ABSTRACT
Excess intra-abdominal adipose tissue accumulation, often termed visceral obesity, is the critical target for medical and public health efforts to reduce the systemic inammation related to the global epidemic of obesity-associated metabolic disorders. Visceral obesity is characterized by ectopic triglyceride (TG) storage closely related to clustering risk factors for chronic age-related disorders including heart disease, diabetes, liver disease, and common forms of cancer. Hypertriglyceridemia, liver insulin resistance, inammation of the liver, increased liver VLDL synthesis and secretion, reduced TG-rich lipoprotein clearance, small dense LDL particles, reduced HDL cholesterol, and increased circulating adipocytokines are among the many metabolic alterations that characterize this common condition. Age, gender, genetics, and ethnicity contribute to the observed variations in visceral adipose tissue accumulation in different populations globally. Efforts to bring all obesity under
Introduction ............................................................................................................ 259 Signicance of Visceral Fat ...................................................................................260 Origins of Visceral Fat ........................................................................................... 261 Hormonal Inuences on Abdominal Visceral Fat .................................................. 262
Testosterone ....................................................................................................... 262 Estrogen............................................................................................................. 262 Cortisol ..............................................................................................................264 Endocannabinoids .............................................................................................265 Growth Hormone...............................................................................................266
Dietary Fructose .....................................................................................................266 Correcting Underlying Hormonal Abnormalities .................................................. 267
