It’s a good idea to reduce visceral fat

The book Getting better, not older by Dr. Sean O’Mara caught my attention, given my interests on this blog. He is a doctor who was in his late forties and himself led a sedentary life and was not very healthy. He discovered the importance of visceral fat, the fat that surrounds our organs, as opposed to subcutaneous fat (“under the skin”). Cosmetically, we normally worry about the nether regions, such as losing your ‘love handles’ or ‘beer belly’, but it’s the intestines that have worse health consequences. Dr. O’Mara found that this is often seen routinely on MRI scans, but is not often noticed by doctors because the scan is usually done to diagnose something else. In his case it was about back problems. After discovering he had excess visceral fat and learning how important it is, he adjusted his own lifestyle, including getting active and cleaning up his diet. This led to a large decrease in visceral fat and became healthier. Dr. O’Mara was so thrilled with the results that he changed his own practice to focus on them, and has since helped many clients become healthier. He goes through a list of ten lifestyle changes, with exercise and diet prominently featured. For exercise, he believes that short, intense sessions are more effective than long cardio sessions. For his own diet, he cut out most processed foods and switched to a low-carb version of the Paleo diet. Since that worked so well for him, it’s what he recommends (or something similar). I’ll go into more detail about whether that specific diet is necessary, but either way I recommend Dr. O’Mara, both for inspiration and for the 10 useful lifestyle tips.

I wanted to know more about the recommendations for exercise and nutrition. Specifically for me, short intensive exercise such as HIIT is not recommended because of my leaky heart valve. That’s why I wanted to know which alternatives work well on visceral fat. As far as diet goes, I wondered if eating low carb was really a key factor or if cutting out processed foods would be enough. This was a good candidate for in-depth research into Gemini AI, so I asked the question “what is the latest evidence on diet and exercise to reduce visceral fat??”. The resulting chat is hereand the generated report is here. The report begins by confirming the negative health effects of visceral fat. It further shows that Dr. O’Mara, even though there are some dietary alternatives.

For exercise, it generated this graph for effectiveness in reducing visceral fat, based on evidence in the literature:

Sucra stands for “Surface Under the Cumulative Ranking curve”, the higher this number the better, it indicates the effectiveness of different treatments. Below I have looked at practicing with my limitations. It turns out that the 10×1 higher intensity intervals I am allowed to do on my bike are enough to check the “high intensity” box and should therefore be effective. As for the diet, there is this graph:

VAT stands for visceral adipose tissue, the same as visceral fat. The type of diet that Dr. O’Mara recommends, so it scores well. I was concerned that the plant-based diet was too vague without specifying “whole foods.” That’s why I asked:

I have a follow-up question about the “Comparative Efficacy of Diets on Visceral Fat” section. I think the plant-based diet (ppbd) result can be misleading. A plant-based diet can consist of highly processed foods and foods loaded with sugar or refined carbohydrates. Plant-based whole foods (wfpb) are better because they eliminate these low-quality foods. Are there research results for VAT reduction specifically for the wfpb?.

The answer is at the bottom of the chat here. The answer is that plant-based diets work well too, although I didn’t have a head-to-head comparison to see their relative effectiveness versus low-carb diets. I would like to point out that you should never trust the results of these chats directly. I looked up the references to confirm the important points, which I recommend.

To be sure, I read a second book on the subject:

This author also recommended short periods of intense exercise, and as for diet, he especially emphasized getting rid of highly processed foods.

My conclusion is that exercise is important, especially at higher intensities. When it comes to diet, everyone seems to agree on cutting out processed foods. If you want to pursue this more aggressively, you can take the next step: a more restrictive diet, such as low-carb or WFPB.

I was curious how the medical understanding of visceral fat has evolved over time, so I did another Gemini question: “History of the medical understanding of the role of visceral fat,” which led to this talk. It seems that our understanding has improved tremendously since about the 1990s to now. One of the confusions that has been cleared up is that some people are overweight and metabolically unhealthy, and some have a lower BMI but are not healthy. This would make sense if the former had more subcutaneous fat and less visceral fat. Here is a summary diagram:

Read the chat if you are interested in more details. The finding about drainage to the liver is significant and fascinating.

Gemini asked me this follow-up question “Want me to find a specific cycling protocol for “master athletes” that balances steady state and intervals for optimal metabolic health?‘ and I said ‘Yes. however, I have moderate aortic paravalvular leakage, so it should be safe for that as wellThe result is in that same chat and it pretty much confirmed what I’m already doing. My 10×1 intervals should be effective, as well as longer, less intense “zone 2” rides.

Published by Bionic OldGuy

I am a mechanical engineer, born in 1953, Ph. D, Stanford, 1980. I have been active in the field of mechanical CAE for decades. I also have a lifelong interest in outdoor activities and fitness. I had both hips replaced and a heart valve replacement due to a genetic condition. This blog chronicles my adventures in staying active despite these bumps in the road. View all posts by BionicOldGuy

Published
February 7, 2026February 6, 2026