Visceral Adipose Tissue (VAT) is a type of fat stored deep within the abdominal cavity, wrapping around internal organs like the liver, pancreas, and intestines. Unlike the pinchable subcutaneous fat located just beneath the skin, VAT is hidden and often goes unnoticed. Dual-Energy X-ray Absorptiometry (DEXA) has emerged as a precise clinical tool used to quantify this internal fat. DEXA scanning measures whole-body composition and isolates the amount of VAT present in the abdominal region, providing a specific indicator of metabolic health.
The Health Implications of Visceral Fat
Visceral fat is metabolically active and functions more like an endocrine organ. Excess VAT poses a significantly greater threat to health than subcutaneous fat because high levels actively secrete inflammatory molecules (adipokines) directly into the portal vein. These substances travel straight to the liver, initiating a state of chronic, low-grade inflammation throughout the body. This inflammatory signal interferes with the body’s ability to respond to insulin, leading to insulin resistance and significantly increasing the risk of developing Type 2 Diabetes. Excess VAT is also strongly linked to the development of metabolic syndrome, which includes high blood pressure and an unfavorable blood lipid profile. Over time, visceral fat accumulation elevates the risk of cardiovascular disease, including heart attack and stroke.
DEXA Technology and Specific VAT Measurement
DEXA is widely considered a gold-standard method for body composition analysis due to its precision and ability to differentiate between various tissue types. The scanner emits two distinct, low-dose X-ray beams through the body. Bone, lean tissue, and fat absorb these beams differently, allowing the software to calculate the exact mass of each component. For visceral fat measurement, the specialized software focuses on the “android” or abdominal region, which is a defined area of the trunk. Within this region, the software separates total abdominal fat into outer subcutaneous fat and deeper visceral fat surrounding the organs. While Magnetic Resonance Imaging (MRI) is the reference standard, DEXA provides a highly reliable estimate of VAT mass and volume. VAT metrics are commonly reported as mass (grams or pounds) or as an area measurement in square centimeters (cm²). This ability to quantify fat volume within the abdominal cavity sets DEXA apart from less precise methods. The measurement provides an objective number that can be tracked over time to monitor metabolic risk.
Understanding VAT Score Ranges
Interpreting the numerical VAT value is essential, as established clinical thresholds categorize risk based on its close association with cardiometabolic disease. While the exact numbers can vary slightly depending on the DEXA manufacturer (such as Hologic or GE Lunar) and the specific population studied, general guidelines exist for the most common output metrics.
VAT Area (cm²)
When VAT is reported as an area in square centimeters (cm²), a score less than 100 cm² is considered low-risk. A VAT area between 100 cm² and 160 cm² indicates a moderate-risk category for metabolic disease. A measurement above 160 cm² is regarded as a high-risk score, which warrants immediate lifestyle or medical intervention.
VAT Mass (lbs)
When VAT is reported as mass in pounds (lbs), a low-to-moderate risk range is under 1.1 lbs. A moderate risk is defined as 1.1 lbs to 2.2 lbs, and a score above 3.3 lbs is considered high risk. These ranges are risk indicators, not diagnostic criteria. Individual thresholds can be lower for certain groups, such as those of South Asian descent or younger adults. Tracking the trend of your score across multiple scans is often more informative than a single reading.
Practical Steps for Reducing Visceral Fat
Visceral fat is highly responsive to targeted lifestyle modifications for those with a high VAT score. Consistent aerobic exercise is particularly effective at reducing VAT, with recommendations often between 150 to 300 minutes of moderate-intensity activity per week. High-intensity interval training (HIIT) is also potent in shrinking the visceral fat depot.
Dietary intervention should focus on reducing refined carbohydrates, trans fats, and sugary beverages, as these strongly contribute to VAT accumulation. Increasing soluble fiber intake (oats, beans, and apples) is linked to a slower rate of visceral fat gain. Prioritizing lean protein sources and whole grains supports muscle preservation while promoting fat loss.
Managing chronic stress and prioritizing sleep are also effective interventions. High levels of the stress hormone cortisol promote fat storage in the abdominal area. Incorporating stress-reducing practices and ensuring seven to nine hours of quality sleep creates a hormonal environment favorable for reducing visceral fat and improving overall metabolic health.