The Truth About Fat
Everything you need to know about fat, including an explanation of which is worse -- belly fat or thigh fat.
White fat is much more plentiful than brown, experts agree. The job of white fat is to store energy and produce hormones that are then secreted into the bloodstream.
Small fat cells produce a "good guy" hormone called adiponectin, which makes the liver and muscles sensitive to the hormone insulin, in the process making us less susceptible to diabetes and heart disease.
When people become fat, the production of adiponectin slows down or shuts down, setting them up for disease, according to Fried and others.
Subcutaneous fat is found directly under the skin. It's the fat that's measured using skin-fold calipers to estimate your total body fat.
In terms of overall health, subcutaneous fat in the thighs and buttocks, for instance, may not be as bad and may have some potential benefits, says Cypess. "It may not cause as many problems" as other types of fat, specifically the deeper, visceral fat, he says.
But subcutaneous fat cells on the belly may be another story, says Fried. There's emerging evidence that the danger of big bellies lies not only in the deep visceral fat but also the subcutaneous fat.
Visceral or "deep" fat wraps around the inner organs and spells trouble for your health. How do you know if you have it? "If you have a large waist or belly, of course you have visceral fat," Whitmer says. Visceral fat drives up your risk for diabetes, heart disease, stroke, and even dementia.
Visceral fat is thought to play a larger role in insulin resistance -- which boosts risk of diabetes -- than other fat, Whitmer tells WebMD. It's not clear why, but it could explain or partially explain why visceral fat is a health risk.
Whitmer investigated the link between visceral fat and dementia. In a study, she evaluated the records of more than 6,500 members of Kaiser Permanente of Northern California, a large health maintenance organization, for an average of 36 years, from the time they were in their 40s until they were in their 70s.
The records included details on height, weight, and belly diameter -- a reflection of the amount of visceral fat. Those with the biggest bellies had a higher risk of dementia than those with smaller bellies. The link was true even for people with excess belly fat but overall of normal weight.
She doesn't know why belly fat and dementia are linked, but speculates that substances such as leptin, a hormone released by the belly fat, may have some adverse effect on the brain. Leptin plays a role in appetite regulation but also in learning and memory.
Belly fat has gotten a mostly deserved reputation as an unhealthy fat. "Understand that belly fat is both visceral and subcutaneous," says Kristen Gill Hairston, MD, MPH, an assistant professor of medicine at Wake Forest University School of Medicine, Winston-Salem, N.C. "We don't have a perfect way yet to determine which [of belly fat] is subcutaneous or visceral, except by CT scan, but that's not cost-effective."