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Original Research

Open Access Special Issue

Relationship between cardiovascular disease risk factors, health behavior and physical fitness according to visceral fat in older men

  • Duk Han Ko1
  • Yong Hwan Kim2,*,
  • Joung Kyue Han3,*,

1Department of Sports Science Convergence, Dongguk University, 04620 Seoul, Republic of Korea

2Department of Physical Education, Gangneung-Wonju National University, 25457 Gangneung, Republic of Korea

3College of Sports Science, Chung-Ang University, 06974 Seoul, Republic of Korea

DOI: 10.31083/j.jomh1806128 Vol.18,Issue 6,June 2022 pp.1-9

Published: 30 June 2022

(This article belongs to the Special Issue Sports and physical activities for men’s health)

*Corresponding Author(s): Yong Hwan Kim E-mail:
*Corresponding Author(s): Joung Kyue Han E-mail:


Background: Obesity in older adults is increasing. The two types of fat involved in obesity are subcutaneous and visceral fat. We investigated the relationship between cardiovascular risk factors, health-related behaviors, and physical fitness based on the level of visceral fat in older men. Methods: Data from 1219 men aged 65 years who underwent health checkups at Korean hospitals from 2012 to 2020 were analyzed. Computed tomography (CT) data was used to divide participants into low visceral fat area (LVFA) and high visceral fat area (HVFA) groups. Cardiovascular risk factors such as blood pressure, triglyceride level, high-density cholesterol, and fasting blood glucose were measured. Bio-impedance analysis was used for body composition, and arteriosclerosis was tested by brachial artery pulse wave velocity (baPWV). Physical activity, exercise type, smoking, and alcohol consumption were investigated and cardiorespiratory fitness, grip strength, leg strength, flexibility, balance, and agility were determined. The odds ratio (OR) of HVFA was calculated by logistic regression analysis. Results: HVFA and LVFA groups exhibited significant differences in waist circumference, systolic blood pressure, triglyceride, glucose, baPWV, weekly physical activity, aerobic exercise, and alcohol consumption. Compared to the high fitness group, the low fitness group had an increased OR for HVFA; cardiorespiratory fitness (OR 3.563), grip strength (OR 2.365), leg strength (OR 4.145), and flexibility (OR 2.523). The group with low aerobic and strength training frequency increased OR by 2.5 and 3.2 times compared to the low frequency group, respectively. The OR of HVFA increased 2.8 times in the group which consumed alcohol more than 4 days a week compared to the group with consumption less than monthly. Conclusions: Men with HVFA exhibited lower levels of physical activity, more alcohol consumption, and lower levels of fitness than those with LVFA. Moreover, low levels of fitness, physical activity, and high alcohol consumption increased the risk of HVFA.


Visceral fat; Cardiovascular disease; Physical activity; Fitness; Odds ratio

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Duk Han Ko,Yong Hwan Kim,Joung Kyue Han. Relationship between cardiovascular disease risk factors, health behavior and physical fitness according to visceral fat in older men. Journal of Men's Health. 2022. 18(6);1-9.


[1] Warburton DER, Nicol CW, Bredin SSD. Health benefits of physical activity: the evidence. Canadian Medical Association Journal. 2006; 174: 801–809.

[2] Nakou ES, Simantirakis EN, Kallergis EM, Skalidis EI, Vardas PE. Long-standing sinus arrest due to the occlusion of sinus node artery during percutaneous coronary intervention: Clinical im-plications and management. International Journal of Cardiology. 2015; 203: 432–433.

[3] Al-Sofiani ME, Ganji SS, Kalyani RR. Body composition changes in diabetes and aging. Journal of Diabetes and its Com-plications. 2019; 33: 451–459.

[4] Curcio F, Ferro G, Basile C, Liguori I, Parrella P, Pirozzi F, et al. Biomarkers in sarcopenia: a multifactorial approach. Exper-imental Gerontology. 2016; 85: 1–8.

[5] Zaidi M, Lizneva D, Kim S, Sun L, Iqbal J, New MI, et al. FSH, Bone Mass, Body Fat, and Biological Aging. Endocrinology. 2018; 159: 3503–3514.

[6] North BJ, Sinclair DA. The intersection between aging and car-diovascular disease. Circulation Research. 2012; 110: 1097–1108.

[7] Cho YJ, Lee AR, Hwang MJ, Chung WS, Song MY. Relation of Physical Activity and Visceral Adipose Tissue Accumulation in Korean Obese and Overweight Women. Journal of Korean Medicine for Obesity Research. 2008; 8: 49–62.

[8] Elffers TW, de Mutsert R, Lamb HJ, de Roos A, Willems van Dijk K, Rosendaal FR, et al. Body fat distribution, in particular visceral fat, is associated with cardiometabolic risk factors in obese women. PLoS one. 2017; 12: e0185403.

[9] Koster A, Murphy RA, Eiriksdottir G, Aspelund T, Sigurdsson S, Lang TF, et al. Fat distribution and mortality: the AGES-Reykjavik study. Obesity. 2015; 23: 893–897.

[10] Kim H, Ahn D, Kim SH, Lee DS, Yoon SH, Zo J, et al. Associa-tion between body fat parameters and arterial stiffness. Scientific Reports. 2021; 11: 20536.

[11] Merlotti C, Ceriani V, Morabito A, Pontiroli AE. Subcutaneous fat loss is greater than visceral fat loss with diet and exercise, weight-loss promoting drugs and bariatric surgery: a critical re-view and meta-analysis. International Journal of Obesity. 2017; 41: 672–682.

[12] Ponti F, Santoro A, Mercatelli D, Gasperini C, Conte M, Mar-tucci M, et al. Aging and imaging assessment of body compo-sition: from fat to facts. Frontiers in Endocrinology. 2020; 10: 861–871.

[13] Zhang H, Tong TK, Kong Z, Shi Q, Liu Y, Nie J. Exercise train-ing‐induced visceral fat loss in obese women: the role of train-ing intensity and modality. Scandinavian Journal of Medicine & Science in Sports. 2021; 31: 30–43.

[14] Kobayashi R, Sato K, Takahashi T, Asaki K, Iwanuma S, Ohashi N, et al. Arterial stiffness during hyperglycemia in older adults with high physical activity vs low physical activity. Journal of Clinical Biochemistry and Nutrition. 2019; 65: 146–152.

[15] Hawkins M, Gabriel KP, Cooper J, Storti KL, Sutton-Tyrrell K, Kriska A. The impact of change in physical activity on change in arterial stiffness in overweight or obese sedentary young adults. Vascular Medicine. 2014; 19: 257–263.

[16] Lee H, Gwak J, Jun H, Kim E. Relationship between Arterial Stiffness and Physical Activity Level Assessed by International Physical Activity Questionnaireshort form (IPAQSF) in the El-derly. Korean Journal of Community Nutrition. 2020; 25: 236.

[17] Myers J, Kokkinos P, Nyelin E. Physical activity, cardiorespi-ratory fitness, and the metabolic syndrome. Nutrients. 2019; 11: 1652.

[18] Kim JA, Choi CJ, Yum KS. Cut-off Values of Visceral Fat Area and Waist Circumference: Diagnostic Criteria for Abdominal Obesity in a Korean Population. Journal of Korean Medical Sci-ence. 2006; 21: 1048.

[19] Chun MY. Validity and reliability of korean version of interna-tional physical activity questionnaire short form in the elderly. Korean Journal of Family Medicine. 2012; 33: 144–151.

[20] American College of Sports Medicine. ACSM fitness book. 3rd edn. Human Kinetics: Champaign, IL. 2003.

[21] Preis SR, Massaro JM, Robins SJ, Hoffmann U, Vasan RS, Irl-beck T, et al. Abdominal Subcutaneous and Visceral Adipose Tissue and Insulin Resistance in the Framingham Heart Study. Obesity. 2010; 18: 2191–2198.

[22] Elffers TDW, De Mutsert R, Lamb HJ, De Roos A, Van Dijk JKW, Rosendaal FR, et al. Body fat distribution, in particular visceral fat, is associated with cardiometabolic risk factors in women with obesity. Atherosclerosis. 2017; 263: e175.

[23] Matsushita Y, Nakagawa T, Yamamoto S, Kato T, Ouchi T, Kikuchi N, et al. Adiponectin and visceral fat associate with car-diovascular risk factors. Obesity. 2014; 22: 287–291.

[24] Okamoto T, Morimoto S, Ikenoue T, Furumatsu Y, Ichihara A. Visceral fat level is an independent risk factor for cardiovas-cular mortality in hemodialysis patients. American Journal of Nephrology. 2014; 39: 122–129.

[25] Meriño-Ibarra E, Artieda M, Cenarro A, Goicoechea J, Calvo L, Guallar A, et al. Ultrasonography for the evaluation of visceral fat and the metabolic syndrome. Metabolism. 2005; 54: 1230–1235.

[26] Arner P. Differences in lipolysis between human subcutaneous and omental adipose tissues. Annals of Medicine. 1995; 27: 435–438.

[27] Umano GR, Shabanova V, Pierpont B, Mata M, Nouws J, Tricò D, et al. A low visceral fat proportion, independent of total body fat mass, protects obese adolescent girls against fatty liver and glucose dysregulation: a longitudinal study. International Jour-nal of Obesity. 2019; 43: 673–682.

[28] Taniguchi A, Nakai Y, Sakai M, Yoshii S, Hamanaka D, Hatae Y, et al. Relationship of regional adiposity to insulin resistance and serum triglyceride levels in nonobese Japanese type 2 diabetic patients. Metabolism. 2002; 51: 544–548.

[29] Dusserre E, Moulin P, Vidal H. Differences in mRNA expres-sion of the proteins secreted by the adipocytes in human subcu-taneous and visceral adipose tissues. Biochimica et Biophysica Acta. 2000; 1500: 88–96.

[30] Chiba Y, Saitoh S, Takagi S, Ohnishi H, Katoh N, Ohata J, et al. Relationship between visceral fat and cardiovascular disease risk factors: the Tanno and Sobetsu study. Hypertension Research. 2007; 30: 229–236.

[31] Sato F, Maeda N, Yamada T, Namazui H, Fukuda S, Natsukawa T, et al. Association of Epicardial, Visceral, and Subcutaneous Fat with Cardiometabolic Diseases. Circulation Journal. 2018; 82: 502–508.

[32] Geovanini GR, Libby P. Atherosclerosis and inflammation: overview and updates. Clinical Science. 2018; 132: 1243–1252.

[33] Cainzos-Achirica M, Rampal S, Chang Y, Ryu S, Zhang Y, Zhao D, et al. Brachial-ankle pulse wave velocity is associated

with coronary calcium in young and middle-aged asymptomatic adults: the Kangbuk Samsung Health Study. Atherosclerosis. 2015; 241: 350–356.

[34] Kim S, Kim J, Lee D, Lee H, Lee J, Jeon JY. Combined impact of cardiorespiratory fitness and visceral adiposity on metabolic syndrome in overweight and obese adults in Korea. PLoS One. 2014; 9: e85742.

[35] Molenaar EA, Massaro JM, Jacques PF, Pou KM, Ellison RC, Hoffmann U, et al. Association of Lifestyle Factors with Ab-dominal Subcutaneous and Visceral Adiposity: the Framingham Heart Study. Diabetes Care. 2009; 32: 505–510.

[36] Zając-Gawlak I, Kłapcińska B, Kroemeke A, Pośpiech D, Pel-clová J, Přidalová M. Associations of visceral fat area and phys-ical activity levels with the risk of metabolic syndrome in post-menopausal women. Biogerontology. 2017; 18: 357–366.

[37] Suresh N, Reddy RL. Effect of lifestyle on body fat percentage and visceral fat in Indian women with above normal body mass index. International Journal of Current Research and Review. 2017; 9: 32–36.

[38] Scott D, Hayes A, Sanders KM, Aitken D, Ebeling PR, Jones G. Operational definitions of sarcopenia and their associations with 5- year changes in falls risk in community-dwelling middle-aged and older adults. Osteoporosis International. 2014; 25: 187–193.

[39] Miyatake N, Takanami S, Kawasaki Y, Fujii M. Relationship be-tween visceral fat accumulation and physical fitness in Japanese women. Diabetes Research and Clinical Practice. 2004; 64: 173–179.

[40] Blaskewicz Boron J, Haavisto W, Willis S, Robinson P, Schaie K. Longitudinal Change in Cognitive Flexibility: Impact of Age, Hypertension, and APOE4. Innovation in Aging. 2018; 2: 249–249.

[41] Wilke J, Macchi V, De Caro R, Stecco C. Fascia thickness, ag-ing and flexibility: is there an association? Journal of Anatomy. 2019; 234: 43–49.

[42] de la Motte SJ, Lisman P, Gribbin TC, Murphy K, Deuster PA. Systematic Review of the Association between Physical Fitness and Musculoskeletal Injury Risk: Part 3—Flexibility, Power, Speed, Balance, and Agility. Journal of Strength and Condition-ing Research. 2019; 33: 1723–1735.

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