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The Missing Fourth Pillar: Why Good Numbers Can Still Mean Bad Hearts
Traditional cardiac risk focused on cholesterol, blood pressure, and smoking. But patients with perfect numbers still had heart attacks. The missing factor was visceral fat creating inflammation that makes arteries vulnerable to damage.
6 hours ago


Strength as a Vital Sign — How We Measure It in Clinic and at Home
Simple grip strength testing predicts heart disease better than blood pressure. Two three-minute muscle function tests reveal your metabolic resilience and can be tracked at home monthly. Strong muscles actively fight visceral fat accumulation across all cardiovascular risk factors.
May 9


Targets for LDL-C, ApoB and Small Dense LDL
LDL-C alone may miss important cardiovascular risk. This article explains why ApoB and small dense LDL often better reflect atherosclerotic burden, especially in metabolic disease and high visceral fat. It outlines practical lipid targets by risk category and shows how LDL-C:ApoB ratios can estimate dangerous particle patterns
Mar 17


How to Measure Your Waist
Measuring your waist isn’t about shape or clothing size. It’s a simple health check that reflects harmful visceral fat around the organs. Measuring the narrowest point can miss risk. For meaningful results, waist must be measured at a fixed anatomical point and tracked consistently over time.
Feb 25


PCSK9, visceral fat, and the modern metabolic environment
Because cholesterol is a fat-like substance, it cannot dissolve or travel freely in blood, which is mostly water. To move around, it must be packaged into microscopic transport particles called lipoproteins. One of these, LDL (low-density lipoprotein), acts as the main delivery vehicle, carrying cholesterol from the liver to cells that need it for repair or hormone production. In small amounts, LDL cholesterol is therefore completely normal and necessary. The problem only beg
Feb 23


Medical imaging is the only accurate way to assess body composition
Medical imaging is the only reliable way to assess true body composition. Weight and smart scales cannot distinguish bone, muscle, or visceral fat. DEXA and low-dose CT provide accurate insight, while home tracking tools support the behavioural change needed to lower visceral fat and long-term cardiometabolic risk.
Jan 10


Smart body composition scales: helpful metabolic tool—or misleading distraction?
Smart body composition scales are not metabolic truth machines. Their value lies in engagement, not precision. During weight loss—especially with GLP-1 therapy—hydration and glycogen shifts distort “muscle” readings. Used within a tiered system that prioritises waist, strength, and function, they can support behaviour without undermining progress.
Jan 10


A New Year Reset: Why Your Waist Matters More Than Your Scales
January isn’t just about weight loss. Much winter weight gain occurs as visceral fat, which drives insulin resistance and cardiovascular risk. Measuring your waist, not just your weight, gives a clearer picture of metabolic health. Building muscle and reducing visceral fat supports a healthier metabolism long after January ends.
Jan 5


Ho Ho Healthy: What Santa’s Belly Can Teach Us About Metabolic Health
Santa’s famous belly is festive, but it highlights an important metabolic lesson: WHERE fat is stored matters more than how it looks. Visceral fat, hidden deep around the organs, drives inflammation and cardiometabolic risk — unlike softer, subcutaneous fat. Understanding this difference is key to real metabolic health.
Dec 22, 2025


Cardiometabolic Health Tools
Patients often ask about home monitoring tools — ECG devices, blood pressure monitors, glucose apps. We now also encourage people to track their waistline and visceral fat, using body composition scales alongside more traditional equipment.
To support this, I have created a page of recommended home gadgets that can help patients take greater ownership of their health — a vital step towards a more proactive, prevention-focused model of care, guided by their clinical and educat
Dec 1, 2025


How to Reduce Visceral Fat Without Medication
The most effective path to reducing visceral fat without medication is not just to “eat less.” It’s to build more muscle, eat smarter, and track your progress. In this blog, which also forms one of the chapters of an ebook, I outline the programme and tools our patients use in our cardiometabolic clinic.
Dec 1, 2025


N-of-1: Why Your Best Health Plan Starts With You
Traditional health improvement plans assume everyone responds the same way. Real life tells us otherwise. N-of-1 explains how to use a personalised, precision-medicine approach to reduce visceral fat, stabilise metabolism and rebuild long-term health. Through weekly reflections, practical tools and small self-experiments, the book guides you to uncover what truly works for you — not for the average patient, but for your own unique physiology.
Nov 28, 2025


Examples of CT VAT scans and normal ranges for VATI
At SCVC we use low dose CT to measure visceral adipose tissue (VAT). With a radiation dose of 1mSv – equivalent to 1/4 of the dose used in a mammogram. The test determines what proportion of an expanded waistline is visceral (metabolically dangerous) versus subcutaneous (metabolically benign) fat. When combined with other anthropometrics such as weight, height, waist we use AI to calculate a metabolically healthy target waist and weight to aim for. A example of a repeat scan
Nov 27, 2025


Carbohydrate Sensitive Phenotype (CSP): Precursor of the Metabolic Syndrome?
Carbohydrate Sensitive Phenotype (CSP) is not a diagnosis of diabetes or obesity. Rather, it’s a biologically driven pattern of visceral fat accumulation and carbohydrate intolerance which is highly prevalent in those with a raised waist-to-height ratio (WHtR > 0.5), triggered by aging, Western-style diet and lifestyle.
More importantly, CSP gives individuals a name for their experience—one that invites support instead of judgement, and allows them to engage with food and hea
Sep 23, 2025


Why everyone is talking about VAT
An article by Dr Edward Leatham, Consultant Cardiologist © 2025 E.Leatham While everyone might think the term ‘VAT’ stands for value added tax, we all need to recognise this new health term, as it is shaping up to be a critical risk […]
Aug 17, 2025


Anthropometrics vs BMI: Why Waist Measures Outperform BMI in Cardiovascular Risk Assessment
VAT is the principal metabolic culprit in cardiovascular risk. BMI—while simple—fails to capture fat distribution, muscle mass, or ageing effects. Waist-based anthropometrics, particularly waist circumference and waist-to-height ratio, more closely reflect VAT and strongly predict cardiovascular outcomes.
For cardiologists, this explains why a tape measure around the waist is more valuable than a BMI calculation. Where precise measurement is required—such as in high-risk pati
Aug 16, 2025


The Rise of Online Home Blood Testing: A Paradigm Shift in Preventative Healthcare
From cholesterol tests and HbA1c for monitoring diabetes, to more specific markers like lipoprotein(a), or LP(a), patients are no longer waiting for symptoms or their GP’s advice before seeking answers. Instead, they are becoming more proactive—taking charge of their health and accessing diagnostics that were once confined to clinical settings.
Apr 11, 2025


How does stress affect your heart?
Stress is an unavoidable part of modern life. We encounter it at work, at home, in traffic, and even while reading the news. Although we often discuss stress casually, its impact on the human body is profound—particularly on the cardiovascular system. In this article, we will explore how stress affects the heart and blood vessels, drawing on clinical insights, expanding scientific knowledge, and practical stress-management strategies. By the end, you will see why stress is a
Jan 22, 2025


Nourishing Life: Integrating Yang Sheng (養生) into Modern Preventive Medicine
An article by Dr Edward Leatham, Consultant Cardiologist. As cardiologists, our primary focus is often on diagnosing, treating, and managing cardiovascular diseases, which is essential to healthcare. However, heart health involves more than just addressing immediate conditions—it also includes promoting […]
Oct 16, 2024


Shedding Central Fat: Strategies for a Healthier Waist-to-Hip Ratio
In this guide, we will explore a multifaceted approach involving increased physical activity, dietary modifications, and consistent monitoring to effectively lose fat and enhance overall health.
Apr 29, 2024
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