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Everything you need to know about fat, including an explanation of which is worse -- belly fat or thigh fat. Reviewed by Louise Chang, MD on July 13, 2009 For most of us, body fat has a bad reputation. From the dimply stuff that plagues women's thighs to the beer bellies that can pop out in middle-aged men, fat is typically something we agonize over, scorn, and try to exercise away. But for scientists, fat is intriguing -- and becoming more so every day. "Fat is one of the most fascinating organs out there," says Aaron Cypess, MD, PhD, an instructor of medicine at Harvard Medical School and a research associate at the Joslin Diabetes Center in Boston. "We are only now beginning to understand fat." "Fat has more functions in the body than we thought," agrees Rachel Whitmer, PhD, research scientist at the Kaiser Permanente Division of Research in Oakland, Calif., who has studied the links between fat and brain health. To get the skinny on fat, WebMD asked four experts on fat -- who, not surprisingly, prefer not to be called fat experts -- to fill us in. Fat is known to have two main purposes, says Susan Fried, PhD, director of the Boston Obesity and Nutrition Research Center at Boston University and a long-time researcher in the field. But that's the broad brushstroke picture. Read on for details about various types of fat -- brown, white, subcutaneous, visceral, and belly fat. Brown fat has gotten a lot of buzz recently, with the discovery that it's not the mostly worthless fat scientists had thought. In recent studies, scientists have found that lean people tend to have more brown fat than overweight or obese people -- and that when stimulated it can burn calories. Scientists are eyeing it as a potential obesity treatment if they can figure out a way to increase a person's brown fat or stimulate existing brown fat. It's known that children have more brown fat than adults, and it's what helps them keep warm. Brown fat stores decline in adults but still help with warmth. "We've shown brown fat is more active in people in Boston in colder months," Cypess says, leading to the idea of sleeping in chillier rooms to burn a few more calories. Brown fat is now thought to be more like muscle than like white fat. When activated, brown fat burns white fat. Although leaner adults have more brown fat than heavier people, even their brown fat cells are greatly outnumbered by white fat cells. "A 150-pound person might have 20 or 30 pounds of fat," Cypess says. "They are only going to have 2 or 3 ounces of brown fat." But that 2 ounces, he says, if maximally stimulated, could burn off 300 to 500 calories a day -- enough to lose up to a pound in a week. "You might give people a drug that increases brown fat," he says. "We're working on one." But even if the drug to stimulate brown fat pans out, Cypess warns, it won't be a cure-all for weight issues. It may, however, help a person achieve more weight loss combined with a sound diet and exercise regimen. White fat is much more plentiful than brown, experts agree. The job of white fat is to store energy and produce hormones that are then secreted into the bloodstream. Small fat cells produce a "good guy" hormone called adiponectin, which makes the liver and muscles sensitive to the hormone insulin, in the process making us less susceptible to diabetes and heart disease. When people become fat, the production of adiponectin slows down or shuts down, setting them up for disease, according to Fried and others. Subcutaneous fat is found directly under the skin. It's the fat that's measured using skin-fold calipers to estimate your total body fat. In terms of overall health, subcutaneous fat in the thighs and buttocks, for instance, may not be as bad and may have some potential benefits, says Cypess. "It may not cause as many problems" as other types of fat, specifically the deeper, visceral fat, he says. But subcutaneous fat cells on the belly may be another story, says Fried. There's emerging evidence that the danger of big bellies lies not only in the deep visceral fat but also the subcutaneous fat. Visceral or "deep" fat wraps around the inner organs and spells trouble for your health. How do you know if you have it? "If you have a large waist or belly, of course you have visceral fat," Whitmer says. Visceral fat drives up your risk for diabetes, heart disease, stroke, and even dementia. Visceral fat is thought to play a larger role in insulin resistance -- which boosts risk of diabetes -- than other fat, Whitmer tells WebMD. It's not clear why, but it could explain or partially explain why visceral fat is a health risk. Whitmer investigated the link between visceral fat and dementia. In a study, she evaluated the records of more than 6,500 members of Kaiser Permanente of Northern California, a large health maintenance organization, for an average of 36 years, from the time they were in their 40s until they were in their 70s. The records included details on height, weight, and belly diameter -- a reflection of the amount of visceral fat. Those with the biggest bellies had a higher risk of dementia than those with smaller bellies. The link was true even for people with excess belly fat but overall of normal weight. She doesn't know why belly fat and dementia are linked, but speculates that substances such as leptin, a hormone released by the belly fat, may have some adverse effect on the brain. Leptin plays a role in appetite regulation but also in learning and memory. Belly fat has gotten a mostly deserved reputation as an unhealthy fat. "Understand that belly fat is both visceral and subcutaneous," says Kristen Gill Hairston, MD, MPH, an assistant professor of medicine at Wake Forest University School of Medicine, Winston-Salem, N.C. "We don't have a perfect way yet to determine which [of belly fat] is subcutaneous or visceral, except by CT scan, but that's not cost-effective." But if you've got an oversize belly, figuring out how much is visceral and how much is subcutaneous isn't as important as recognizing a big belly is unhealthy, she says. How big is too big? Women with a waist circumference more than 35 inches and men with a waist circumference more than 40 inches are at increased disease risk. Abdominal fat is viewed as a bigger health risk than hip or thigh fat, Whitmer and other experts say. And that could mean having a worse effect on insulin resistance, boosting the risk of diabetes, and a worse effect on blood lipids, boosting heart and stroke risks. While men tend to accumulate fat in the belly, it's no secret women, especially if "pear-shaped," accumulate it in their thighs and buttocks. Evidence suggests that pear-shaped women are protected from metabolic disease compared to big-bellied people, says Fried. "Thigh fat and butt fat might be good," she says, referring to that area's stores of subcutaneous fat. But the benefit of women being pear shaped may stop at menopause, when women tend to deposit more fat in the abdomen. So when you lose weight, what kind or kinds of fat do you shed? "You're losing white fat," Fried tells WebMD. "People tend to lose evenly all over." The results change a bit, however, if you add workouts to your calorie reduction, she says. "If you exercise plus diet you will tend to lose slightly more visceral fat from your belly." "We're at an exciting point in science," says Whitmer, echoing the input from other scientists in the field. Whitmer and others expect more discoveries about fat of all types to be made in the near future.
Foods and drinks contain nutrients (such as carbohydrates, proteins, fats, vitamins and minerals). Some foods or drinks contain a large amount of one nutrient such as soft drink, which contains a large amount of sugar, or fried food, which contains a large amount of fat. The term ‘fat’ and ‘oil’ are often used to mean the same thing. Dietary fat (fat in foods and drinks) is important for many body processes. For example, it helps move some vitamins around the body and helps with making hormones. There are 4 types of dietary fat – each one can have a different effect on our blood cholesterol levels. For this reason, it is recommended to replace food and drinks high in saturated and trans fats with alternatives that contain more polyunsaturated or monounsaturated fats. Each gram of fat contains twice the kilojoules (energy) of carbohydrate or protein. Because of this, if you have foods and drinks with too much dietary fat, it can be difficult to maintain a healthy weight. Fats can bring out flavour in foods, so consuming meals with small amounts of fat can make foods more enjoyable and can satisfy our hunger for longer. Throughout the day you should consume a wide variety of foods including foods with small amounts of dietary fat, particularly polyunsaturated and monounsaturated fats, to meet your daily requirements. Energy density of dietary fatDietary fat has more than double the number of kilojoules per gram (37 kJ/g) than carbohydrate or protein (17 kJ/g), making it very ‘energy dense’. Foods high in fat are usually high in kilojoules which means they are more likely to increase body fat. Therefore, it is recommended to choose ‘low-fat’ food options if the choice is available. Carrying too much body fat is a risk factor for many diseases, including cardiovascular disease, type 2 diabetes and many cancers. Dietary fats and our blood cholesterolThe 2 types of blood cholesterol are low density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol. LDL is considered the ‘bad’ cholesterol because it contributes to the narrowing of the arteries, which can lead to cardiovascular diseases (such as heart disease and stroke). HDL cholesterol is considered ‘good’ cholesterol because it carries cholesterol from the blood back to the liver, where it is broken down – reducing the risk of cardiovascular disease. Types of dietary fatsDietary fat can be classified into 4 types. These are:
Each type of fat behaves differently inside the body. Saturated fatsSaturated fats (sometimes called ‘bad fats’) contribute to the risk of cardiovascular diseases (such as heart disease and stroke), because they raise our blood LDL cholesterol levels. These fats are commonly found in many discretionary foods and drinks (those to only have sometimes) – such as energy-dense takeaway (‘fast food’) meals and some commercial products (such as biscuits and pastries). Saturated fats are also found in some everyday, healthy foods (such as dairy products and meats). Unlike discretionary foods, these products have other important nutrients such as protein, vitamins and minerals, and can be important foods to include in your diet. It is recommended to select lower saturated fat options. For example, choose: Monounsaturated and polyunsaturated fatsMonounsaturated and polyunsaturated fats (sometimes called ‘good fats') tend to lower your blood LDL cholesterol when they replace saturated fats in the diet. Polyunsaturated fats have a slightly greater ability to reduce LDL cholesterol than monounsaturated fats. Where possible, replace foods and drinks high in saturated fat with either monounsaturated or polyunsaturated alternatives. For example:
Limit trans fatsTrans fats tend to behave like saturated fats in the body, as they raise blood LDL cholesterol levels and increase the risk of cardiovascular diseases (such as heart disease and stroke). Unlike saturated fats, they tend to also lower HDL (good) cholesterol, so are likely to be even more damaging. Trans fats are rare in nature – they are only created in the stomach of cows and sheep. Because of this, trans fats are naturally found in small amounts in milk, cheese, beef and lamb. Trans fats can also be found in some processed foods (such as, pies, pastries, cakes, biscuits and buns) and in deep-fried takeaway meals. It is these trans fats produced during food manufacturing that we should be most concerned about, not the small amounts of trans fats naturally found in healthy foods like low-fat dairy products and lean meats.Sources of dietary fatAlthough foods can contain a mixture of different types of fat, they generally contain one main group of fat. Saturated fat sources include:
Monounsaturated fat sources include:
Polyunsaturated fat sources include:
Plant sterols can lower cholesterolPlant sterols are components in all plants that are very similar in structure to human cholesterol. Intakes of 2 to 3 g of plant sterols per day have been shown to reduce blood cholesterol levels by an average of 10%. This is because they block the body’s ability to absorb cholesterol, which leads to a reduced level of cholesterol in the blood. However, it is hard to eat this amount of plant sterols from natural sources, so there are now plant sterol-enriched margarine and dairy products on the market. Eating 1 to 1.5 tablespoons (4 to 6 teaspoons) of sterol-enriched margarine each day can help to lower blood cholesterol levels. Fatty acids are essential in our dietFatty acids are a component of dietary fats that are necessary for vital functions in our bodies. There are 2 essential polyunsaturated fatty acids – omega-3 and omega-6. Essential means our bodies cannot create these fatty acids, so we must consume them in our diet. Omega-3 fatty acids are found in both plant and marine foods, although it is the omega-3 fatty acids from marine sources that have the strongest evidence for health benefits (including reducing the risk of heart disease). Plant food sources include canola and soy oils, canola-based margarine and seeds. Marine sources include fish, especially oily fish (such as Atlantic salmon, mackerel, Southern blue fin tuna, trevally and sardines).Omega-6 fatty acids are mainly found in nuts, seeds and plant oils (such as olive, corn, soy and safflower). Benefits of omega-3 fatty acidsResearch is ongoing, but the benefits of omega-3 fatty acids in the diet appear to be that they:
Olive oilOlive oil is produced by the pressing or crushing of olive fruit. It comes in different grades, depending on the amount of processing involved. There are unrefined (virgin) grades and refined grades. The less the oil is refined by heat and chemical treatments, the higher the quality of the oil. Olive oil is an important source of omega-6 fatty acids and antioxidants, which are beneficial for overall health and can reduce risk of cardiovascular disease. Types of olive oilVirgin varieties of olive oil are believed to offer the greatest health benefits as they retain most of the healthy compounds from the olive fruit. Varieties include: Extra virgin oil
Virgin oil
Olive oil
Light and extra light oil
Olive oil and the Mediterranean dietResearchers are investigating the possibility that a diet rich in monounsaturated fats, (such as olive oil), may be protective against the development of coronary heart disease. People who have a high consumption of monounsaturated fats from olive oil (for example, in Greece and Italy) tend to have low rates of coronary heart disease, regardless of their body weight. Olive oil contains many compounds that are beneficial to human health, including omega-6 fatty acids, plant sterols and phenolic compounds, which seem to possess strong antioxidant properties. Because of these compounds, olive oil consumption may have a protective role against development of breast, colon, lung, ovarian and skin cancers. Several studies have also shown that olive oil may have additional beneficial effects on blood pressure, obesity, rheumatoid arthritis and immune function. Recent research has also indicated a link between olive oil consumption as part of the Mediterranean diet, and reduced Alzheimer’s disease risk. However, the Mediterranean diet contains much more than olive oil. It’s possible that the low rate of coronary heart disease in these countries relates to a high intake of vegetables, legumes, fruits and cereals, which are all rich in antioxidants and plant sterols.Choosing extra virgin olive oil as your main source of dietary fat, as well as eating a healthy and balanced diet high in fruits, vegetables, nuts, seeds, and whole grain breads and cereals, may reduce your risk of chronic disease development and increase your life expectancy. Current recommendations on fats in your dietThe Australian Dietary recommend:
Remember, low-fat diets are not suitable for children under the age of 2 years. If unsure of your dietary needs, please see your doctor or a dietitian. Where to get help
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