Visceral obesity and cardiometabolic risks: lessons from the VACTION.J study

Atherosclerosis, the underlying cause of atherosclerotic cardiovascular disease, develops not only due to a single cardiovascular risk factor, but to a variety of complex factors. Body fat distribution, especially visceral fat accumulation, is a major correlate of a cluster of metabolic abnormalities and atherosclerotic cardiovascular disease in Japanese metabolic syndrome. Reduction of visceral fat through individualized lifestyle recommendations by medical personnel (health guidance ‘Hoken-shido’ in Japanese) contributes to changes in the number of obesity-related cardiovascular risk factors in subjects with, but not without, visceral fat accumulation. For the prevention of atherosclerotic cardiovascular disease in Japan, it might be practical to stratify subjects with multiple risk factors based on visceral fat accumulation and conduct health education (‘Hoken-shido’) based on conceptualization of visceral fat accumulation, from the results of the VACATION-J study, a Japanese population-based cohort study. This article discusses visceral adiposity as a target for the management of metabolic syndrome, including lessons learned from the VACATION-J study.