"Visceral Fat's Role in Carotid Atherosclerosis Uncovered"

In a recent publication, researchers have highlighted the significant role of visceral fat in association with carotid atherosclerosis, a condition characterized by the buildup of plaques in the carotid arteries, which is crucial for supplying blood to the brain. This important study, published on October 29, 2025, asserts that higher visceral fat levels are correlated with increased instances of atherosclerosis of the carotid artery, persisting even after adjusting for common cardiovascular risk factors.

The Distinction of Visceral Fat

Visceral fat, unlike subcutaneous fat, is largely concentrated around internal organs. While body mass index (BMI) serves as a readily accessible metric by comparing height to total weight, it incorporates all fat, including that found beneath the skin. This makes BMI a less accurate measurement for assessing organ fat, which has profound implications on cardiovascular health.

Accumulating evidence suggests that examining visceral adipose tissue and hepatic fat provides critical insights into an individual's cardiometabolic risk and overall health. Various studies have identified this form of fat as a contributing factor to conditions such as:

• Type 2 diabetes mellitus (T2DM)
• Hypertension
• Elevated cholesterol
• Increased inflammation
• Poor cognitive function
• Certain cancers

Study Design and Cohorts

The research team utilized data from two extensive cohorts: the Canadian Alliance for Healthy Hearts and Minds (CAHHM), with 6,760 Canadian participants, and the UK Biobank (UKB), which comprised 26,547 participants. Each cohort offered valuable insights, with mean ages of 57.1 and 54.7 years, respectively. However, it is important to note that these mainly European cohorts may limit the generalizability of the findings to more diverse populations.

Measuring Atherosclerosis

To assess carotid atherosclerosis, the researchers employed advanced imaging techniques:

Findings and Implications

The findings revealed that in the Canadian cohort, both visceral adipose tissue and hepatic fat fraction were positively associated with increased cardiovascular risk factors, including a higher probability of hypertension, diabetes, and dyslipidemia. Moreover, an increment in visceral adipose tissue volume correlated with a notable increase in carotid wall volume, regardless of cardiovascular risk factors.

Similarly, the UK cohort established a connection between visceral adipose tissue and carotid intima-media thickness, even after adjusting for cardiovascular risks. This reinforces the conclusion that visceral fat and hepatic fat are critical factors in the development of carotid atherosclerosis.

“This study shows that even after accounting for traditional cardiovascular risk factors like cholesterol and blood pressure, visceral and liver fat still contribute to artery damage,” stated Russell de Souza, co-lead author of the study.

Clinical Implications

The implications of this research are vast and raise further questions in clinical practice. As visceral fat emerges as a crucial marker for cardiovascular conditions, there is a growing consensus among experts that assessing obesity and cardiovascular risk needs a more nuanced approach. As Sonia Anand, the corresponding author, suggests, “You can’t always tell by looking at someone whether they have visceral or liver fat.”

Recommendations

Currently, the most effective methods for reducing visceral and hepatic fat include lifestyle and behavioral modifications:

• Regular exercise
• Maintaining a healthy body weight
• Adopting a Mediterranean diet, while avoiding unhealthy foods such as fried or heavily processed items
• Implementing time-restricted eating and exploring dietary patterns like very low-calorie ketogenic diets

Conclusion

This study adds substantial evidence to the already extensive literature on the impact of visceral fat on cardiovascular health and challenges conventional interpretations of obesity based solely on BMI. The findings highlight the crucial need for further research to establish effective interventions that target visceral fat.

Literature Cited

[1] de Souza, R. J., et al. (2025). Visceral adipose tissue and hepatic fat as determinants of carotid atherosclerosis. Communications Medicine, 5(1), 424.

[2] Brixner, D., et al. (2008). Association between cardiometabolic risk factors and body mass index. Journal of Managed Care Pharmacy, 14(8), 756–767.

[3] Neeland, I. J., et al. (2019). Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. The Lancet Diabetes & Endocrinology, 7(9), 715–725.

[4] Anand, S. S., et al. (2022). Evaluation of Adiposity and Cognitive Function in Adults. JAMA Network Open, 5(2), e2146324.

[5] Al Rifai, M., et al. (2015). The association of nonalcoholic fatty liver disease and subclinical atherosclerosis. Atherosclerosis, 239(2), 629–633.

[6] Mellinger, J. L., et al. (2015). Hepatic steatosis and cardiovascular disease outcomes. Journal of Hepatology, 63(2), 470–476.

[7] Pisto, P., et al. (2014). Fatty liver predicts the risk for cardiovascular events. BMJ Open, 4(3), e004973.

[8] Kotronen, A., & Yki-Järvinen, H. (2008). Fatty liver: a novel component of the metabolic syndrome. Arteriosclerosis, Thrombosis, and Vascular Biology, 28(1), 27–38.