Belly fat is made of both visceral fat and subcutaneous fat. Subcutaneous fat is the fat stored under the skin all over our body as well as in the belly, and in and of itself, is less harmful. Visceral fat forms the second component of belly fat. Visceral fat pads the space between abdominal organs and sets the stage for disease. But why? What is the difference between these two types of fat?

These two types of fat cells look and function differently.

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Subcutaneous fat cells are smaller than visceral fat cells and there are more of them.

Visceral fat cells are larger in size than subcutaneous fat cells and are biologically active. They actually function like an endocrine organ. Visceral fat cells produce different products that affect our health and lead to disease. They produce:

Cytokines
Specific proteins
Free fatty acids

1. Cytokines affect the behavior of other cells and are especially important for immune function where they regulate inflammation. The balance between pro- and anti-inflammatory cytokines plays a critical role in the body's response to inflammatory stimulus. Visceral fat cells release pro-inflammatory cytokines which support the development of inflammation, cancer (especially colorectal cancer and breast cancer), heart disease, type 2 diabetes, stroke, as well as oxidation which leads to dementia, Alzheimer's disease and ageing.

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2. Proteins such as retinol-binding protein are also released by visceral cells which lead to insulin resistance increasing the risk for type 2 diabetes by affecting the body's ability to metabolize sugar due to glucose intolerance. Another protein that visceral fat promotes its production is the steroid hormone cortisol, the stress hormone. Higher and more prolonged levels of cortisol in the bloodstream have negative effects on the thyroid gland, decrease bone density and lower immunity as well as influence our mood.

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3. Free fatty acids are also released by visceral fat cells. Free fatty acids are the building blocks for making triglycerides. Due to the close proximity between the visceral fat and the portal vein, which carries blood from the intestinal area to the liver, the free fatty acids released from the visceral fat enter the portal vein and travel to the liver, where they influence the production of blood lipids, increasing total cholesterol and LDL cholesterol. Both are risk factors for heart disease. Furthermore, excess fat in the liver is a key marker of metabolic dysfunction inhibiting the ability of insulin to stimulate muscle glucose uptake.

So how do you know when visceral fat levels are too high?

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You can do an MRI scan to get precise results, but also just by measuring your waistline you can determine if it is time to urgently change your lifestyle habits:

Men are considered at high risk if they have a waistline of over 40 inches.
Women are considered at high risk if they have a waistline of over 35 inches.
Measure your waistline one inch below your belly button by using a seamstress measuring tape.

It is obviously best to start changing lifestyle habits before this critical stage is reached.

If you have determined that it's time to change your lifestyle habits, where should you begin?

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Spot exercising, such as doing sit-ups, will tighten abdominal muscles, but won't reduce visceral fat. Instead, start with any chosen endurance exercise, including walking, and do it continuously for 30 minutes, at least three times a week.

Increase fiber intake which helps remove fat from the body before it gets absorbed. Do this by increasing fruit, vegetable and whole grain intake while removing empty calories including sugar and excess alcohol.

Reducing overall energy intake will also lead to a large reduction in liver fat and improvement in insulin sensitivity. The best way to do this is to reduce the amount of fat rich foods eaten during any given meal and to snack on healthy, low energy density foods especially vegetable sticks and fruit in between meals.