Sperling Prostate Center

Is the “Spare Tire” Around Your Middle Shortening Your Life?

UPDATE: 5/24/2023
Originally published 10/11/2018

When we originally posted the blog below, we included three dietary suggestions to help reduce visceral fat.

As it happens, we may look to the Dutch for a more comprehensive dietary style.

A multicenter study examined the extent to which adherence to the Dutch dietary guidelines affects the amount of visceral fat in men.[i]

The Dutch guidelines were established in 2015 and promoted by the Government.

The guidelines go beyond our own three suggestions, and include:

  • Eat fruits, vegetables, whole grains, nuts and dairy daily
  • Eat legumes and fish weekly; replace refined grains with whole grains
  • Replace solid fats like butter with liquid fats like vegetable oil
  • Limit red and processed meat, sugary drinks, alcohol and excess salt.

If this sounds familiar, it’s because it parallels the Mediterranean diet that we’ve posted about many times.

The multicenter study bears out the value of combining all these foods into a lifestyle eating plan.

The researchers assigned point values to the components to form a numerical index (score) ranging from 0-130. The men in the study (average age 56) had an average score of 71. Those who had a mere 10 points higher had less visceral fat, as measured by MRI.

The moral of the story is, to have less visceral fat, follow the Dutch guidelines.


If you’re at midlife or older, chances are you may be facing the “battle of the bulge.” It is common after age 40 to discover creeping weight gain, and the need to be more committed to healthy diet and exercise. Gaining pounds, however, is not as much of an issue as WHERE you’re gaining them. Extra pounds in the thighs, upper arms or buttocks are much less concerning than a “spare tire” around your midsection. What’s causing that thickening is called visceral fat because it’s padding your internal organs, called viscera. Therein lays the danger.

Two kinds of fat

Did you know that each person has two kinds of fat?

  • Brown fat looks brown. It has tiny blood vessels and iron-containing components called mitochondria. It is “good fat” because it burns calories to generate heat. Infants have a higher proportion than adults. As we age, we lose brown fat but gain white fat.
  • White fat stores energy, and it does a lot more. It is actually an endocrine organ that produces hormones and other biochemicals. It has receptors for insulin, adrenaline, cortisol and growth hormone.  In men, it primarily occupies the abdominal area (“apple shaped”) while in women it is more often in the thighs, hips and buttocks (“pear shaped”) until menopause, when it also builds up in the abdomen.

The dangers of visceral white fat

As a rule of thumb, men with a waist measurement of at least 40” and women with at least 35” are carrying around a kind of time bomb. Belly fat is linked with cardiovascular disease and diabetes since white fat helps generate a cocktail of hormones that influence appetite, insulin use, and inflammation. In particular, inflammation is now known to be a precursor for cancer; it seems that the chronic irritation to cells fosters mutations. In the case of prostate cancer (PCa), the visceral fat (white fat) that builds up in the pelvic bed as a man heads toward obesity has been associated with more aggressive forms of PCa at the time of diagnosis, and a higher chance of recurrence after treatment.[ii]

How to turn the situation around

A person does not need to be grossly overweight to harbor higher levels of white fat in the abdomen. The trouble is that visceral white fat is difficult to shed because this is not fat you can shed simply by toning up abdominal muscles with exercises like sit-ups. Weight loss through a wholesome diet and exercise — activities like walking and strength-training — is the only surefire way to get rid of it. … Chances are you’ve periodically seen ads on the internet for seemingly magical ways to reduce belly fat. Before you throw good money after bad, let it be said that no pill or potion has been scientifically shown to dissolve abdominal fat. You have to work at it.[iii]

If you don’t have much visceral fat, you want to prevent getting it. If you do, you want to get rid of it and keep it off. Here are some basic principles:

  1. Sugar is your worst friend. It’s in an amazing array of food products, not just candy, cake and ice cream, so it’s almost impossible to entirely eliminate. Read ingredients on the label, and cut down on alcohol.
  2. Increase the proportion of fresh (not canned or frozen) fruits and vegetables in your diet. Consider eating more raw veggies by chopping them up and putting them in salads. Eat more dark leafy greens like kale or spinach.
  3. If you eat grains, eat whole grain products, not refined.
  4. Get a good night’s sleep. Sleep disturbances throw off a body’s biochemical balance and also erode brain health.
  5. Finally, vigorous, sustained aerobic exercise at least three times a week for a half hour. If you prefer non-weight-bearing workouts, swimming or stationary bikes will get your heart pumping—but consider adding free weights or gym machines to increase muscle for better metabolism and fat-burning.

Above all, consult with your doctor before beginning or changing a diet and workout. Everyone is different, so make sure your health plan is tailored to your needs.

It’s worth it to get rid of – or prevent altogether – the spare tire that so easily starts to build up in your body. At the Sperling Prostate Center, we support a whole-person approach to well being, including physical, mental, emotional and spiritual wellness in whatever form is right for you!

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] van Eekelen E, Geelen A, Alssema M, Lamb HJ et al. Adherence to dietary guidelines in relation to visceral fat and liver fat in middle-aged men and women: the NEO study. Int J Obes (Lond). 2020 Feb;44(2):297-306.
[ii] Gucalp A, Ivengar NM, Zhou XK, Giri DD et al. Periprostatic adipose inflammation is associated with high-grade prostate cancer. Prostate Cancer Prostatic Dis. 2017 Dec;20(4):418-423.
[iii] Jane Brody. “The Dangers of Belly Fat.” New York Times – Personal Health. Jun. 11, 2018. https://www.nytimes.com/2018/06/11/well/live/belly-fat-health-visceral-fat-waist-cancer.html


About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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