How Ectopic Fat Increases Your Risk for Cardiovascular Disease

Everyone knows that carrying excess fat is not good for your health. But not all fat is created equal. The fat most dangerous to health is the fat you don’t see.

Most body fat is subcutaneous, just below the skin. Hidden fat is known as visceral body fat – stored deep inside the abdomen – and ectopic fat, which accumulates in the liver, heart, pancreas and muscles. Visceral fat, which surrounds some of the vital organs, has been known for many years to cause insulin resistance and pose a risk for type 2 diabetes and cardiovascular disease. More recently, evidence has shown that ectopic fat also increases risk for these diseases.

What Is Ectopic Fat?

Ectopic literally means “in an abnormal place” – fat that collects where it does not belong. If you’ve heard of non-alcoholic fatty liver disease, that is a type of ectopic fat. It’s insidious and often goes undetected. But just like visceral fat, ectopic fat can interfere with cellular and metabolic functions and increase risks of serious health problems, such as type 2 diabetes, heart disease, high blood pressure and stroke.

How do you know if you have a hidden fat problem? People with large waistlines and high body mass index (BMI) measurements are most at risk. But even those with flat stomachs and normal BMI can have hidden fat that puts them at risk, says UH cardiologist Ian Neeland, MD.

“BMI is a crude measurement of excess body fat,” Dr. Neeland says. “In large populations, it can identify people at higher risk for disease. But it doesn’t provide enough information to fully assess individual risk.”

Dr. Neeland’s research has focused on using medical imaging to precisely measure distribution of body fat. He hopes one day that quick scans will be standard practice for assessing risk of disease.

“In a clinical setting, a six-minute MRI scan can quantify fat deposits around the body,” says Dr. Neeland, Director of the UH Center for Cardiovascular Prevention. “We can screen people at high risk and detail their risk. We can do the scans quickly and safely.”

Exercise Can Help

Dr., Neeland is lead author of a 2019 report published in The Lancet Diabetes & Endocrinology that advocated for identifying visceral and ectopic fat in clinical practice. The researchers said visceral and ectopic fat should be monitored along with body weight as people age.

The good news is that diet and exercise can reduce the amount of hidden body fat. Dr. Neeland’s research has found that exercise especially is beneficial. One study used magnetic resonance imaging (MRI) and computed tomography (CT) imaging to measure visceral body fat of about 3,600 participants, and found exercise was more effective than medications at thinning the fat.

“Diet and aerobic activity are extremely important. They can reduce hidden fat, even without weight loss,” he says.

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UH Harrington Heart & Vascular Institute offers more options for cardiovascular care close to home with multiple locations across Northern Ohio. Ongoing investments in our local facilities ensure our team has the latest tools and therapies available to continue to deliver truly personalized care for patients where and when they need it most. Learn more about cardiovascular care at UH Harrington Heart & Vascular Institute.