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VISCERAL FAT
AND
COGNITION
Presented by:
Dr. Nidhi Sharma (PT)
Associate Professor
MMIPR, MM (DU), Mullana,Ambala
CONTENTS
 Introduction to body fat
 Types of Fat
 Visceral fat
 Prevalence of visceral fat
 Measurement of visceral fat
 Pathophysiology behind
visceral fat
 Adverse effects of visceral fat
 Cognition
 Types of cognition
 Relation between visceral fat
and cognition
 Recent studies
 Neurological conditions
involved
 Visceral fat reduction
 Physiotherapy management
 Other exercises
Introduction to Body Fat
 Bad reputation
 Everyone tries to exercise it away
 But for researchers, it is the most fascinating
and intriguing organ
 Fat has more functions in the body than we
thought.
 When we are hungry, fat stores could be
mobilized.
 Metabolism could be controlled by the hormones
released from fats.
Types of Fat
 Brown fat: activated when you feel cold, helps to
maintain body temperature by producing heat.
 White fat: store energy and produce hormones
that makes us less susceptible to diabetes and
heart diseases.
 Subcutaneous fat: found directly under the skin,
normally harmless and may even protect from
some of the diseases
Abdominal Subcutaneous AdiposeTissue: A Protective Fat Depot? Porter et al.; Diabetes
care, 2009 June; 32(6)
Types of Fat contd...
 Visceral Fat: fat wraps around the inner
organs and drives up the risk for many
diseases.
 Belly fat: Belly fat has gotten a mostly
deserved reputation as an unhealthy fat.
Belly fat is both visceral and subcutaneous
https://www.webmd.com/diet/features/the-truth-about-fat#1
VISCERAL FAT
 Visceral fat also termed as
deep fat or active fat.
 It is found in the abdomen
surrounding the internal
organs externally.
 Often misinterpreted as
subcutaneous fat.
1. Dae HyunYoon.et.al:The relationship between visceral adiposity and cognitive performance in older adults:Age and Ageing 2012; 41:
456–461.
VISCERAL FAT contd...
 ensures that there is
some spacing between
the internal organs.
 Visceral obesity is
defined as visceral fat
area more than 130 cm²
at the level of Lȝ.
Tao Huang.et.al: Associations of Cognitive Function with BMI, Body Fat Mass andVisceral Fat inYoung Adulthood:
Medicina 2019, 55, 221.
PREVALENCE
 Central adipocity or obesity rate in 2014 were 41.2% in China.
 In a study of 2018 a total of 35.5% children were categorized as
obese.
 In a study of 2019, they estimated that >340 million children and
adolescents aged 5–19 years and 41 million children under the age
of 5 years were overweight or obese upto 2016.
 In the survey for 2018-2019, at least one- third of the global
population was overweight or obese and >60% of people with
obesity lived in developing countries.
2. Tao Huang.et.al:Associations of Cognitive Function with BMI, Body Fat Mass andVisceral Fat inYoung Adulthood: Medicina 2019, 55, 221.
3. Lauren Raine.et.al:TheAssociations betweenAdiposity,Cognitive Function, and Achievement in Children: Med Sci Sports Exerc . 2018
September ; 50(9): 1868–1874.
4. John E. Hall.et.al: Obesity, kidney dysfunction and hypertension: mechanistic links: nature reviews nephrology.
MEASUREMENT OF VISCERAL
FAT
 Bioelectrical impedance
analysis.
 Body mass index( BMI).
 Dual energy X-ray
absorptiometry.
 VAT Area.
 CT scans.
 Hip-to-waist circumference
ratio.
1. https://care.diabetesjournals.org/content/28/2/451
2. Tao Huang.et.al: Associations of Cognitive Function with BMI, Body Fat Mass and Visceral Fat in Young Adulthood: Medicina 2019, 55, 221.
3. https://www.sciencedirect.com/science/article/pii/S2211568413001393
4. Sandra Henri ´Quez.et.al: Effect of two training modalities on body fat and insulin resistance in Postmenopausal women: Jr. of strength and conditioning
research 31(11)/2955–2964.
PATHOPHYSIOLOGY
Pathophysiology contd...
ADVERSE EFFECT OF
VISCERAL FAT
5. Kyung Mook Choi.et.al: Sarcopenia and sarcopenic obesity: Korean J Intern Med 2016;31:1054-1060
1. Lauren Raine.et.al:The Associations betweenAdiposity, Cognitive Function, andAchievement in Children: Med Sci
Sports Exerc . 2018 September ; 50(9): 1868–1874
COGNITION
 Cognition refers to the
process of thinking.
 Mental action or
process of acquiring
knowledge and
understanding them
through thought,
experiences and the
senses.
8. Deborah H. Schwartz.et.al:Visceral fat is associated with lower executive functioning in adolescents: Int J Obes (Lond)
. 2013 October ; 37(10): 1336–1343
TYPES OF COGNITION
RELATION BETWEEN COGNITION
AND VISCERAL FAT
 Visceral fat produces inflammatory cytokines and hormone.
 It serves as an endocrine organ which secretes
adipocytokines such as interleukins that can exacerbate
inflammation and impair vascular functions.
 It could act to limit cerebral perfusion that can culminate
cognitive functions.
9. Deborah H. Schwartz.et.al:Visceral fat is associated with lower executive functioning in adolescents: Int J Obes (Lond) . 2013 October ;
37(10): 1336–1343
10. Gianluigi Mazzoccoli .et.al:Analysis of MTNR1B gene polymorphisms in relationship with IRS2 gene variants, epicardial fat thickness,
glucose homeostasis and cognitive performance in the elderly: Jr of biological and medical rhythm research 0742-0528 (Print) 1525-6073.
• It drains directly into portal circulation and then to liver in
form of very-low density lipoproteins which leads to disorders
like dyslipidaemia, hypertension and diabetes mellitus.
• IRS2 gene variants are responsible for central adiposity, insulin
sensitivity, cognitive performances and in turn glucose
metabolism.
• Impaired micro vascular function may reduce oxygenation in
the brain and adversely contribute to the pathogenesis of
cognitive disorders.
• A stronger correlation between reduced cognitive function
and increased visceral adiposity (VFA) than global obesity
(BMI) exists in older adults withT2D.
• In younger individuals also, deficits in attention, executive
function, verbal learning, verbal memory, and manual
coordination have been noted with increasing BMI.
• Studies suggest that hormone milieu associated with
obesity itself modulates cognitive changes.
11.Gianluigi Mazzoccoli .et.al:Analysis of MTNR1B gene polymorphisms in relationship with IRS2 gene variants, epicardial fat thickness,
glucose homeostasis and cognitive performance in the elderly: Jr of biological and medical rhythm research 0742-0528 (Print) 1525-6073.
12. Mei Chung MOH.et.al: Role of endothelium-independent vasodilation in the relationship between visceral adiposity and reduced cognitive
performance in older adults with type 2 diabetes: NMRC/CIRG/1398/2014.
13. R.M. Bove.et.al: Metabolic and Endocrine correlates of cognitive function in healthy young women: Obesity (Silver Spring). 2013 July ; 21(7):
1343–1349.
RECENT STUDIES
 According to this recent
study of 2019, males and
females with higher amount
of visceral fat area
calculated by Biomedical
impedance analysis were
slower in task switching
cognitive paradigm as
compared to lean ones.
14.Tao Huang.et.al: Associations of Cognitive Function with BMI, Body Fat Mass andVisceral Fat inYoung Adulthood:
Medicina 2019, 55, 221.
 Results: children who were
obese and hat higher
accumulation of visceral
fat area were poor in
cognitive abilities and
thinking abilities as
compared to children who
were under normal BMI.
15. Lauren Raine.et.al:The Associations between Adiposity, Cognitive Function, andAchievement in Children: Med Sci
Sports Exerc . 2018 September ; 50(9): 1868–1874.
 According to this study of
2017, it is stated that,
people with high visceral
adipose fat have worse
cognitive values as
compared to those with
sub-cutaneous adipose
tissue.
16. Kirby G. Parker.et.al: Relationships of Clinical and ComputedTomographyImaged Adiposity with Cognition in Middle-
Aged and Older African Americans : J Gerontol A Biol Sci Med Sci, 2018,Vol. 73, No. 4, 492–498.
NEUROLOGICAL CONDITIONS
 The neurological conditions
pertaining to cognitive aspects
are:
a) Development of dementia
b) Alzheimer’s disease
c) Parkinson’s disease
d) Multiple sclerosis
e) Huntington's disease, etc.
VISCERAL FAT REDUCTION
Physical
-
therapy
DIETING
17.T. Rice.et.al:Total Body Fat andAbdominalVisceral Fat Response to ExerciseTraining in the HERITAGE Family Study:
Evidence for Major Locus But No Multifactorial Effects : Metabolism,Vo148, No 10 (October), 1999: pp 1278-1286.
PHYSIOTHERAPY MANAGEMENT
 Aerobic exercises including walking
and cycle ergometer are the main
interventions for continued 2 weeks
helps in reduction ofVAT.
 Resistance training benefits the
obese to improve functional
outcomes and cognitive abilities with
decrease in visceral fat cognition and
insulin sensitivity.
18. A.Sabag.et.al: Exercise and ectopic fat in type 2 diabetes : A systematic review and meta-analysis: Elsevier 1262-3636/ 2017.
19.Wayne L.Westcott.et.al: ResistanceTraining is Medicine: Effects of StrengthTraining on Health: Exercise is medicine 1537-
890X/1104/209Y216.
20. Ahmed.H.Abdelhafiz.et.al: Diabetes, nutrition and exercise: Clin. Geriatr. Med. 2015.
 A protocol consisiting of high
intensity endurance (aquagym,
cycling, walking) and resistance
training( free weight training) for 8
weeks was said to proof faster
reduction in visceral fat.
 Bouts of interval training also reduces
visceral fat.The protocol was 4
minute cycling exercise, followed by 3
minutes for recovery excluding warm
up and cool down exercises.
21.A S Alberga.et.al: Effects of aerobic and resistance training on abdominal fat, apolipoproteins and high-sensitivity C-reactive protein in
adolescents with obesity:the HEARTY randomized clinical trial: Internat. Joun. Of Obesity july 2015.
22. Frederic Dutheil.et.al: Different modalities of exercise to reduce visceral fat mass and cardiovascular risks and metabolic syndromes:
internat. Jr.Cardio. 18 (2013).
This presentation contains my own created
material, I declare no conflict of interest.
Copy of material without consent and permission
would be a violation.
Viseral fat & Cognition.pptx

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Viseral fat & Cognition.pptx

  • 1. VISCERAL FAT AND COGNITION Presented by: Dr. Nidhi Sharma (PT) Associate Professor MMIPR, MM (DU), Mullana,Ambala
  • 2. CONTENTS  Introduction to body fat  Types of Fat  Visceral fat  Prevalence of visceral fat  Measurement of visceral fat  Pathophysiology behind visceral fat  Adverse effects of visceral fat  Cognition  Types of cognition  Relation between visceral fat and cognition  Recent studies  Neurological conditions involved  Visceral fat reduction  Physiotherapy management  Other exercises
  • 3. Introduction to Body Fat  Bad reputation  Everyone tries to exercise it away  But for researchers, it is the most fascinating and intriguing organ  Fat has more functions in the body than we thought.  When we are hungry, fat stores could be mobilized.  Metabolism could be controlled by the hormones released from fats.
  • 4. Types of Fat  Brown fat: activated when you feel cold, helps to maintain body temperature by producing heat.  White fat: store energy and produce hormones that makes us less susceptible to diabetes and heart diseases.  Subcutaneous fat: found directly under the skin, normally harmless and may even protect from some of the diseases Abdominal Subcutaneous AdiposeTissue: A Protective Fat Depot? Porter et al.; Diabetes care, 2009 June; 32(6)
  • 5. Types of Fat contd...  Visceral Fat: fat wraps around the inner organs and drives up the risk for many diseases.  Belly fat: Belly fat has gotten a mostly deserved reputation as an unhealthy fat. Belly fat is both visceral and subcutaneous https://www.webmd.com/diet/features/the-truth-about-fat#1
  • 6. VISCERAL FAT  Visceral fat also termed as deep fat or active fat.  It is found in the abdomen surrounding the internal organs externally.  Often misinterpreted as subcutaneous fat. 1. Dae HyunYoon.et.al:The relationship between visceral adiposity and cognitive performance in older adults:Age and Ageing 2012; 41: 456–461.
  • 7. VISCERAL FAT contd...  ensures that there is some spacing between the internal organs.  Visceral obesity is defined as visceral fat area more than 130 cm² at the level of Lȝ. Tao Huang.et.al: Associations of Cognitive Function with BMI, Body Fat Mass andVisceral Fat inYoung Adulthood: Medicina 2019, 55, 221.
  • 8.
  • 9. PREVALENCE  Central adipocity or obesity rate in 2014 were 41.2% in China.  In a study of 2018 a total of 35.5% children were categorized as obese.  In a study of 2019, they estimated that >340 million children and adolescents aged 5–19 years and 41 million children under the age of 5 years were overweight or obese upto 2016.  In the survey for 2018-2019, at least one- third of the global population was overweight or obese and >60% of people with obesity lived in developing countries. 2. Tao Huang.et.al:Associations of Cognitive Function with BMI, Body Fat Mass andVisceral Fat inYoung Adulthood: Medicina 2019, 55, 221. 3. Lauren Raine.et.al:TheAssociations betweenAdiposity,Cognitive Function, and Achievement in Children: Med Sci Sports Exerc . 2018 September ; 50(9): 1868–1874. 4. John E. Hall.et.al: Obesity, kidney dysfunction and hypertension: mechanistic links: nature reviews nephrology.
  • 10. MEASUREMENT OF VISCERAL FAT  Bioelectrical impedance analysis.  Body mass index( BMI).  Dual energy X-ray absorptiometry.  VAT Area.  CT scans.  Hip-to-waist circumference ratio. 1. https://care.diabetesjournals.org/content/28/2/451 2. Tao Huang.et.al: Associations of Cognitive Function with BMI, Body Fat Mass and Visceral Fat in Young Adulthood: Medicina 2019, 55, 221. 3. https://www.sciencedirect.com/science/article/pii/S2211568413001393 4. Sandra Henri ´Quez.et.al: Effect of two training modalities on body fat and insulin resistance in Postmenopausal women: Jr. of strength and conditioning research 31(11)/2955–2964.
  • 11.
  • 12.
  • 13.
  • 16. ADVERSE EFFECT OF VISCERAL FAT 5. Kyung Mook Choi.et.al: Sarcopenia and sarcopenic obesity: Korean J Intern Med 2016;31:1054-1060
  • 17. 1. Lauren Raine.et.al:The Associations betweenAdiposity, Cognitive Function, andAchievement in Children: Med Sci Sports Exerc . 2018 September ; 50(9): 1868–1874
  • 18. COGNITION  Cognition refers to the process of thinking.  Mental action or process of acquiring knowledge and understanding them through thought, experiences and the senses. 8. Deborah H. Schwartz.et.al:Visceral fat is associated with lower executive functioning in adolescents: Int J Obes (Lond) . 2013 October ; 37(10): 1336–1343
  • 20. RELATION BETWEEN COGNITION AND VISCERAL FAT  Visceral fat produces inflammatory cytokines and hormone.  It serves as an endocrine organ which secretes adipocytokines such as interleukins that can exacerbate inflammation and impair vascular functions.  It could act to limit cerebral perfusion that can culminate cognitive functions. 9. Deborah H. Schwartz.et.al:Visceral fat is associated with lower executive functioning in adolescents: Int J Obes (Lond) . 2013 October ; 37(10): 1336–1343 10. Gianluigi Mazzoccoli .et.al:Analysis of MTNR1B gene polymorphisms in relationship with IRS2 gene variants, epicardial fat thickness, glucose homeostasis and cognitive performance in the elderly: Jr of biological and medical rhythm research 0742-0528 (Print) 1525-6073.
  • 21. • It drains directly into portal circulation and then to liver in form of very-low density lipoproteins which leads to disorders like dyslipidaemia, hypertension and diabetes mellitus. • IRS2 gene variants are responsible for central adiposity, insulin sensitivity, cognitive performances and in turn glucose metabolism. • Impaired micro vascular function may reduce oxygenation in the brain and adversely contribute to the pathogenesis of cognitive disorders.
  • 22. • A stronger correlation between reduced cognitive function and increased visceral adiposity (VFA) than global obesity (BMI) exists in older adults withT2D. • In younger individuals also, deficits in attention, executive function, verbal learning, verbal memory, and manual coordination have been noted with increasing BMI. • Studies suggest that hormone milieu associated with obesity itself modulates cognitive changes. 11.Gianluigi Mazzoccoli .et.al:Analysis of MTNR1B gene polymorphisms in relationship with IRS2 gene variants, epicardial fat thickness, glucose homeostasis and cognitive performance in the elderly: Jr of biological and medical rhythm research 0742-0528 (Print) 1525-6073. 12. Mei Chung MOH.et.al: Role of endothelium-independent vasodilation in the relationship between visceral adiposity and reduced cognitive performance in older adults with type 2 diabetes: NMRC/CIRG/1398/2014. 13. R.M. Bove.et.al: Metabolic and Endocrine correlates of cognitive function in healthy young women: Obesity (Silver Spring). 2013 July ; 21(7): 1343–1349.
  • 23.
  • 24. RECENT STUDIES  According to this recent study of 2019, males and females with higher amount of visceral fat area calculated by Biomedical impedance analysis were slower in task switching cognitive paradigm as compared to lean ones. 14.Tao Huang.et.al: Associations of Cognitive Function with BMI, Body Fat Mass andVisceral Fat inYoung Adulthood: Medicina 2019, 55, 221.
  • 25.  Results: children who were obese and hat higher accumulation of visceral fat area were poor in cognitive abilities and thinking abilities as compared to children who were under normal BMI. 15. Lauren Raine.et.al:The Associations between Adiposity, Cognitive Function, andAchievement in Children: Med Sci Sports Exerc . 2018 September ; 50(9): 1868–1874.
  • 26.  According to this study of 2017, it is stated that, people with high visceral adipose fat have worse cognitive values as compared to those with sub-cutaneous adipose tissue. 16. Kirby G. Parker.et.al: Relationships of Clinical and ComputedTomographyImaged Adiposity with Cognition in Middle- Aged and Older African Americans : J Gerontol A Biol Sci Med Sci, 2018,Vol. 73, No. 4, 492–498.
  • 27.
  • 28. NEUROLOGICAL CONDITIONS  The neurological conditions pertaining to cognitive aspects are: a) Development of dementia b) Alzheimer’s disease c) Parkinson’s disease d) Multiple sclerosis e) Huntington's disease, etc.
  • 29. VISCERAL FAT REDUCTION Physical - therapy DIETING 17.T. Rice.et.al:Total Body Fat andAbdominalVisceral Fat Response to ExerciseTraining in the HERITAGE Family Study: Evidence for Major Locus But No Multifactorial Effects : Metabolism,Vo148, No 10 (October), 1999: pp 1278-1286.
  • 30. PHYSIOTHERAPY MANAGEMENT  Aerobic exercises including walking and cycle ergometer are the main interventions for continued 2 weeks helps in reduction ofVAT.  Resistance training benefits the obese to improve functional outcomes and cognitive abilities with decrease in visceral fat cognition and insulin sensitivity. 18. A.Sabag.et.al: Exercise and ectopic fat in type 2 diabetes : A systematic review and meta-analysis: Elsevier 1262-3636/ 2017. 19.Wayne L.Westcott.et.al: ResistanceTraining is Medicine: Effects of StrengthTraining on Health: Exercise is medicine 1537- 890X/1104/209Y216. 20. Ahmed.H.Abdelhafiz.et.al: Diabetes, nutrition and exercise: Clin. Geriatr. Med. 2015.
  • 31.  A protocol consisiting of high intensity endurance (aquagym, cycling, walking) and resistance training( free weight training) for 8 weeks was said to proof faster reduction in visceral fat.  Bouts of interval training also reduces visceral fat.The protocol was 4 minute cycling exercise, followed by 3 minutes for recovery excluding warm up and cool down exercises. 21.A S Alberga.et.al: Effects of aerobic and resistance training on abdominal fat, apolipoproteins and high-sensitivity C-reactive protein in adolescents with obesity:the HEARTY randomized clinical trial: Internat. Joun. Of Obesity july 2015. 22. Frederic Dutheil.et.al: Different modalities of exercise to reduce visceral fat mass and cardiovascular risks and metabolic syndromes: internat. Jr.Cardio. 18 (2013).
  • 32. This presentation contains my own created material, I declare no conflict of interest. Copy of material without consent and permission would be a violation.