May 5, 2026, 12:01 pm | Read time: 5 minutes
A link between obesity and health risks is well-documented. Less clear until now was the role of fat distribution in the body on the brain. An international long-term study now shows: Apparently, it’s not just body weight that matters, but especially the so-called visceral belly fat. A long-term reduction of this “inner” fat is associated with less cognitive decline.
The Known Dangers of Visceral Fat
The medical term “visceral fat” refers to fat that lies deep in the abdominal cavity and surrounds the internal organs. Colloquially, it is also known as inner belly fat. It differs significantly from subcutaneous fat, which appears as visible “love handles.”
As internist Dr. Matthias Riedl explained to FITBOOK in earlier articles on the topic, visceral fat is metabolically active and acts like an inflammation-promoting gland. It releases signaling substances that drive inflammatory processes in the body. According to the doctor, this can strain the cardiovascular system over time and thus promote the development of arteriosclerosis.
But that’s not all. The subtle inflammatory processes triggered by inner belly fat can also affect the brain, warns Dr. Riedl. The result can be an increased risk of cognitive decline up to dementia. How strong this connection actually is and what role visceral fat plays in long-term brain health has now been examined in more detail by an international long-term study.1
Study Examines the Impact of Visceral Fat on the Brain
The study was conducted by an international research team led by Ben-Gurion University of the Negev, with participation from scientists at Reichman University and Harvard University. Against the backdrop of the known health risks of belly fat, the team investigated whether a long-term reduction of visceral fat is associated with less brain atrophy (loss of brain volume) and better cognitive performance.
The analysis is based on data from the so-called Follow-Interventions-Trials (FIT) project, which consolidates several previous lifestyle intervention studies. For the current follow-up, the researchers re-recruited 533 participants from four of these randomized studies–between 5 and 16 years after the original interventions were completed.
Also interesting: Tipping point! From this age, brain changes affect memory
Details of the Study
The research team conducted magnetic resonance imaging (MRI) on the subjects. With these examinations, they were able to capture both the abdominal fat and the condition of the brain in detail. Additionally, they assessed the cognitive performance of the participants using the Montreal Cognitive Assessment (MoCA), a standardized test for evaluating memory, attention, and thinking skills.
To capture the long-term burden of visceral fat, the scientists used a specific measure: the so-called “area under the curve.” This considers both the level of fat values and their duration over the entire observation period, from the start of the intervention to the follow-up. Various metabolic parameters (such as blood sugar levels, blood fats, and inflammatory markers) were also included in the analysis to investigate possible connections with changes in the brain.
Results
The evaluation shows a clear connection between visceral fat and brain health over many years. For example, participants with less “inner belly fat” achieved better results in the MoCA, indicating higher cognitive performance.
Notably, participants who lost visceral fat during the original intervention had larger brain volumes years later–even if they did not lose more weight overall. The researchers conclude that targeted reduction of belly fat is of particular importance.
In a subgroup of participants for whom three MRI measurements were available, it was also shown that less visceral fat over the years was associated with a slower decline in brain volume. This connection did not occur with subcutaneous fat–the effect was apparently specific to visceral fat. Another significant finding: Improvements in blood sugar control were more strongly associated with positive changes in the brain than changes in blood fats or inflammation levels.
How Does Vitamin D Supplementation Affect Mood and Memory? Study Reveals Insights
Body Weight Apparently Not So Crucial in Preventing Diabetes
Possible Significance of the Results
Visceral fat seems to play a central role in long-term brain health. It is not only crucial how much belly fat is present, but also how it develops over the years. Lifestyle measures that–through diet and exercise–specifically target the reduction of visceral fat could thus not “only” reduce the risk of metabolic diseases but also maintain mental performance.
Blood sugar control is also coming into sharper focus. The results suggest that it could be a possible mechanism through which visceral fat affects brain health. A stable metabolic state thus seems to play an important role in maintaining cognitive performance. For middle-aged and older people, these findings could help derive more targeted strategies for preventing cognitive impairments.
Limitations
The consistent results across various analyses are a strong indication of the importance of visceral fat for brain condition. However, the study’s limitations should also be noted.
First, regarding the participant pool. With about 86 percent of the participants being male, the results may not be transferable to women. Additionally, the participants had already taken part in lifestyle studies. They may therefore differ from the general population in important characteristics, such as motivation or health awareness.
Furthermore, the follow-up is an observational analysis. While connections can be shown, no definitive cause-and-effect relationships can be established. Even though various metabolic parameters were considered, not all possible influencing factors can be completely ruled out.