The Link & What ro Do

The gut-brain connection, known as the gut-brain axis, has become a hot area of research over the past decade. Much of the conversation has revolved around gut bacteria and brain health. However, we also know that high amounts of visceral (abdominal or adipose) fat are linked to dementia later in life. 

“Unlike subcutaneous fat that lies just beneath our skin, visceral fat accumulates around our internal abdominal organs, including the liver, pancreas and intestines. This type of fat is associated with a number of negative health outcomes, including cardiovascular disease, diabetes and metabolic syndrome,” says Lauren Harris-Pincus, M.S., RDN, a registered dietitian nutritionist. The connection between visceral fat and dementia isn’t straightforward—it’s multifaceted. Still, many modifiable lifestyle factors can reduce your risk and improve your health.

Here, dietitians will explain the connection between visceral fat and dementia and provide practical ways to reduce visceral fat and potentially lower your dementia risk. 

What Is Visceral Fat? 

Pinching your skin won’t help you determine if you have visceral fat. Visceral fat differs from the type of fat you can see or feel. It resides deep within your abdominal cavity or belly and can infiltrate other organs. Excess visceral fat may increase your risk for several metabolic diseases, including heart disease and diabetes. This type of fat is metabolically active in driving chronic low-grade inflammation that can damage blood vessels, thereby reducing the flow of oxygen and nutrients to the brain, adds Maggie Moon, M.S., RD, Los Angeles-based registered dietitian.

What Is Dementia? 

Dementia is an overall term used to describe a cluster of diseases that impact the brain. Moon notes, “Dementia describes a set of symptoms that affect how we think, learn and remember.” While the most common type of dementia is Alzheimer’s disease, there are others, including vascular dementia, Lewy body dementia, frontotemporal dementia and mixed dementia. Specific types impact varying brain parts and can cause a range of symptoms. “Advanced age is the number one risk factor, though not cause, of dementia, and unfortunately one that we can’t reverse,” says Moon. 

She adds that other risk factors are:

• Family history
• Genetics
• Low physical activity
• Poorly managed diabetes
• High blood pressure
• Hearing loss
• Alcohol or tobacco use
• Depression
• Abdominal adiposity (excess visceral fat) 

Many of these factors, such as physical activity and eating habits, are modifiable and can directly impact diabetes control, blood pressure, and the amount of visceral fat. 

What’s The Link Between The Two?

A variety of factors connect visceral fat to an increased risk of dementia. “We’ve known for at least 15 years that visceral fat is linked with lower brain volumes in healthy middle-aged adults,” says Moon. She adds that, more recently, studies suggest a higher level of visceral fat in older adults is associated with worse cognition and damage to white matter (what helps conduct messages between brain cells) and a thinning of gray matter, which is made up of neurons that help us think, learn and remember.

Visceral fat is also an indirect risk factor for dementia because of the other types of conditions it is associated with, like diabetes. Pincus notes, “An older, but important meta-analysis of 28 studies showed a 73% increased risk of all type dementia, 56% increase of Alzheimer’s Disease, and 127% increase of vascular dementia in patients with diabetes.”

Elevated blood sugar and its related conditions, such as high cholesterol and blood pressure, can impact blood vessels and cause inflammation. Pincus adds, “Chronic elevated blood glucose damages blood vessels in the brain while insulin resistance affects brain glucose metabolism.” This is important because the brain thrives on glucose and needs it to function optimally. Moon adds that damage to blood vessels can reduce the flow of oxygen and nutrients to the brain.

How to Reduce Visceral Fat to Prevent Dementia

Neither the scale nor body mass index (BMI) is the best indicator of visceral fat. Instead, your waist-to-hip ratio can be a better diagnostic tool, though not perfect. Other measurements include biometrical impedance analysis, MRI, CT scan and DXA scans, although these tests can be costly and time-consuming.

Moon highlights that modifying behavioral habits known to help reduce your risk of visceral fat and dementia is the best strategy. These habits include eating well, moving more, sleeping soundly and managing stress. Pincus suggests, “Physical activity, both aerobic and strength training, as well as caloric restriction and dietary modifications that resemble a Mediterranean style pattern, can help to reduce visceral fat. Pay attention to managing stress and establishing good sleep hygiene.” 

Similarly, physical activity has beneficial effects on brain health. “Physical activity improves blood flow to the brain, which means an influx of nutrients and oxygen to help it thrive. Moving more also stimulates the production of brain-derived neurotrophic factor (BDNF) to help brain cells develop, connect, stay adaptable and survive by fighting damage and degeneration,” says Moon. She recommends starting your day with gentle stretching, moving around for at least an hour and taking walks after meals.

Simple, consistent and sustainable habits are things you can take action on right away. In addition to exercise, Moon suggests eating brain-healthy foods. These foods provide the essential nutrients the brain needs for normal brain development and its cells’ structure, function and communication while protecting it against damaging oxidative stress and inflammation. Many brain-healthy foods are also rich in fiber, helping you feel satisfied. By feeling fuller, you may consume fewer calories, which can contribute to weight loss. 

Moon shares these recommendations:

• Plan your meals around leafy green vegetables, another deep-colored vegetable (red, yellow, orange or purple), beans and whole grains. These foods are key to the MIND diet, which combines the Mediterranean and DASH diets and is optimized for brain health. For example, start with leafy greens, then add whole grains, at least two other vegetables and a smaller amount of protein, such as fish, chicken or tofu.
• Add baby greens, berries, nuts and soymilk to your next smoothie.
• Enjoy nuts as a weekday snack, on top of a breakfast parfait or in your hot cereal or smoothie bowl.
• Make a hearty, one-pot soup and add multiple brain-healthy foods, such as beans, winter greens such as kale or chard, tomatoes, sweet potatoes, quinoa, mushrooms, olive oil and garlic.
• Set a timer for a couple of hours before bedtime as a reminder to start your winddown routine.
• Evaluate how much sugar you eat. If you are consuming an excess of added sugars like sweetened beverages, table sugar, syrups, candy, cookies and cakes, try to reduce your intake. Pincus says, “Limit added sugars to 24 grams per day for women and 36 grams per day for men, based on the American Heart Association guidelines.” Note that one teaspoon of sugar is roughly four grams.

You don’t have to implement all of these tips at once. Start small and from where you’re at. For example, if you currently don’t eat green vegetables, start by adding one serving (1 cup raw or ½ cup cooked) at one to two meals per day. 

The Bottom Line 

The link between visceral fat and dementia is multilayered, but reducing the risk of both is a matter of the same principles. Start with modifiable risk factors, such as eating nutrient-dense foods like colorful fruits and vegetables, legumes, whole grains, nuts, seeds and lean protein sources. Limit added sugars found in sweetened beverages, cookies, cakes and candy. Move your body as much as you can and work towards establishing a good sleep routine. Make small, realistic, tangible changes and work up to long-term goals. To keep yourself accountable, find a buddy to join you; you’ll both be thankful.