What’s Your Gut Tell You?

Stanley Hazen M.D., Ph.D.,

Here’s why: While women tend to gain weight in their hips and thighs, men are more likely to develop potbellies. In general, above-the-waist fat, which is associated with visceral or truncal fat, is different from below-the-waist bulges, which mostly is made up of so-called peripheral fat. Visceral fat has a different cellular composition, including an abundance of white blood cells. This fat generates pro-inflammation mediators such as hormones and proteins linked to hardening of the arteries, or atherosclerosis.

In addition, the white blood cells direct other cells to turn on and off, so the person ends up with a new metabolism that is not as sensitive to recognizing insulin. When signaling by the insulin receptors in the body becomes blunted, insulin cannot as readily regulate glucose metabolism. The changes, however, don’t stop there. Levels of high-density lipoprotein (HDL) cholesterol, or “good” cholesterol, drop, and low-density lipoprotein (LDL) cholesterol, or “bad” cholesterol, and triglyceride levels climb, putting patients at higher risk for heart disease. "This all works together to put patients who have significant visceral fat at higher risk for heart disease," notes Dr. Hazen.