In our October 2018 blog –  ‘The Dangers of Belly Fat’ , we looked at the health risks associated with belly fat as opposed to subcutaneous fat (think arms and thighs) and the positive effect of diet (reduced calorie intake) and exercise on shedding excess belly or visceral fat. New research has teased this out even further and has shown that a low carbohydrate Mediterranean Diet has a more dramatic effect on reducing both visceral and liver fat than a low carbohydrate diet alone.

The following information is taken largely from articles by Sam Downing writing for and Abigail Leichman for

All Body Fat is Not Created Equal

There are two broad types of body fat: subcutaneous fat, the kind that sits right underneath the skin; and visceral fat, the kind stored deep inside the abdomen.

Most people fret about subcutaneous fat, but it’s visceral fat that’s far worse for your health because of the pressure  it puts on organs such as the heart, the pancreas and especially the liver.

the-new-normalBut is aiming to reduce weight overall enough to reduce the most harmful forms of visceral fat, or do different diets have different effects on different stores of body fat? They’re some of the questions Israeli researcher sought to untangle in a study published in the Journal of Hepatology.

A team from Ben-Gurion University of the Negev (BGU) conducted a weight-loss trial that lasted 18 months and included almost 300 participants — mostly men with abdominal obesity, meaning they carried high levels of visceral fat.

A reduced calorie low-fat diet was compared to a low carbohydrate Mediterranean diet

For the trial period, participants were randomised to one of two diets.

The first was a low-fat diet where fat accounted for no more than 30 percent of participants’ total daily energy intake, and saturated fat for no more than 10 percent. They were also instructed to increase their fibre intake from low-fat grains, vegetables, fruits, and legumes.

(Though this diet was dubbed “low fat”, those fat intake percentages are in line with Australian government health recommendations.)

The second diet combined a Mediterranean-style diet (one rich in vegetables, olive oil and nuts and low in red meat, with poultry and fish replacing beef and lamb) with a low-carb diet (up to 70g carbohydrates each day for most of the trial).

Both diets were pretty healthy: each aimed to restrict intake of trans-fats and refined carbohydrates, and increase intake of vegetables.

Participants regularly checked in with a dietitian for nutrition support. After six months they were also prescribed an exercise program: three one-hour sessions each week in the gym, that combined cardio and resistance training.

Their body fat composition was measured using MRI before, during and after the trial. After 18 months, their overall weight loss was moderate — only about 3kg on average.

mediterranean dietComparing the results of subjects who reduced calorie intake through a low-carb Mediterranean diet or a low-fat diet, they saw that both groups lost a moderate amount of weight – especially those who also were put on a moderate exercise regimen.

Result: Mediterranean Diet is best for cutting the most harmful fat

The low-carb Mediterranean diet, however, had a greater effect on reducing fat in and around the liver (by about 30 percent) and the heart (11 percent) compared to low-fat diets with similar calorie counts.

The researchers noted that high levels of liver fat are linked to metabolic syndrome, type 2 diabetes and coronary heart disease and now believe that a  reduction in liver fat is a better predictor of long-term health than reduction of visceral fat, which was previously believed to be the main predictor.

The findings are a significant contributor to the emerging understanding that for many obese individuals, excess liver fat is not merely a sign of health risks associated with obesity, including cardiovascular disease and diabetes, but is likely also a cause.

Dr. Sandi & the team at Como Diagnostic have long been at the forefront of recognising visceral fat and fatty liver as contributors to metabolic syndrome, type 2 diabetes and coronary heart disease and have long advocated for the principles of the Mediterranean diet. img-DrSandi

Whether you are in a weight loss, weight maintenance mode or simply want to adopt healthy habits – the Mediterranean diet can be adapted for whichever phase is deemed appropriate for you.

In addition to its beneficial effects on liver & visceral fat the Mediterranean diet also forms the basis of our anti-inflammatory nutrition programs. In a nutshell the anti-inflammatory diet is based on whole, nutrient dense foods that contain anti-oxidants and avoids highly processed products and provides a healthy balance of protein, carbs and fat at each meal.

Are you carrying extra tummy fat? Need to lose weight or just want to eat more healthily? Talk to Dr. Sandi and the medical nutrition team @ Como Diagnostic – we’re ready to help you.

T: 9826 4300 or email us


This blog is general in nature only and should not be relied upon as medical advice. For further information please contact our clinic or your own medical practitioner before commencing any diet or exercise regime.