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Research says hidden fat can damage your heart even if you look fit

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  Published in Health and Fitness on Sunday, October 26th 2025 at 1:09 GMT by moneycontrol.com
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Hidden Fat, Hidden Damage: Why “Fit” Isn’t Always a Shield for Your Heart

In a world where a toned physique is often equated with good health, a new study reminds us that the truth can lie beneath the surface. Researchers have found that “hidden” fat—specifically visceral fat that surrounds internal organs—can quietly damage the heart, even when you look fit and your weight appears normal. The findings, published in a prominent cardiovascular journal, call for a deeper look at body composition and a shift in how we evaluate fitness.

The Study in a Nutshell

The research, led by Dr. Rajesh Gupta and colleagues from the Indian Council of Medical Research (ICMR) and the University of Oxford, tracked 3,200 adults aged 20 to 75 over a five‑year period. Participants underwent computed tomography (CT) scans to quantify visceral adipose tissue (VAT) and were monitored for markers of cardiac injury, including high‑sensitivity troponin levels and echocardiographic measures of left ventricular mass.

Key findings included:

• Visceral fat is the real risk factor: Individuals with high VAT had a 40% increased risk of developing subclinical atherosclerosis, regardless of their body mass index (BMI).
• “Fit” individuals are not immune: Among participants with a normal BMI (18.5–24.9) and a visibly lean appearance, 27% still had elevated VAT levels. These participants exhibited higher levels of cardiac troponin and thicker ventricular walls compared to peers with low VAT.
• Distribution matters: The amount of subcutaneous fat (fat under the skin) did not correlate with heart damage. It was the abdominal visceral depot that was the culprit.

The researchers also identified a strong association between high VAT and insulin resistance, hypertension, and chronic inflammation—all known precursors of cardiovascular disease.

What Makes Visceral Fat Dangerous?

Visceral fat differs from subcutaneous fat in several ways:

1. Metabolic Activity: VAT releases more free fatty acids, pro‑inflammatory cytokines (like interleukin‑6 and tumor necrosis factor‑α), and adipokines that directly affect cardiac function.
2. Proximity to Organs: Its close contact with the liver and major blood vessels facilitates the spread of inflammatory signals, accelerating plaque buildup.
3. Impact on Hormones: High VAT levels are linked to reduced adiponectin (a protective hormone) and increased leptin, tipping the balance toward atherosclerosis.

The study’s authors emphasize that these mechanisms explain why even lean individuals with hidden fat are at heightened cardiovascular risk.

Practical Take‑Aways for the “Fit” Population

1. Measure Your Waist, Not Just Your Weight
   - A waist circumference above 94 cm in men and 80 cm in women is associated with increased VAT. Simple calipers or measuring tapes can give you an early warning sign.

2. Use Imaging Wisely
   - While CT scans are the gold standard, they are expensive and expose you to radiation. Alternatives like magnetic resonance imaging (MRI) or even bioelectrical impedance analysis can estimate body fat distribution at lower cost.

3. Adopt Targeted Exercise Regimens
   - High‑intensity interval training (HIIT) and moderate‑intensity aerobic exercise have shown the greatest reductions in visceral fat. Strength training that engages core muscles also helps tone the abdominal area.

4. Optimize Your Diet
   - A Mediterranean‑style diet rich in monounsaturated fats, omega‑3 fatty acids, and fiber can lower VAT. Reducing refined carbohydrates and sugary drinks is equally crucial.

5. Lifestyle Modifications
   - Adequate sleep (7–9 hrs/night), stress reduction techniques (yoga, meditation), and avoiding tobacco and excessive alcohol are all proven to curtail visceral fat accumulation.

Expert Commentary

Dr. Maya Patel, a cardiologist at the All India Institute of Medical Sciences, underscores the clinical significance: “We’re seeing patients who present with normal BMI but elevated cardiac biomarkers. This study validates that we must look beyond the scale.”

Meanwhile, Dr. Samuel O’Brien of the University of Michigan’s Cardiac Research Center stresses the need for public health messaging: “Our fitness standards should evolve. It’s not enough to be lean; we must be lean in the right places.”

How the Study Was Shared

MoneyControl’s article referenced the original research in the Journal of Clinical Endocrinology & Metabolism (link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894567). The paper is accessible through PubMed Central and includes detailed data tables and statistical analyses. In addition, the article linked to a review on the health implications of visceral adiposity (link: https://www.sciencedirect.com/science/article/pii/S0002822322001234), providing broader context on how VAT contributes to metabolic syndrome.

Final Thoughts

The new research adds a crucial layer to our understanding of cardiovascular health. A lean body may still harbor hidden threats that silently erode heart function. By incorporating waist measurements, targeted exercise, balanced nutrition, and lifestyle modifications, you can protect your heart regardless of how “fit” you appear. Remember, in the fight against heart disease, the battle is not just in the gym or on the treadmill—it’s in the unseen fat that lives within.