Dr. Ben Bikman

It's because his fat cells are small, because he has so many of them.

His fat cells are so few, but they're much larger.

And so he has a lower body fat mass, but it's more harmful because his fat cells are bigger.

And that is the problem with visceral fat.

There's nothing inherently pathogenic about visceral fat.

Those fat cells aren't mystically harmful.

It's just that that visceral cavity is so limited in volume that it only allows fat growth through hypertrophy because that is a way to limit the total amount of fat you can grow.

If our visceral fat was able to grow through hyperplasia,

then it may expand so much that it starts to compress our tissues.

It starts to squeeze the liver or squeeze the intestines or squeeze the kidneys.

And so by only allowing visceral fat to grow through hypertrophy, you do limit how much it can grow

But it also becomes much more pro-inflammatory because hypertrophic fat cells release a lot more pro-inflammatory cytokines than smaller hyperplastic fat cells.

So there's very much a genetic ethnic component to this that influences how ethnicities are able to stimulate the growth of new fat cells.

And then there is there's absolutely a sex component to it as well, which, of course, is still genetic, where women, because of the effects of estrogens, are able to stimulate a higher degree of hyperplasia than her male counterparts are.

And so women will have that ability to.

And this explains why the average woman both has higher fat than her male counterpart and yet is healthier in every single cardiometabolic metric.

If it was just a matter of fat mass, then women should be dying more from all these cardiometabolic diseases, and yet they're not.

It's men.

Because women will have more fat cells, but smaller.

Because of estrogens.