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A groundbreaking new study published October 17, 2025, challenges conventional wisdom about heart health, revealing that fat stored deep within the abdomen and liver can silently damage arteries, even in people who appear outwardly healthy.
A large-scale analysis of over 33,000 adults in Canada and the United Kingdom has prompted researchers to question the reliability of body-mass index (BMI) as a sole indicator of cardiovascular risk. The findings suggest that “hidden fat” may pose a danger equal to,or even greater than,visible weight.
For years, visceral fat – fat surrounding internal organs – and hepatic fat – fat stored in the liver – have been linked to conditions like Type 2 diabetes, high blood pressure, and heart disease. Though, the direct impact of these fat deposits on artery health remained unclear until now.
Researchers utilized advanced MRI scans to assess fat distribution and artery condition, discovering a strong correlation between higher levels of visceral and liver fat and the thickening and clogging of the carotid arteries in the neck. These arteries are crucial for supplying blood to the brain, and thier narrowing significantly increases the risk of stroke and heart attack.
“This study shows that even after accounting for traditional cardiovascular risk factors like cholesterol and blood pressure, visceral and liver fat still contribute to artery damage,” explained a senior researcher involved in the study.
A Wake-Up Call for Clinicians and the Public
The implications of this research are far-reaching. According to a lead author, the findings serve as “a wake-up call for clinicians and the public alike,” urging a shift in focus towards identifying and addressing hidden fat, rather than solely relying on visible weight. The research was co-led by researchers at McMaster University,with contributions from Marie Pigeyre,associate professor in McMaster’s Department of Medicine.
The analysis drew data from two major population studies: the Canadian Alliance for Healthy Hearts and Minds (CAHHM) and the UK Biobank. The team’s findings demonstrated that visceral fat was consistently associated with plaque buildup and artery wall thickening, while liver fat exhibited a smaller, yet still significant, effect. These relationships persisted even after accounting for lifestyle factors like diet, exercise, and cholesterol levels.
Rethinking Obesity Assessment
The study underscores the need for healthcare professionals to move beyond traditional measurements like BMI and waist circumference when evaluating heart risk. More sophisticated imaging tests capable of revealing fat stored around internal organs may provide a more accurate assessment of cardiovascular health.
For individuals in midlife, the research serves as a critical reminder that maintaining a normal weight does not automatically guarantee a healthy heart. Hidden fat can silently elevate the risk of serious disease without any obvious physical signs.
“You can’t always tell by looking at someone whether they have visceral or liver fat,” stated Sonia Anand, a vascular medicine specialist at Hamilton Health Sciences and professor in the Department of Medicine at McMaster. “This kind of fat is metabolically active and perilous; it’s linked to inflammation and artery damage even in people who aren’t visibly overweight. That’s why it’s so important to rethink how we assess obesity and cardiovascular risk.”
Funding and Collaboration
this research was supported by the Canadian Partnership Against Cancer, Heart and Stroke Foundation of Canada, and the Canadian Institutes of Health Research. Additional contributions came from the Population Health Research Institute, Montreal Heart Institute, Sunnybrook Health sciences Center, and others. Sunnybrook Hospital provided in-kind support for MRI reading costs, while Bayer AG supplied IV contrast. The study also utilized data from the Canadian Partnership for Tomorrow’s Health and the PURE Study.
The findings represent a significant step towards a more nuanced understanding of cardiovascular risk and highlight the importance of proactive screening and intervention to address the hidden dangers of visceral and liver fat.
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