Shedding Light on the Shadow: Visceral Fat Reduction Through Diet, Exercise, and MRI Monitoring

Wayne Blackshear

Feb 10

10 min read

Visceral Fat — Fat around your organs. You can’t pinch it, you can’t see it. It is inside you.

Deep subcutaneous fat — between muscle and Scarpa’s Fascia, “love handles”

Subcutaneous fat — Fat just underneath the skin. You can pinch it.

Problems with Visceral Fat

Increased risk of autoimmune diseases
Increased risk of heart disease
Increased risk of cancer
Potential for higher blood pressure
Increased risk of all-cause mortality

Causes of Visceral Fat

Poor diet, processed food, excess carbohydrates
Too much stress build up
Chronic low intensity exercise
Toxins
Etc…

How I Measured my Visceral Fat

I hired Dr. Sean O’Mara to help me treat my chronic inflammation. He performed a MRI of my brain, heart, abdomen and thighs to look for Visceral Fat in my abdomen, around my heart, in my muscles, and any major vascular impediments in my brain. The abdomen will be the focus of this article.

Measuring visceral fat can be tricky because of the nature of the MRI produced image. They typically are low resolution and have lots of noise. This is just the result of the MRI and software technology. Luckily for humans, it is something we can visualize. It isn’t an abstract number, percent, or score. You don’t need specialized training. If you can see black and white contrast, all you need is a brief explanation and you have all the tools you need to decipher it.

How MRI Works

If you are interested in visceral fat, and have found this information, I bet you are interested in knowing how an image from a MRI machine actually comes to be. Here is a super high-level introduction to the imaging process for MRI.

If you are not interested in how MRI works, feel free to skip this next part. For those like me that need to understand how the screwdriver works before I can use it, well, keep reading.

The way a MRI image is produced is very abstract. It isn’t a direct image process like a camera. It uses a lot of physics and timings to produce the images. A high level summary:

The person lays down on an adjustable platform, and the platform is adjusted to position the body part of interest correctly. The person must lay as still as possible since the images are constructed over time, much like a long-exposure photograph. The scene must remain still over time to get a accurate image.
When the MRI’s magnets are turned on, they create a powerful magnetic field that aligns the protons of the hydrogen atoms in your body. These protons normally spin randomly but will align parallel or anti-parallel to the magnetic field.
A radio frequency (RF) pulse is applied, directed toward the area of interest, causing the protons to rotate axial alignment 90 degrees from parallel. When the RF pulse is turned off, the protons fall out of phase and their alignment decays back to their original alignment, either parallel or anti-parallel to the magnetic field, releasing energy in the process.
The energy released by the protons as they decay is detected by the MRI machine. This signal is then converted into an image through software. The process is repeated to build a slice to create a detailed image of the area of interest.
In the grand scheme of things, this is not too dissimilar to how a camera sensor captures photons of light (energy) and converts them to a number that corresponds with a color and location (pixel) to form a digital image.

There are 3 main image sequences commonly used:

T1 Weighted: T1-weighted images are good for visualizing normal anatomy and are particularly useful for imaging the brain, where they highlight fat tissue and suppress signals from water.
T2 Weighted: T2-weighted images are useful for detecting edema and inflammation, enhancing the signal of water or fluid. This is also useful in comparison of fat and muscle.
FLAIR: (Fluid Attenuated Inversion Recovery) is a special inversion recovery sequence that suppresses the signal from fluids like cerebrospinal fluid (CSF) to make certain lesions, such as those caused by multiple sclerosis, more conspicuous.
These are commonly used to highlight certain lesions, such as those caused in multiple sclerosis, more visible when they lie close to or next to CSF.

Now that you understand the basics of how a MRI image is constructed, and a few useful differences in the types of images, I want to take you through my abdominal scans and discuss the before and after taken six months apart. The next images of my abdomen are T2 sequences. Most of the dark is muscle, and fat will show up as light.

The medium-gray objects are various organs.

Before

After (6 months)

Using the measurements of the purple dimension lines overlayed on the images above, the reduction is about between 20% and 30%. This is a relatively imprecise number because of the nature of the blurriness and other factors. This type of quantification is only really helpful when determining trend over time. Subsequent follow up scans will be needed to continue numerically quantifying progress.

The number doesn’t matter here, you can see that I have significantly less visceral fat after 6 months. That tells me I am on the right track and should stay the course and keep working the strategies.

Let’s compare the before and after in a different way since the blurriness inherit of MRI images makes volume measurements less-than-perfect in accuracy to begin with. I like numbers in comparisons, but in the case of MRI and visceral fat comparison, it is better to be a little subjective in nature when comparing before and afters.

Below is a before and after. The images are to scale with one another, and the yellow boxes are the exact same size in both pictures. Subjectively there is a “lot less” total area in the entire abdominal cavity. Something had to have went away. That something is some of the Visceral fat. You can see the organs are in slightly different positions.

Remember this is 1 slice and any vertical movement of organs will cause them to be out of phase with this slice.

You can see that my abdomen is flatter overall. This is the equivalent of going from “dad bod” gut to a “flatter stomach”. You can also see that from side to side my width is less.

My muscles on both sides are moved into the yellow box a bit because there isn’t as much visceral fat in the way. There is also a bit more room for more of my organs to take up this cavity in this slice.

Thinking of an sequence of MRI images (slices) as a total fourth dimension experience helps if you are accustomed to that. I won’t go into detail of the fourth dimension in this post. Feel free to explore on your own.

I still have too much subcutaneous fat for my abs to be visible in the mirror, but the point of my fat reduction is targeted at visceral fat for now. Different strategies related to caloric intake and expenditure are more optimized for targeting for subcutaneous fat reduction.

In the outer layer of fat surrounding the muscles, there is a thin line visible. This is called Scarpa’s Fascia. It is a thin membrane that separates the subcutaneous fat from the deep subcutaneous fat. It is connective tissue that you have likely encountered in steak, or when separating meat. A chuck roast cut of meat has a lot of this same stuff. Its the chewy stuff between layers of fat that is chewy.

The fat on the outside of Scarpa’s Fascia is not harmful and provides some protection as well as an energy store the body can use in the absence of constant carbohydrate intake. Again that fat is the subcutaneous fat, and and is not harmful as long as it isn’t in excess. This is the fat that you can pinch on your belly.

The fat on the inside of Scarpa’s Fascia is called deep subcutaneous fat. It is similar to visceral fat in that is is harmful. On the back side of the body this is also what is known as love handles. It mimics visceral fat and often comes and goes in accumulation and volume in conjunction with the internal visceral fat.

Strategy to Reduce my Visceral Fat; The most significant changes I have made to target reducing visceral fat:

100% no cheating on food. I only eat meat + ferments + coffee now. Before I would cheat with small amounts of “junk” here and there as cravings got the better of me time and time again.
I also stopped snacking between meals all together. Once my cravings were conquered, the need/want to snack just evaporated. This wasn’t a goal, it is just something that happened. If I do get hungry when it isn’t meal time, I will just eat early. That usually carries me over to the next meal. I don’t have specific times to eat, but normally eat around 11:00 AM and 6:30 PM.
I also stopped eating at restaurants 2–3 times per week. This took my wife some convincing, but she is on board now. I only eat non-home food about once per month now, and it is only at places that I trust the meat and preparation. We now treat it as date night instead of eating out just for convenience.
90% (ish) of the meat I eat is grass fed-grass finished 80/20 ground beef. I also throw in some steaks if I find a good deal, or something I see is really calling my name.
No dairy that isn’t fermented, and only a small amount at that. I eat small amounts of home made yogurt and some store bought kefir and blue cheese.
I have reduced the total volume of exercise from 6 days of CrossFit per week down to only sprinting 3–4 days a week, and weightlifting/strength training 2–3 days per week. My workouts are shorter in length and higher in intensity than a standard CrossFit class. The biggest advantage here, is recovery, and the max intensity from sprinting. It triggers release of myokines which have all kinds of beneficial effects on the body. You want to run like a lion is chasing you.
I like to sprint either outside on foot, or inside on my Rogue Echo bike. Currently on foot, I like to do about 5 100m sprints, with about 2 minutes rest between rounds. Currently on the bike, I like to do 10, 10 second sprints, with 1 minute rest between rounds.
Now, I consistently go to bed at 9PM on weeknights (a bit later on the weekends). This gives me 7–9 hours of good quality sleep depending on what time I wake up and have planned in the morning. I used to stay up until 11–12 and still wake up at 4:30 for CrossFit. I am glad I have changed up my habits with this one. Over time this just broke me down, and I would walk around always feeling tired and broken.
I wear a sleeping mask in bed, and use blue light blocking glasses starting at 7 PM.
I have been working on fasting at least once per week with 24–72 hour fasting windows. My longest fast was 96 and I don’t think I was ready for it yet. I feel pretty good at the 24–36 hour mark. For me the biggest struggle is I never seem to lose the feeling of hunger. I am still working at it and am determined to keep improving.
My meals consist of a full day, or part of a day’s meat portion and ferments. I have found that about 1 ounce of ferments per pound of meat seems to suit me well; anymore and I get gas. I normally eat 2–3 pounds of meat per day. In the beginning I was only eating about 1.5 pounds of meat per day and lost 8 pounds in about 2 months. Since then, I have regained 8 pounds (mostly muscle I hope) and am back at my weight of 153 pounds when I met Dr Sean. I am 5’ 8” and currently around 15–18% total body fat total according to my bioelectric impedance scale.
I have focused on my water quality. I avoid chemically treated water, and only drink filtered water at home that I know does not have chlorine or fluoride in it. I have a few brands of bottled water I trust, and often take my own from home.
I get morning and evening sunlight in my eyes almost every day. I also wear blue light blocking glasses starting at 7pm every night.
I try to spend time bare foot outside each day. No specific time length, but normally a minimum of 10 minutes at least in the back yard.

Benefits that I have noticed

Improved mood
MS spot reduction and so far, no new or active lesions detected on followup MRIs, no new symptoms.
Blood flow, I can see my pulses on my ankles and elbows. I am still waiting for the ones on my wrists to become visible.
Improved cognition. I used to have problems transposing small number in the > 5 digits size. I would always mix up digits and have to re-type and triple check everything. I don’t remember when the last time this has happened. I feel sharper over all.
Increased attention span. I used to have trouble focusing on long tasks for more than a few minutes. I can now focus for hours and hours at a time without interruption. I also get back into the flow of things faster when interruptions do occur.
Sweet and processed food cravings are completely gone. My cravings are now for meat and ferments. I have to be careful not to indulge in too much ferments, or you won’t want to sit near me.
Clearer skin and scalp.
I can breath better. I used to constantly get small bits of “stuffiness” in my nose. I rarely get that anymore.

Plans moving forwards.

I am planning to keep up with what I have been doing, and hopefully this year introduce sauna as another major strategy.
I am paying closer attention to my environment and what chemicals I encounter.
I am also starting to spend time meditating and working on my thoughts. Writing has become part of this process, its the reason that I actually wrote about this.
I would like to increase the volume of sprinting. Its a balance of recovery.
I will start sauna soon if I can make it a priority. It is a logistics issue I haven’t prioritized yet.
Continue researching, learning, and experimenting with what works for me.