than those who use strictly diet alone. In a separate study from the University of Pennsylvania, researchers found that among women who made no dietary changes, a twice-weekly, strength-training program slowed down the visceral fat gain over a two year period.

At least visceral fat is not stubborn. It’s not hard to lose. Even a small effort can make a big difference in cardiovascular health. Research shows that 30 to 45 minutes of brisk walking, (as if you’re late for a bus,) five days a week will take a good whack at visceral fat. The exercise should be intense enough that you feel your heart rate increase and could even sweat, but you should still be able to carry on a conversation.

The fact that research participants who became more active lost a significant amount of belly fat could help explain why some people who start an exercise regime say their pants fit better, even though they haven’t lost much weight. If you start with a realistic, achievable goal that you can stick to, you can start adding up the inches lost.

It has been said that visceral fat is sort of like a checking account: easy in, easy out. Excess peripheral fat, like the fat in the rear end, is like a retirement account. It’s not that easy to get out!

Next month we’ll cover the surprising news that one way to get rid of fat in the mid-section is to take active steps to reduce stress. I’ll also explore some of the encouraging news about dietary choices that work well in combination with these stress reduction methods.

– Pam Brooks