内脏脂肪：沉默的杀手及其可逆性

@Ana Rosa : 作为一名放射科医生，我经常在扫描中看到内脏脂肪，它是一个沉默的杀手，会导致慢性炎症和多种疾病。现代生活方式导致内脏脂肪积累，但通过改变生活方式，我们可以逆转这些问题。我的个人经历和对患者的观察都表明，通过控制压力、改善饮食和增加运动，我们可以减少内脏脂肪，改善健康状况。重要的是要找到自己的理由，并坚持执行这些策略，才能获得长期的成功。MRI扫描可以帮助我们了解身体内部的情况，并促使我们采取行动。即使你很瘦，也可能有大量的内脏脂肪，所以不要被外表所迷惑。选择你的内心，选择健康的生活方式，你就能战胜内脏脂肪，拥有更美好的生活。

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作为一名放射科医生，我每天都会阅读大量的医学影像检查报告。令人担忧的是，超过95%的受检者都存在不同程度的内脏脂肪堆积。内脏脂肪，这种隐藏在我们腹部腔内的脂肪，并非简单的肥胖问题，它是一个“沉默的杀手”，是多种慢性疾病的根源。

内脏脂肪的危害：远超你的想象

内脏脂肪并非简单的能量储存，它更像是一个“自主代谢器官”，持续不断地释放炎症因子（细胞因子），例如皮质醇、胰岛素抵抗相关分子、白介素6、白介素1、肿瘤坏死因子α等。这些炎症因子会对我们的身体造成广泛的损害：

• 引发慢性炎症: 这是几乎所有慢性疾病的根源。
• 损害免疫系统: 影响嗜酸性粒细胞、中性粒细胞、白细胞和淋巴细胞等免疫细胞的功能。
• 增加患癌风险: 内脏脂肪与至少13种癌症相关，包括乳腺癌、卵巢癌、子宫内膜癌、前列腺癌、淋巴瘤、白血病等。
• 导致代谢紊乱: 引发2型糖尿病、脂肪肝（甚至发展为非酒精性脂肪性肝炎、肝纤维化、肝硬化和肝癌）、痴呆（被梅奥诊所重新命名为3型糖尿病）等。
• 影响其他器官: 内脏脂肪还会影响大脑（导致脑雾）、眼睛（视力下降）、肌肉（肌脂沉积、肌少症）、心脏（动脉粥样硬化、心肌梗塞、心房颤动）、胰腺（胰岛素抵抗）等。

现代生活方式：内脏脂肪的帮凶

我们所处的时代，几乎所有事物都在促进内脏脂肪的积累：

• 缺乏阳光照射: 长时间暴露在人工光线下和电子屏幕前。
• 饮用水质差: 含氯量高的水会破坏肠道菌群平衡。
• 食物污染: 农药、除草剂、压力过大的动物肉类（含有过量的皮质醇）。
• 环境污染: 塑料、对羟基苯甲酸酯、植物油等。
• 不良生活习惯: 加工食品、超加工食品、酒精、香烟、电子烟、睡眠不足等。

逆转内脏脂肪：我的亲身经历与建议

我自己的经历也印证了内脏脂肪的可逆转性。2020年，我体重达到226磅，腹部脂肪堆积严重。在学习并实践了相关的健康策略后，我的体重下降到140磅，腹部形状也从凸出变得更加平坦，肌肉量也增加了。我的转变并非一蹴而就，而是经历了反复尝试和调整的过程。

有效的策略包括：

• 控制压力: 这至关重要。我通过慢跑、高强度间歇训练、桑拿、冷疗、冷水浴、冥想、正念练习、与大自然亲近等方式来缓解压力。
• 改善饮食: 彻底戒除加工食品、糖分和含糖饮料，减少碳水化合物的摄入，选择低血糖指数的碳水化合物，增加优质蛋白质和健康脂肪的摄入。我个人逐渐转向以肉类为主的饮食，并摄入发酵食品。
• 规律运动: 每天至少步行10000步，每周进行几次高强度间歇训练（例如短跑），并进行力量训练。长距离有氧运动则应谨慎，因为它可能增加皮质醇水平。
• 充足睡眠: 每天保证7小时以上高质量的睡眠。
• 补充营养: 根据自身情况，补充镁、维生素D3、维生素K2等营养素。

MRI扫描：洞悉内脏脂肪的利器

MRI扫描可以清晰地显示内脏脂肪的量和分布，包括肝脏、胰腺、心脏周围的脂肪等，帮助我们更直观地了解自身状况，并促使我们采取行动。即使BMI正常，也可能存在大量的内脏脂肪。

找到你的“为什么”，坚持下去

逆转内脏脂肪的关键在于找到你坚持下去的理由——你的“为什么”。这不仅仅是为了拥有更好的身材，更是为了拥有更健康、更长寿、更有质量的生活。将你的“为什么”写下来，并经常提醒自己，这将帮助你克服困难，坚持下去。

从现在开始，迈出第一步

不要被眼前的困难吓倒，从最简单的步骤开始：戒除加工食品和糖分，保证充足的睡眠，多喝水。然后，逐步增加其他健康策略。记住，这并非一场竞赛，而是一场马拉松，需要耐心、坚持和自我关爱。选择你的内心，选择健康的生活方式，你就能战胜内脏脂肪，拥有更美好的生活。

Edit:2025.07.02

00:00

Coming up on today's show…

00:01

All these problems we are having right now, all of these have been documented that are reversible just by burning your visceral fat. As a radiologist, I see visceral fat in 95% plus these exams I read daily. The visceral fat that was hitting our face, it has never been mentioned. It has never been discussed. And unfortunately, I don't believe it has been improved and started to being taught in medical school.

00:29

school yet. Don't fool yourself. You could be a skinny person that you were looking in the mirror and you think that you are healthy. And when I have your MRI read, you're going to be surprised that you might be one of the people who also has lots of

00:45

of visceral fat in your abdominal cavity. My journey started when I met Sean in 2020 and I learned about the strategies. I know that I'm getting better. I know that I'm following the strategies. I can see the difference in my abdominal shape. I can see the difference in my energy. I rise from the ashes and I invite you to burn your visceral fat and rise from the ashes of your visceral fat because you can do it.

01:14

Ana, what is visceral fat and why does it matter? So visceral fat is the fat that we have inside our abdominal cavity, inside our abdomen, our stomach. Visceral fat is important because it's a silent killer. We have it inside of us and many of us, in fact, the majority of us are not aware of it.

01:41

And it is very important because it is considered an autonomous metabolic organ, producing inflammation, chronic low-grade inflammation in our bodies all day long. And this chronic inflammation, characterized by molecules that visceral fat secretes called cytokines,

02:05

This chronic inflammation is the major root foundation of almost all diseases that we are dealing right now in the time that we are living. So visceral fat releases molecules that produce like increase in cortisol and

02:24

increase in insulin resistance, and interleucine 6, interleucine 1, tumor necrosis factor alpha, fibroblasts, macrophages. It affects our immune system, affecting the eosinophils, the neutrophils.

02:47

the cells that are responsible, the leukocytes and the lymphocytes, in fact, I'm sorry, and visceral fat leads to a disruption in our health system, our environment in our body that protects us against cancer and autoimmune diseases. So all these molecules that visceral fat is secreting 24-7 in our bodies are leading to

03:15

Dementia, which is diabetes type 3, now renamed by the Mayo Clinic. Diabetes type 2 and also like

03:27

fatty liver, fat in your liver, and fat in your liver usually progresses to inflammation in your liver, which is called the metabolic-associated steatohepatitis, metabolic-associated steatoliver disease. And if it does not get addressed,

03:46

It will progress to fibrosis, architectural distortion in your liver, cirrhosis, and even liver cancer, which is the hepatocellular carcinoma.

03:57

In other organs, visceral fat, because it's affecting our whole body, so in the brain, we already talked about the dementia, and also brain fog. And also, it could affect your vision with increase of fat in your retrobubble area in your eyes. And also, it could affect your muscles in your voice, too.

04:21

by infiltration of fat in the muscles all over your body, which is the myosteatosis, right? The sarcopenia. Then if you go down, visceral fat can be in your chest, surrounding the vessels that are very important, which is the aorta, the major vessel of your body that brings blood to everywhere, right? So it can surround the aorta. It can lead to deposition of fat,

04:51

in the walls of the arteries that are going to become stiffer and are going to lead to stenosis or decrease in the blood vessel diameter.

05:02

And that is going to lead to cardiovascular disease, to heart attacks, major correlation with atrial fibrillation, which is disruption and abnormal electric conduction in your heart. And lots of people nowadays are dealing with atrial fibrillation and are like being referred to do radioablation in the heart and

05:28

while they should start first decreasing the visceral fat, reversing the visceral fat and getting better.

05:36

Also, visceral fat is related with strokes because, again, it's affecting the arteries of your whole body. And then you have in your pancreas insulin resistance, pancreatic replacement by fat, and then the insulin resistance is the culprit that leads to increased blood sugar, high

05:58

And then you have the increase in cortisol, the decrease in testosterone, the decrease in growth hormone. And then you have the visceral fat also affecting other hormones in your body because the fat accumulates also in your subcutaneous soft tissue.

06:19

And then it will release like a different kind of estrogen that is associated with cancer, especially in women in menopause, like breast cancer, endometrial cancer, ovarian cancer. And it has been related already that visceral fat is associated with at least 13 different types of cancer. So breast cancer, ovarian cancer, endometrial cancer, prostate cancer, lymphoma, leukemia, etc.

06:47

the dementia with amyloid protein depositing in your brain. So all these things are related to visceral fat. That's why it's so very important because it is a silent killer. It is a metabolic marker that could be easily tracked with MRI and because it's easily reversible with strategies that we are going to discuss here. Okay, so good news.

07:12

We can do something like an MRI to see how much of this is going on in the body. It's reversible. But before we get into other aspects, in your estimation, how many people right now are affected by this? Well, Jesse, this is very, very sad because we are living in a time that everything is created to produce visceral fat.

07:39

in our bodies. So we don't enjoy the sun. We don't enjoy the sunshine, the sunrise, the sunset. We are all the time with artificial light and screens.

07:53

We drink water that has lots of chlorine and is really, really bad for our microbiome, leading to increase in visceral fat. The food we eat has pesticides, herbicides, meat that the animals are stressed. So we are eating the cortisol from the animals and…

08:14

Also, like plastics, parabens, vegetable oils, all these things lead to accumulation in visceral fat. Processed foods, ultra-processed foods, alcohol, cigarettes, vape,

08:28

any kind of drugs. So all these things are what we have, right, available to us in the world right now. And the sleep deprivation, because sleep is really important for the decrease in cortisol and improvement in growth hormone. So as a radiologist, I see visceral fat in 95% plus people

08:50

the exams I read daily. Either x-ray, either ultrasound or CT scans or MRIs. So 95% plus of the people have a severe amount of visceral fat and

09:07

an advanced amount of visceral fat in their abdominal cavity, plus other things that come together, which is the fat in your chest, which is the ectopic fat, the fat surrounding your heart, which is the epicardial adipose tissue,

09:25

which is the fat in the pancreas, which is the fat in the liver, which is the fatty liver, and also the huge amount of fat in the deep subcutaneous soft tissue, which releases inflammation similar to visceral fat in your abdomen, and the muscle, the muscle being replaced by fat with sarcopenia and frailty of our bodies. So at least greater than 95%. And don't fool yourself.

09:53

You could be a skinny person that you were looking in the mirror and you think that you are healthy. And when I have your MRI read, you're going to be very surprised that you might be one of the people who also has lots of visceral fat in your abdominal cavity. So being skinny doesn't protect you from having lots of visceral fat when you have the MRI. As a medical doctor, when you went through your training,

10:21

Was visceral fat something you even learned about? No, no, visceral fat was not. And I have done two different trainings. I had done my medical college in Brazil, and I graduated in 1994. And then I did my radiology residency and my doctorate in radiology in Brazil, and

10:44

Then I moved to the United States. Then I redid the radiology residency here in the United States. And also I did a body fellowship here in the United States. And I have participated in

10:58

innumerable conferences discussing fatty liver, discussing liver cancer, discussing dementia, discussing diabetes, discussing metabolic associated problems. And the visceral fat that was hitting our face in all the exams, it has never been mentioned, it has never been discussed. And unfortunately, I don't believe it has been improved and started to being taught in medical school yet.

11:26

which is a major problem because again, like I said, it is reversible. And since it could be the root cause of everything that we are discussing, the final treatments,

11:38

Whenever we start focusing on that, on med school and training and reversing visceral fat, we might, I believe firmly that we're going to be able to reverse chronic disease and prevent all these things that we are focusing in all the conferences I go. I have learned about visceral fat in 2020, 2021.

12:00

When I was working with my friend, my doctor, my mentor, Dr. Sean O'Mara in Minnesota, and he came to my office and he asked me, Hey, Dr. Rosa, how could you start reporting in your exams, CT or MRI about visceral fat? And I looked at him like, surprised, visceral fat? Well, I do see visceral fat every day, but visceral.

12:26

What about describing visceral fat? You know, I have never heard about it. So he taught me about it. He showed me results from a research he was doing and he keeps doing. And he demonstrated to me the importance of describing visceral fat. And then I started. I started describing visceral fat in my reports. And as a radiologist, I think it's very important because I am the doctor from your doctor, right?

12:53

I am the backup of your provider. So as soon as I start describing visceral fat in my reports, I also start describing what you could do next with your patient, with your client. Because that's usually what the provider who asks exams for radiology, that's usually how we interact. You as a doctor, you ask for an exam.

13:18

And then you ask me many times, what do I do next? Like if I see a lung nodule that is suspicious for cancer, I'm going to tell you, it's probably good for you to do a PET scan. It's probably good for you to do a biopsy. You know, like…

13:36

So for visceral fat, I believe it's very important like how I am describing right now. I describe the visceral fat. I describe the fat in the pancreas. I describe the fat in the liver. I describe the fat surrounding your heart. I describe the fat in your muscles. And then in my impression, I say, constellational findings are highly concerning and associated with several metabolic disorders. And then I put…

14:05

It is important because it's reversible through life strategies. And according to what I see in your exam, like if you are a person who is young and you don't have much vascular disease,

14:20

and less than 50 years old, I'm going to tell you should be doing for these patients no processed foods, low carb foods or no carb foods, and high interval training, strength training, and sprinting strategies. If you are older than 50 and if you have lots of vascular disease,

14:45

calcification in your coronary arteries or dilation of your arteries like the aorta, you know, if you have anything that might be a cardiovascular issue that I would be concerned that I don't want to tell you to do sprinting, right? Because I don't want you to have a heart attack because you're sprinting. Then I say I stop at the avoid processed foods.

15:10

low carb foods, strength training. And then I leave to the doctor, the provider, to evaluate that patient if that patient is, if it would be proper for him to start doing anything else that would exert too much their heart, right? Because it's a sure, slowly but surely progress of improvement. If you have lots of vas calcification in your arteries,

15:38

it might be of risk for you to do something that will exert you too much in the beginning, right? Okay, before we go forward, I think it's important we bring a visual in here. And this visual is actually your before and after. Yes. So as a medical doctor, you're also a patient. And you talked about how relatively recently in your career, you just found out about visceral fat and made these changes with the way you look at imaging and report.

16:07

But let's look at your image here. And this is side by side, one image on top of the other of your abdomen. So I'll have you take us through what you're looking at here. When you say this is somebody else and you're looking at it, how would you describe what you're seeing?

16:26

So this is the top image was the first image. Again, my journey started when I met Sean in 2020 and I learned about the strategies. 2020 was a very stressful year for all of us.

16:40

So I haven't been very successful in 2020 in getting them done because stress is a major problem that prevents burning visceral fat, reversing visceral fat. And that's why he talks about the strategies that are specific for decreasing stress. So I started more in 2022. And again, I'm

17:01

Now I am also a high-performance coach. And I believe that changing my mindset was extremely important to obtain success and to sustain success. Because like before, from 2020 to 2022, in 2020, I was weighing 226 pounds. So from 2020 to 2022, I would start…

17:26

I would fail, I would get out of track, and I would just not have the commitment, the consistency, and the compassion of getting back on track, right? The mindset that would make me keep moving forward and getting the strategies and understanding that it's an exercise of patience, right? Because if I got to 226 pounds in 50 years, I'm not going to get to

17:51

reverse in visceral fat in a year or six months. It's going to take my time for my body to heal itself and burn the visceral fat. So in 2022, I was already like 186 pounds. And you can see in the top image at the level of the belly button, you can see the area there. I don't know. You can see. So on the top, there is this…

18:17

This area that separates the fat in the abdominal wall. And that's my belly button. So everything that is white…

18:27

inside the abdominal cavity below the muscles is visceral fat. So as you can see, it's easy to see visceral fat. It's just not reported because doctors have not learned about it. Let me jump in for a quick second here. So this top image here is you, and this is after you've already lost a significant amount of weight, correct? Yes. Okay.

18:52

So I don't have my beginning MRI because, yeah, I don't have my beginning MRI when I was at 226. And I got to 226 pounds because my husband died from colon cancer and I was just eating my stress, eating my sadness, eating my grief, right? Which is something that it's very important to understand that it's a healing process for life too, a grief journey.

19:16

So when I met Sean, after I started implementing some of the strategies with a fail and coming back, fail, coming back, fail, coming back process, I got to 186 pounds and that's the top image. So all the fat that you have, all the white inside the abdominal cavity is visceral fat and it's a severe amount. So the bottom image is also me.

19:45

There are two interesting things that I would like to catch your attention here. First is that the anterior-posterior diameter of the belly button on the top, you can see that it's more of a protuberant abdomen. And on the bottom, you can see that it's more kind of a flat oval abdomen. And that's how you could see your own improvement in visceral fat. When you lay down in your bed or on the floor,

20:13

If you see a protuberant abdomen, almost like as if you are pregnant, it's because you have lots of visceral fat. If your abdomen, after you start the strategies, goes from protuberant to more oval, flat-shaped, it's because you are decreasing your visceral fat. And again, you can see that it's more oval, flat-shaped, and the amount of visceral fat has decreased.

20:42

And also another thing is that since I am doing my sprinting, since I am doing my daily walking, since I am doing strength training, you can also see that there is improvement in the muscle mass, particularly the oblique muscles. On the left side, you could see it better. You can see that they are more thicker, the oblique muscles of my abdominal wall.

21:07

And I want to tell the women or even the men, but specifically the women who believe that it's so hard to build muscles, especially if you are on menopause. I have been in menopause since 2019 because I had a surgery that I needed to remove my ovaries and it was an abrupt menopause. So I can tell you, it is a myth. You definitely can build muscles. It's commitment, consistency, and compassion to you.

21:36

If you are less, then consult your gynecologist because another myth is that hormonal replacement therapy is prejudicial for your health, is detrimental to your health, which is not. Hormonal replacement therapy, there are lots of new studies showing that depending on when you start after the beginning of menopause, even better if you are in perimenopause,

22:01

It protects your brain. It protects your memory. It protects your heart. It protects from muscle and bone loss. So again, I'm just advocating for my women community here. So decreasing visceral fat, improvement in muscle mass, and that's the picture that shows my own journey. And right now, I am very happy to say that I am even better than the bottom image, but

22:30

Because I lost more weight and my measurements have decreased as well. And I can see that my abdomen is even flatter. Because, yes, so again, day in, day out, keep doing the strategies. Choose your heart. My why, connect to your why. You know, it was very important for me to move from bottom to from the top one.

22:53

to the bottom one, it was very important for me to understand that my reason for following the strategies wasn't only that I wanted to lose weight, look better, and fit in a smaller pair of pants. This is awesome, and I applaud each one of you who want to look better, but it was also like

23:17

My grandma had diabetes and she died from complications of diabetes. She had a heart attack and she was also blind with renal problems and all the problems from the neuropathy. She lost like a few toes in her feet. So my why, I didn't want to have diabetes and my glucose levels were always super high and

23:39

And my hemoglobin and A1C was always high. And my insulin was 10. So like, yes, it was extremely high too. So that was my first why. My second why, which grounded and anchored me even more in walking and doing the exercise portion that I have never liked very much because I have always been sedentary, was my father.

24:05

My father was a surgeon and he died in 2021. And he spent his whole life taking care of other people, being sedentary, knowledgeable, smart, like amazing person with his clients, with us too. But that point is, I want to say like the doctor life, right? The sedentary life.

24:25

So he had this extremely sharp brain, but he had an extreme amount of visceral fat too. And when he got hospitalized because he had a femur fracture, he had a CT of his chest, abdomen, and pelvis. And when I looked at his exam, I was in shock. Like my father barely had muscles.

24:51

All his muscles in his body were like 95% replaced by fat. The extreme sarcopenia. He could barely walk and that's why he fell and broke his hip. And yes, so he had this huge amount of visceral fat. He looked like as if he was pregnant of an 18-month kid, not even a nine-month pregnancy, you know. And…

25:18

And again, I saw his body failing while his brain was so sharp.

25:23

And that made me realize, man, that's how I'm living my life. You know, I am sedentary. I sit in front of a computer. I have artificial life in front of me all the time. I'm eating all this processed foods, Doritos, Coke Zero, and, you know, pasta and bread and eating late at night, sleeping really bad, never going outside. And Sean gave me all these strategies, right?

25:51

But I didn't have the mindset, the perfect mindset. And then my grandma and my father linked together, anchored in my heart, connected my brain to my heart. And I was able to realize I got to take care of me because I had to choose my heart. And my heart is strong.

26:12

I don't want to get diabetes. I want to have quality of life with muscles, bones, memory, because they are all connected. Muscles, bone, and memory are all connected. And yes, I don't know how many years I'm going to live. That's not for me to decide on my faith. But I know that how many years I have to live, I want to live them to my best so

26:40

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29:03

Okay, coming back to your pictures here. Yes. What was the timeline between the two of them? And you've mentioned walking, exercise. I'm assuming really significant dietary changes to have that change that we're seeing here. But talk about what that timeline was and then more specifics on what you did in that period.

29:25

to cause the changes we're seeing? So the timeline from these two pictures would be when I really started when I really started implementing the strategies with commitment and consistency and discipline. So the timeline would be around almost two years. And again, I was going through a lot of stress due to health issues and professional issues. So

29:53

There are people in, so again, it's one part. You are your own comparison, right? So different people improve faster. Different people improve slower. I took at least two years if I consider right now where I am right now. And I am now at 140 pounds and my visceral fat is very, way smaller. But again, I want to go to zero or minimal and

30:21

But I would say for me, it took two years because in the first, at least in the first year, I saw very little improvement because I was dealing with a huge amount of stress. So I started implementing the strategies to control the stress, which are mainly the sprinting, the high interval exercise, the sauna, the cryotherapy, the cold plunges, the showers that are cold in the end.

30:52

and taking good care of my sleep. Now I definitely take good care of my sleep. I use this Oura Ring. No, I'm not making propaganda, but it really helped me on taking care of my sleep because I am aware like of how many hours and if it was a restful sleep. And it made a huge difference. It made a huge difference in my energy. And when I felt like, wow, I do feel calmer now,

31:20

So that's when I started losing visceral fat faster, although the strategies were always being implemented.

31:27

So I definitely tell myself that the mindset strategies make a huge difference in the stress, like going outside, enjoying the sun, looking at the sunset, looking at the sunrise, and having a walk in the sun for 10 minutes with no technology, where you just release everything that is hurting, painful, worrying you, and you have time to be with yourself and it increases creativity as well.

31:56

Or mindfulness with the vagus nerve technique, like breathing in, breathing out. Breath work is really amazing. And connecting with the five senses when you are feeling stressed. Everything is important. For you to reduce visceral fat, you have to work in your stress.

32:13

And I would say all these techniques that reduce stress are extremely, extremely positive and extremely like they do work powerful. So taking care of the sleep. Let's see what, oh, gratitude. I practice gratitude daily. Hence in my Instagram, I am Ana Rosa Gratitude. And I've learned gratitude when my husband died because the grief journey is very raw.

32:40

and it hurts you a lot. And I needed to find, to build something that would give me a foundation that I would be able to keep living and building life. And that's when I grounded myself in gratitude. Every time I would feel hurt, I would ask myself, instead of why is this happening to me? Why had this happened to me? I would ask myself, what can I learn from this? How can I move on using this? And that's

33:06

That's when I started being grateful. Yes, grief sucks. Yes, grief hurts. But I wouldn't choose not having grief because having grief made I have my husband and I have my husband. So I am grateful and I have my foundation in love. Anyway, I kind of went on a tangent. But the other strategies, but it's a tangent that it's needed to burn visceral fat.

33:32

So other strategies that work very well, since December 21, 21, I walk daily. I do it like I haven't missed one day. One day, not even when I was sick, not even when I was tired. Even if I walk just a little bit here and there, by the end of the day, I get at least 10,000 steps. And what has it become to me? It became my mental health tool.

33:59

Teaching my brain that I am my best partner, my best accountability partner, that I get my back, that I am my friend, that I can trust myself. And then anytime I have something challenging to go through, I know I can do it because I am walking every day.

34:19

So my walking is my time to connect with me, to connect with friends, to text and say, hey, I miss you. I love you. I'm here for you. And to go outside and enjoy the sun. So walking every day, 10,000 steps plus.

34:35

If you don't know how much time that would take in general for the other people who started walking with me, in 10 minutes, you walk a thousand steps. So you can plan that throughout your day. If you are a workaholic, like I have the tendency to be, you can schedule in your phone every hour you're going to stop and walk for five minutes or 10. Outside, enjoy the sun, take a deep breath in, breath out, drink your water. So walking, sprinting.

35:04

I don't do sprinting very much. I should say that I am guilty on first instance for the sprinting, but I try to do it at least twice a week. I kind of do sprinting more on my bike. I have a stationary bike in my house and I do the sprinting on the bike. You can do sprinting

35:24

By normal sprinting on the street or on the grass, you could do sprinting on your bike, stationary bike, on your elliptical. So there are different kinds of technique that you could sprint. So you can check that for whatever feels more comfortable for you, especially in the beginning because you don't want to hurt yourself. I do fasting regularly.

35:49

I do prolonged fastings up to 72 hours. I did a couple of 96. It's too hard for me. And I follow what Sean tells, taught me like,

36:03

You are doing this not to stress you even more. You are doing this for the opposite, to decrease your stress. So do it while you feel comfortable, pushing yourself a little bit out of the comfort zone. But do it in a way that you don't feel sluggish, you don't feel low energy, because you want to keep doing it. So you need to teach your brain that it brings you good energy, not sluggish, right? So I do fasting regularly.

36:30

I do drink my water without chlorine and I add apple cider vinegar and I add electrolytes and I add mineral salt like Sean teaches. I enjoy the sun as much as I can because I was in Minnesota, so it wasn't very easy. What else? Oh, I do not eat any processed foods. I cut all of it, all of it, all of it.

36:59

I eat some vegetables. I do. I don't do street carnivore. Sometimes I eat my vegetables. I am working on decreasing them progressively and being more of a carnivore. I love the fermented food. I didn't in the beginning, but I taught my microbiome and I love the fermented food now. And I do like Sean teaches, water, fermented food, good quality of meat.

37:30

good quality of eggs because again, if you are eating meat that it's extremely marbled, like it's the meat that has myosteatosis, right? And you don't want that because that meat is a meat that was produced with cortisol. The animals were stressed. The animals were eating grains. So you don't want that because otherwise you are eating their stress, right? And what else?

38:00

Water, exercise. Oh, I do strength training three times a week and I do my strength training until failure. And I love Pilates and I do Pilates because I know it's not in the strategies, but I like Pilates because it calms me down. It works in my balance and it also works more with my core. And I guess that's it. Anything else that I'm forgetting?

38:32

Well, one thing I noticed with your journey on the timeline is you had that period of time when you met Sean and learned about this. And then before you got your first MRI, I know you had other lifestyle changes and stress and things going on too during this period of time that we're discussing here. But when you got that image, and what I want to highlight here is the fact of actually seeing inside your body and seeing what's going on

38:59

Yes. So for you, was that part of the catalyst to finally make the change when you could see what was actually happening in your abdomen? Yes. Of course, I knew I had lots of visceral fat even before I did the MRI because I knew as a medical doctor, I knew what to look for metabolic disorders. So I had high blood sugar, high insulin, high cholesterol.

39:24

triglycerides and high hemoglobin A1c, I knew that my abdomen was my dad's abdomen, right? The abdomen of being pregnant. Hence, lots of people would ask me, are you pregnant? And I would feel so mad. But anyway, whatever. But when I did the MRI and I saw the huge amount of visceral fat, that definitely was a huge impact. Why? Because it's a visual impact.

39:55

After you see it, you cannot unsee it. You cannot forget. It's there in your brain. You think about it all the time. So that's the difference between the MRI and other like diagnostic imaging or BMI. Like the BMI is the height and the weight, right? Again, normal skinny people would have a normal BMI. Like right now, I have a normal BMI. But I know that if I do an MRI…

40:24

I am better than the bottom image, but I still have lots of visceral fat or deep subcutaneous fat. So it's deceitful, right? It doesn't discriminate anatomically how much fat I have and what's the quality of the fat.

40:43

Same for the DEXA scan. The DEXA scan gives you a number. And as a radiologist, I give value to the DEXA scan because the DEXA scan tells me about my bones too, which I want to improve to not have fractures, right? But the DEXA scan gives a general number, like when I started, I was 44% fat in my body.

41:07

But when you say 44% fat and you are telling me a percentage of visceral fat, that number is a number. I don't keep thinking about, oh yeah, I have 44% of fat. I am 44% of fat. Man, almost half of my body is fat. But when I look at the MRI, I am like, wow, wow.

41:30

This is a lot. I can see this white all the time. So I believe firmly that, like Sean says, the visual impact, connecting to your sense, connecting to a sense visual, makes a huge difference in alarming your brain on taking action.

41:50

you know, and again, the MRI has the benefit, as you can see in the top, both of them, but as you can see in the top image better, the MRI gives me not only the visual, I have lots of visceral fat, severe visceral fat, so quantity, quantity, but MRI gives me the quality of the fat. So I can see that I have lots of fat inside of my abdominal cavity.

42:16

Upper, I could see that I have fat in my chest surrounding my heart. And I also can see the subcutaneous fat, which shows me how much superficial fat I have, which is beneficial in protecting the heart by secreting a substance called adiponectin.

42:37

But I also see that I have lots of deep subcutaneous fat, which are as damaging to my body as the visceral fat because they secrete the same inflammatory molecules, the cytokines. Interleucine 1, 6, tumor necrosis factor, alpha, fibroblasts affect the immune system. So the MRI gives you all this image.

43:01

and disinformation. And the MRI also gives, because it's the upper abdomen, right? So I'm showing only that image there, but I can see my upper abdomen in the MRI exam. So I'm cutting a little bit of the lower chest, which gives me the information of the fat surrounding the heart.

43:20

I have the image of my liver, which tells me if I have fat in my liver. I have the image of my pancreas, which tells me how much fat I have in my pancreas. Then I have the image showing all the visceral fat surrounding my organs as an ocean of fat inside of my abdomen. And I have the image telling me the differentiation in the subcutaneous fat. Is it

43:45

more superficial, good, or is it more deep subcutaneous fat really damaging to my body as well? And I can see the amount of muscles I have, if they are getting better, if they still have lots of fat. So I can see all that with the MRI. So quantity and quality. And then the visual connection telling my brain, you've got to take action.

44:14

Is there a certain path that this fat likes to follow? As you're sharing there, the fact that it can accumulate in muscles, in organs, you got your deep subcutaneous, which is also bad. You have your visceral fat in around the organs. Is there a certain path, like I said, that

44:34

You can see as a radiologist, as somebody is accumulating this, that it typically goes in through all those different structures, which isn't good. And then the other way around, when somebody like you takes charge and starts to lose it, what's the path in the body that I should say order in the body that usually follows as you go through that process?

44:58

So this is going to be my own speculation, okay? Because I haven't learned about this before. So that's what I'm observing in my patients and in myself as well. So I would say, and again, my speculation, when I open an exam and it's a thin person, skinny person, thin outside, fat inside, that means the visceral fat starts first, right?

45:28

Because the person still looks like as if there is no subcutaneous fat, right?

45:35

So thin outside, fat inside, the visceral fat starts first. And that makes sense because the visceral fat, it's a defense mechanism of your body. You are poisoning yourself daily with, like we said, all these processed foods, chlorine, pesticides, herbicides, plastics, oils, and artificial light. Boom, you are damaging your body, all sides, right?

46:02

So that is a huge high carbohydrate intake, and that overloads your liver in the triglycerides, in the glycerol path. And that leads to increasing your blood sugar, increasing your insulin.

46:24

And we hit the culprit, the increased insulin resistance, right? With the increased insulin resistance, the visceral fat starts accumulating fat in the cells inside of your abdomen, the adipocytes, the fat cells inside of your abdomen. So the first defense mechanism is insulin.

46:47

wow, I need to store, I need to be a storage for this fat because it's damaging my body. How am I going to do to keep the homeostasis, which is the body equilibrium? I am going to store this fat in my fat cells. So they increase the volume, they increase the volume up to 200, their normal volume, to a point that they realize,

47:12

I can't increase the volume anymore. So now I'm going to increase the number of the fat cells. So first is hypertrophy and then is hyperplasia. Then you start increasing the number of the fat cells. While you are doing it, the visceral fat, the cells from the visceral fat are dealing with increased insulin and increased blood sugar and increased triglycerides in your blood.

47:40

And then the visceral fat starts secreting the cytokines. The visceral fat secretes cortisol. The visceral fat secretes all the other ones that are molecules that will lead to chronic disease, disruption of your immune system function, normal function, and

48:04

which lead to cancer, right? So that's a vicious cycle, which in medicine we call the cascade, the cascade of inflammation. So one feeds the other, that feeds the other, that feeds the other, and it never ends and it just keeps escalating, right? Exponential poisoning of your body.

48:25

So again, like you asked me, I would say the high carbohydrate diet, the horrible way we are living right now, leads to increase in glucose, increase in triglycerides, increase in insulin, insulin resistance, increase in visceral fat. And then at that time you are thin outside and you become fat inside.

48:49

Deposition of fat in your liver, which is the fatty liver and inflammation in your liver and cirrhosis and liver cancer. Deposition of fat in your brain, which is the amyloid that the deposition starts 10 to 15 years before you develop the whole memory loss, the whole first symptom of memory concern and the dementia. Deposition of fat in your pancreas, diabetes type 2.

49:16

Deposition of fat surrounding your heart and cardiovascular disorders and also in the walls of your arteries. Deposition of fat in your pelvis, which leads to urinary incontinence, stool or fecal incontinence, and erectile dysfunction and pelvic organ prolapse.

49:37

Decrease in testosterone, increase in bad estrogen, decrease in growth hormone, impairment of your sleep, affecting your melatonin and circadian rhythm,

49:53

And that's the fat inside of your abdomen. And then you start putting fat in your subcutaneous soft tissue, the superficial, the deep, and in your muscles, evolving to sarcopenia and frailty of your body. And since all these people are usually going to be sedentary, then you are also losing bone mass. When somebody learns about what we're talking about today, takes on the strategy, starts to burn this visceral fat…

50:23

Is the body smart in how it preferentially burns the visceral fat versus the subcutaneous fat early on as somebody begins this journey?

50:34

I believe so, because again, as you look in my images and what I have seen with some people too, some patients too, clients, is that you can see that my visceral fat inside the abdominal cavity decreased way more than the subcutaneous fat. The subcutaneous fat is still there. Both are bad, right? The deep subcutaneous fat is as bad as the visceral fat.

51:00

But I believe from what I've seen in me, so now I am analyzing me, okay? I believe from what I've seen in me that the visceral fat goes away first and then the deep subcutaneous fat goes away later.

51:18

I am not the best person to answer you that because I am following me. But Sean, he has seen different results in his clients. So some people decrease both of them together.

51:34

And probably these are the people that deal with less stress, less chronic stress. And some people decrease, like me, the visceral fat first and then start decreasing the deep subcutaneous fat, which we were discussing the other day and we don't have a reasoning. But I believe and he believes too that might be because of the chronic stress. Okay.

51:57

But either way, when you are doing these strategies, you just have to have patience because you're going to decrease both. And I cannot pass because you can just look at me. So far, we've talked a lot about the chemical changes in the body with the visceral fat, the cytokines, the inflammation, and the detriment that does throughout the whole body. What about the actual physical volume of visceral fat in the abdomen with all the organs there and the intestines?

52:28

Is there anything that we've come up with an understanding of how physically it taking up space there impacts things?

52:40

I don't believe that physically it taking up space there would make a difference in the organs because, again, you just keep expanding your abdomen like when you are pregnant, right? You just keep expanding the uterus and you just keep expanding your abdomen. So your body finds a space for everything.

53:00

I do believe that the damage is the pathophysiology of all the inflammation and all the chronicity and all the release of the substances and altering the function of the cells and altering the function of the immune system and altering like the deposition of

53:23

damaging substances like the amyloid and the protein in your brain that leads to dementia, the fat in your liver that leads to fatty liver, the fat in your muscles. So yes,

53:33

And again, when you are increasing your volume, it's just like your life for you doing your normal life, it's going to get more overwhelming because you are carrying all this additional extra weight in you. And then because of the chronic inflammation, your levels of energy, your levels of joy, your levels of like anxiety,

53:58

you know, living the full life you are supposed to live just are not really there very much, right?

54:04

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54:33

I'd have to imagine as the muscles begin to accumulate fat, that would affect their function. And why this is especially critical as part of the strategies for overcoming this is to exercise and move the body, specifically high intensity like sprinting. So talk about how muscle function changes as it becomes marbled.

54:59

So if you are replacing your muscles with fat, which is the marbleization, you definitely are going to decrease the strength in your muscles, the function of your muscles. And that's why the patients in the end stage of sarcopenia, they are very frail, right? Um,

55:18

they don't walk very well. They are not able to stand like tall because the muscles don't support your spine. The perivertebral, the erector spinal muscle doesn't support your spine. And then your bones are bad and then you have fractures of your vertebral bodies. And that's why elderly people who are not, you know, they walk like that with increased kyphosis. And you don't, so you don't have a lot of,

55:46

uh, strength and you lose the turgor of your skin too. And it's so easy to hurt. And it's so, it gets like hematoma and bruises so easily. And all this is because it's increased cortisol too, you know, and, um,

56:02

Yeah, so it's easy to break your bones. It's easy to… And then the mortality and the morbidity in an elderly person when they break their femur is extremely high, right? Because they're going to be even more sedentary. They could have pulmonary embolism from fat, the fat of the bone, the fat inside the bone that got broken. So, yes. Yes.

56:28

So for you to start doing the strategies, it might be hard, but again, choose your heart, right? And what I said in the beginning, choose what is less difficult.

56:43

difficult for you in the beginning because you don't want to feel overwhelmed and you don't want to hurt yourself. You want to be able to keep repeating because repetition is the mastery of getting the results. You want to be able to keep repeating and Sean teaches it very well, how to sprint when you haven't sprinted for years.

57:01

30 years. You know, you could go to his videos and see that he teaches like to go on a hill, to start slow, to you just want to do it in a way that it's going to increase your heart rate and make you short of breath. He teaches how to breathe when you finish your sprinting. So then you improve your nitric oxide because that's the purpose of the sprinting also to increase your nitric oxide.

57:27

So that's a very important thing to see. So again, what I would say is start, start.

57:35

Start slowly and then start increasing. Like when I started walking before 12-21-21, I didn't start walking 10,000 steps in a day. I started 3,000 because usually if you are doing your normal activities, you might walk around 2,000 steps a day without just only by living your life, right? Walking around the house or walking at your work.

58:01

So I started at three. I jumped to five. Then I stayed at five for a while. Then I jumped to seven. Then I stayed at seven for a while. Then I jumped to 10. So I reached 10. My first day I reached 10, 1,000 was 12, 2,121.

58:19

And then I never stopped because I knew I could do it. Right? And I don't, and it's, sometimes I walk 10,000 steps in a row. I go outside and I go for a walk. But many days I walk 30 minutes here, 30 minutes there, because I'm doing life too. Right? So again, start slowly, increase progressively, slowly.

58:41

Give yourself grace. Give yourself kindness that you might fall off track. But again, the problem, the concern is not falling off track. It's not when you fall off track that you are doing something that

58:59

It's not good for you. It's when you don't get back on track because you are thinking, oh, I already fall off track so I can just eat the whole pizza. Right? No. It's like, yes, I am going to have grace because I was tired. I'm going to have grace because I was sick. And then I am getting back on track.

59:20

And then celebrate yourself because there is a mechanism. It was proven by a study from the Harvard University that people tend to punish themselves so much or to blame themselves so much when they get off track, when they do something that they feel like they failed. But when they do something that is positive for them, they forget to celebrate themselves.

59:44

And when you celebrate yourself, you close the cycle and you are locking a mechanism in your brain telling you, I get my back.

59:55

And celebrating yourself, it's so easy. Celebrating yourself is just putting a huge smile in your face, even if it's fake, because then it becomes real. And patting yourself on the back, you got this. Or hugging yourself, or taking a deep breath, or stopping in front of the mirror and high-fiving yourself. That's just this. One simple thing that takes one second, teaches you high-fiving yourself, teaches your brain that you are

01:00:24

closed the cycle. You got back, you did the action, and you celebrated. Boom. Locked. And that's why the mindset is so important for sustainable success. Because our brains are the caveman brains.

01:00:43

And we are in a default mechanism to pay attention to everything that is negative, to everything that brings fear, to everything that is dangerous because we are in the mode of protecting ourselves. So right now in the life we are living, we need to rewire our brain through neuroplasticity and teach our brain that we are safe, that we are okay, that we are loved, that we could calm down.

01:01:11

So that's why high-fiving, celebrating, hugging yourself, vagus nerve techniques, breathing, closing your heart, telling yourself that you're safe, humming. It's so important because it calms down the amygdala, which is the cave brain. We have to run, run, run. Calms down the amygdala and then teaches your brain, you're good.

01:01:34

You're good. Just keep doing it. And sprinting acts like that. Sprinting is running from the lion, is running from to get your food. Sprinting activates food.

01:01:49

And teaches the amygdala, calm down. High interval training exercises, calm down. All these are mechanisms to decrease your stress by calming down nervous system, vagus nerve, parasympathetic nervous system. When it comes to movement, so far we've really hammered home the importance of walking, sprinting, or other high-intensity exercise.

01:02:15

What about long distance cardio, aerobic work? So somebody tuning in right now, say they're a 10K runner, marathon runner, or they do some other form of long distance exercise thinking that's good for them in their visceral fat. Talk about the connection there. So Sean explains that really well too, and I love it. So there are two types of muscle fibers in our body. We have the slow twitch and the fast twitch.

01:02:46

When you are sprinting, when you are doing high-intensity interval training, you are activating your fast twitch muscles and you are releasing substances that build muscle and decrease stress. When you are doing long cardio exercise,

01:03:08

like running, you are activating your slow twitch muscles. And your slow twitch muscles release two molecules, which are… I have this written down, but now I forgot. Anyway, you release two molecules,

01:03:27

that are going to affect your muscles. In fact, they increase cortisol, they increase stress, and they lead to sarcopenia in the long term. So you could Google the name of the substances. I really don't have this right now. If it comes to you, we can share them. If not, share after and we'll put them in the show notes. Sounds good. I'll do that. Anyway…

01:03:56

That's why they have studies nowadays with women in menopause showing that we were taught so many wrong things. We were taught about do more, do more, do more, run, run, run, and do more cardio. And no, all these increase the stress, increase the cortisol. And when you increase cortisol, what are you doing? You are feeding visceral fat.

01:04:20

You are feeding fat in your liver. You are feeding sarcopenia and muscle marbling.

01:04:26

So you don't want to do that. And that's why they have some kind of exercise for women that is really good as a cardio. You go to your treadmill and you put on the incline 12 and you're going to do 30 minutes at three miles per hour. And that was proven that for women in menopause is a good form of cardiovascular exercise that does not lead to triggering cortisol, does not lead to increasing cortisol.

01:04:55

So again, the sprinting and they affect the… They act in the fast twitch muscles and the long-term cardiovascular running affect the…

01:05:07

slow twitch muscles and they release different kinds of substances and they lead to differentiation in increasing stress or decreasing stress, cortisol and fat in your abdomen, in your muscles. I hope it made sense. No, that's great and important we got into. One of the things that's come up a few times in your sharing is this phenotype of TOFI.

01:05:31

where somebody is skinny, but they still have the visceral fat accumulating. And you have a slide here I'm going to bring up. Yes. This will be a good visual for us to see what we're talking about there. So I'll have you explain…

01:05:47

For somebody listening, there's six different images. Yes. And this is somebody with, on the high end of normal, a 24 BMI. Yes. But we're just addressing the point that you can be in that normal range. Yes. And you might have little or no visceral fat or quite a bit. So we can't just go by that phenotype of what you look like on the outside. Yes. So as you can see in this image,

01:06:15

All the patients have the same BMI. And on the top left, you have a person who has very little subcutaneous soft tissue and very little visceral fat, which is what we expect. Minimal to none, which is very rare to see.

01:06:40

And when you move from the top left to the bottom right, you see that what increases much, and that's connected to what I was saying that I believe the visceral fat starts first, what increases much is the amount of fat, which is the white inside of the abdominal cavity, which is the visceral fat.

01:07:05

the subcutaneous fat doesn't increase much. So you can see that same BMI, all the six people in this slide,

01:07:20

they believe that they are healthy because they have upper normal BMI and they don't seem fat because they don't have much subcutaneous fat. You cannot pinch a lot of fat. You don't have the love handles much there for you. But when you go from the normal metabolic healthy person, that person does not have much visceral fat. That person does not have

01:07:47

low chronic inflammation released in their body 24-7 and increasing metabolic disorders such as dementia, diabetes type 2, fatty liver, and sarcopenia.

01:08:01

When you go to the bottom right, you see that that person doesn't have much subcutaneous soft tissue still, so you don't have the love handles. But you only know that that person is metabolic unhealthy because you see lots of visceral fat producing all the chronic inflammation we have discussed so far, increasing the risk for chronic disorders that we have discussed so far as well.

01:08:28

So again, we go back to the muscles, okay? So the muscles, when you are doing sprinting maximal effort exercise, you are increasing your testosterone, increasing your growth hormone, and decreasing your cortisol, okay?

01:08:48

When you are doing resistance, when you are doing the long cardiovascular, you are acting on substances called lactate phenylalanine. And this might be the cause of increasing stress, increasing cortisol and sarcopenia. The differentiation between sprinting and long-term exercise in production of the lactate phenylalanine.

01:09:18

Earlier when you're sharing your journey, talking about your goal with visceral fat, you mentioned getting it down to zero or near zero. Yes. What is the optimal? Can we actually get that right down to zero where there's none in the body? Just so people have a realistic goal to shoot for. 95% of us have a severe amount of visceral fat. So again, I would say it's a journey for life.

01:09:48

Like grief, there is no final destination. There will be days that will be harder. There will be days that would be easier. But it's a journey for life. There is no final destination. So for visceral fat and for grief, there will be always room for improvement, right? So I would say start your journey. Celebrate every amount. It gets lower and lower, getting better and better and better.

01:10:14

And you aim for minimal or zero. And if you look at image 12, you could see that this is minimal or none. This is zero visceral fat, like zero deep subcutaneous fat, a good muscle bulk. And this is not AI created. This is a real person. So every one of us could get there.

01:10:43

How long will it take for each one of us to get there? I don't know. It will depend on your effort, commitment, consistency, and compassion. Like, what you put is what you get, right? If you keep drinking your alcohol, if you keep eating your pizza, if you keep, you know, you already know the strategies. You already, yeah. So,

01:11:11

I don't know how much time it's going to get for you to get there. I know you can get there because this person is my inspiration.

01:11:18

Right? So I know you can't get there. I know I can't get there. And I know that I just have to choose my heart. I just have to choose my heart daily. I don't want to go to the gym. It's not about wanting. It's not about wanting. It's activation energy. It's like I saw my husband doing chemotherapy when he had cancer. Did he want to do chemotherapy? No. But he had to. Right? So when I wake up,

01:11:48

And I don't want to go to the gym because I wanted to sleep until 6 a.m. and it's 5. I remember, I remind myself, it is not chemotherapy. It's something that I have to do, but it's not chemotherapy. So I get up and I go. And guess what? It's something called activation energy therapy.

01:12:12

I get up and I go because it's my why, it's my deep why. And that's why I'm asking you, why do you really want to do this? Because if it's only because you want to fit in a better jeans, you're not going to wake up 5 a.m. some days. So why do you really want to do this? So when I connect that I want to do this for my health, for me to have a functional body,

01:12:39

For me to be able to get up from the toilet when I am 80 years old without people helping me. For me to be able to carry my groceries. Then I know that I can do this. And the activation energy comes from I do it when I don't want it. I do it when I don't feel like it. I do it because it's important for me. Really important for me. And after that, my body, my brain…

01:13:08

gets that I am trustworthy, releases the endorphins, and I feel good because I got my back. By the sounds of it, somebody that's gonna embark on this journey we're talking about today, applying the strategies, attacking visceral fat, finding your why would be the start to all this. And it sounds like taking your time and really coming up with detailed reasoning why this is important to you, and I assume write it down, would be the first step.

01:13:40

Yes. Finding your why is important for everything you do in your life. It's important like for how do you want to live your life? What do you want? What do you need from life? And what are the steps you need to take daily to get there? And then after you know that, how to get there, you have to figure out, but why do I want this? Why is it so important for me? And it's not going to be your first answer.

01:14:07

My first, for example, you have to ask that at least five times and it's going to get uncomfortable. But you have to face yourself. Like Anna Rosa, why do you want to burn visceral fat? Because I want to look elegant. Because I want to feel beautiful. Because I want to fit in my pair of jeans that I used to use when I was younger. Superficial.

01:14:34

You're going to fail. You're going to eat one slice of pizza when you are angry or one cup of ice cream when you are angry. And you just feel like, whatever, I'm just going to do that and tomorrow I start again. And then second, why? But why do you want that? Because I want to be more active. Because I want to have better memory. Because I want to keep improving as a person. But why do you really want that?

01:15:04

to be more active, to have better memory, because I don't want to die like my dad with a frail body and a great sharp brain, because I don't want to have my blood sugar and my insulin so high as they are right now when they were, and I don't want to get diabetes and become blind or with renal problems or lose my toes like my grandma.

01:15:34

So when I look, I don't have the cravings anymore. But in the beginning, when I would look at a pizza or a burger or a freddo pasta or an ice cream, and I would want some, I would tell myself, what is my why? Is this slice of pizza worth my vision? You know, if I get diabetes and become blind? No, it's not.

01:16:06

Or when I don't want to go for a walk or when I don't want to go for, no, for a walk, I'm going to say differently. Or when I don't want to go to the training or, you know, stop and enjoy the sun. What is my why to have a good, to build a good quality of life?

01:16:26

for me to be functional, to take care of myself. And what do I walk for since 12-21-21 without stopping one day? Because it became my mental tool health. You know, now my depression, my anxiety, my PTSD, my fear, my stress, I know I'm there for me.

01:16:52

And I'm sure you can attest to this. Once you start to feel differently, look different, those can become secondary motivating factors to keep going. Yes. Which early on you're not going to have, obviously, and that's where the why comes in. Yes. But now you have all that compounding together and it's been this period of time and you're feeling better and better.

01:17:15

looking better. And yeah, so I can see how all this can snowball in a good way. Yes. And then we change from the cascade vicious cycle of inflammation and visceral fat to

01:17:27

to a joyful, virtuous cycle that you are building for yourself. And I love that you said the compounding effect because that's what I tell the people who are with me in this journey is like, we are stacking habits, right? We are stacking improvement. We are getting better and better every day in every way. So again, how do you stack habits? I walk my 10,000 steps. Some of them I walk outside and enjoy the sun.

01:17:59

I walk my 10,000 steps. For a while, I am walking outside disconnected from technology, just inhaling the abundance of the five senses around of me, calming my mental nervous system. I'm walking my 10,000 steps, and

01:18:19

And I am connecting with friends because connection and community has been proven in studies, too, that it's one of the major things that keep elderly people feeling alive, feeling meaningful. You know, I wake up and I take my cold shower and.

01:18:38

I practice my gratitude while I'm taking my shower. I'm talking to God, the higher power, whoever you believe. I am saying, thank you, you know, and I'm practicing my gratitude. So shower, cold shower, and

01:18:55

Walking, sun, vagus nerve, breathing, five senses. So it's tech habits, you know? I am walking and drinking my water. I am exercising, strength training and drinking my water, you know? Yeah. For somebody, again, who's going to begin this journey, we've made it clear. You got to start with your why and take your time on that step and really come up with a concrete reason you're doing this.

01:19:23

But throughout our conversation, we've speckled in so many different inputs and habits people want to take on over time to eliminate visceral fat. But what I fear for somebody who right now is inflamed, overweight, overwhelmed, this all sounds like a lot. Yes. So after somebody comes up with their why, they write it down, they're ready to get started.

01:19:50

Name one or two things that you think would be most beneficial to get the ball rolling. And then they can go back and listen again or watch again and get some of these other secondary things as to not become overwhelmed. So yes, overwhelm is definitely, you don't want to overwhelm. So let's create a plan together. Okay. Start before you have your why. Eliminating all processed foods and sugar.

01:20:22

decreasing your carbs to carbs that are to minimal or to carbs that have low glycemic index. So you don't want carbs that grow below the ground. They all have high glycemic index. And also take care with fruits and juices. They have a lot of sugar.

01:20:42

So start without your why, tomorrow or now. Eliminate all your car, eliminate all your processed foods, ultra-processed foods, vegetable oils and sugar, alcohol, eliminate.

01:21:00

And or at least start decreasing progressively. You want to have as minimal alcohol as you could. There is a video, there is a podcast from Andrew Huberman talking about the horrible effects of alcohol in your brain. I would highly recommend people to watch it because then you will see that alcohol is not like, it's not something that it's for fun. In fact, it's really bad for your body.

01:21:27

So again, eliminate, eliminate, eliminate processed foods, alcohol, sugar, drugs, smoking. Do your best again, right? Do your best. Everything is about doing your best. It's not all or nothing. It's doing your best. Processed foods, I would say it's all or nothing. And the sugar, I would say is all or nothing. But everything is doing your best, having compassion to you.

01:21:51

Secondly, take care of your sleep. Sleep is a pillar because sleep is related to, while you are sleeping, you are working on your cortisol, your glucose, your insulin, your growth hormone, and your melatonin. All these are very important in the visceral fat cascade mechanism. So take care of your sleep, at least seven hours. How do you take care of your sleep?

01:22:17

At least one hour before bed, just disconnect from all technology. I know how it is very difficult because we are so used to scrolling on Instagram or social media on our bed. But like at least one hour, disconnect from your technology.

01:22:37

One other thing is also enjoying the sunset and enjoying the sunrise for three minutes. It helps regulate your circadian rhythm, which controls the melatonin, which helps with the sleep. Again, which is also simple, hydration. Look at the water you have in your house and do your best to have water without chlorine.

01:23:02

And then you could add mineral salt, like the Redmond salt, or you could add electrolytes and apple cider vinegar to your water. One tablespoon of apple cider vinegar for each liter of water is what I do because then it's diluted and it's not going to hurt my food pipe, my esophagus. You don't want to drink the apple cider vinegar alone because otherwise you're going to have

01:23:28

chemical esophagitis and you don't want that. So these are the three things that are very easy because although they might seem like three things, they are connected to each other. You have to drink water. So water with electrolytes and apple cider vinegar and try your best to take the chlorine. You have to sleep. Sun helps with sleep.

01:23:50

And technology of one hour. And you're eating. You have to eat. So use your eating to eliminate all processed foods and sugar. And then start adding other things later on. So these are the three things I would ask people to start. I would tell people to start. And while you already start that, then you start working on your why.

01:24:15

And then you start working on your why. For you to keep doing them when it's difficult, when it's a challenge. And for you to come back to them when you feel like you failed or fell off track.

01:24:30

And after you do all of them, you could start stacking habits. Oh, while I'm drinking my water, I'm walking. While I'm drinking water and walking, I am enjoying the sun. While I'm enjoying the sun, I am improving my sleep. When I go back to sleep, I turn off technology. And I could do my 10-minute walk at night, so then I am out of technology and I am already cleaning my brain.

01:24:54

And while I'm walking, I can practice gratitude from all the things I'm doing and celebrating myself and high-fiving the mirror and hugging myself and breathing and five senses. See, all of this can be done together. You just have to do one, get used to that, and then you add another and get used to that, and then you get another. And at some point, you don't even see that you're doing it because doing all of them because they become who you are.

01:25:20

They go from chores and roles and rules, and they become ceremonies and rituals that you are doing for your body, which is a sacred body because it's the vessel of your soul. So you mentioned ACV. You add that to water. Yes. I believe you may have mentioned minerals. Yes. Yes.

01:25:42

- What other supplements are part of your baseline for general health and then any specifics that we can include supplement wise to attack visceral fat? - Yes, for that, I would definitely consult Sean O'Mara.

01:25:58

Because I am a radiologist. I am the doctor of the doctor. So I'm going to tell you what I do that he taught me. Okay? So I drink two to three liters of water a day. And you can calculate that by your weight. And I drink two to three liters of water a day. For each liter, I put one. I probably put two. I put two tablespoons of apple cider vinegar. And I put one…

01:26:27

little scoop of Redmond mineral salt and I put one little scoop of electrolytes without flavor that I buy on Amazon. So this is the water I drink throughout the day. For supplements, I do get, my hair was falling a lot and

01:26:51

And it was much more because of the stress. And it was a lot too because of androgenic alopecia. I have a history of that in my family, which again is also related to the inflammation and the visceral fat. So what I do, I take a multivitamin supplement because of my hair and

01:27:11

But what Sean told me to have is, and if you go look at like recent studies for all of us, we are very depleted in magnesium. And magnesium is very important for many, like innumerable reactions in our bodies, greater than 300, in fact. And so I get magnesium.

01:27:38

I get two kinds of magnesium. I get magnesium that goes to the brain better for memory and energy, which is the magnesium L-threonate. And I get magnesium bisglycinate that comes together with another kind of magnesium that helps with bowel movement because I have a tendency of being constipated. So again, it's going to be each person has their own recipe, right?

01:28:06

But I get magnesium. Magnesium needs to be taken together with vitamin D3, which the majority of us are also depleted. And with magnesium, vitamin D3 and vitamin K2. Because if you don't take them, because first of all, they are synergic. So they help the absorption of the odor better.

01:28:30

And if you don't take them together, you can lead to deposition of calcium in the walls of your arteries. So that's not going to be good. That's going to be bad as well, detrimental as well. So you want to take magnesium together with vitamin D3 and together with vitamin K2. What else? I do take creatine, five, five, I think it's five grams a day.

01:28:58

But again, it's me. You have to check with your provider because I know that some people are concerned regarding renal function. I'm telling you what I do. It's not your recipe. It's not medical advice. Each person is unique.

01:29:13

But I take creatine once a day. I take my apple cider vinegar, my Redmond salt, my electrolytes. I do take my vitamin D3, K2, and magnesium. I do take my multivitamin. And yes, and that's mainly what I do take. Yes. But again, different people will need different supplements. Makes sense. Yes. Thank you for that.

01:29:44

So throughout our conversation, we've shared a number of slides. You sent me a whole deck beforehand. And specifically for visceral fat, as we talked about before, seeing the visual can be really helpful.

01:29:57

So before we part ways and close here, any other slides you think would be applicable that you'd like us to look at? Yeah. So this slide shows the fat in your chest. So that central image is your heart. So I just want to show you the fat in your chest, which is as detrimental as visceral fat called ectopic fat.

01:30:19

And then you have the fat surrounding your heart with the epicardial adipose tissue. And it's extremely related to cardiovascular risk and myocardial infarcts. And again, it's very reversible with the strategies we have talked about. And lots of people who believe they are healthy, they are thin outside, fat inside, they have a severe amount of

01:30:49

epicardial adipose tissue, which is the fat surrounding your heart. And these are the people that are young, 40, 45 years old, and they are having a heart attack and having sudden death. So I believe that it's good for you to see. Another image would be image zero. This is a sequence of MRI that you are going to get when you do the upper abdominal MRI. And for visceral fat, it's needed only without intravenous contrast. You don't need intravenous contrast.

01:31:18

This is a sequence called out-of-phase, and it's really good to show the amount of fat you have in your liver, the fatty liver infiltration. And as you can see, the liver is extremely black, and it's because this person has a severe amount of fat in their liver. And you can see all the white surrounding the liver and the spleen, and that's the white that is the visceral fat.

01:31:45

And what I want to say about this slide is that the MRI allows you to see how much fat you have in your liver. If it's mild, moderate, or severe, you don't want any fat in your liver because it leads to inflammation. And a good thing is that you can reverse the fat in your liver while you have fatty liver, metabolic-associated steatoliver disease,

01:32:12

And while you have inflammation in your liver, metabolic-associated steatohepatitis. When you start developing fibrosis, it starts harder to revert. And if you start developing cirrhosis, it's a stage four, it's advanced, and it's not very reversible anymore.

01:32:39

That is progressive, it leads to liver failure, and it could lead to liver cancer.

01:32:46

So again, take action while you have a chance to improve your liver and you are not in the level of stage three or four fibrosis and cirrhosis or you have not developed yet a liver cancer. So that I think it's really important to bring to attention too because the MRI can lead to the diagnosis.

01:33:10

And I believe image two. So this image shows your liver, the huge amount of visceral fat that it's all this white hitting your face. And unfortunately, that's the majority of the people I see exams every day. And in the middle of your abdomen,

01:33:30

You see this structure that has like a fluffy appearance, white and grayish, and that's the pancreas. And the fluffy appearance, white and grayish, it's because this pancreas has fat. And you don't want that fat in your pancreas because, again, it can lead to pancreatic insufficiency and the diabetes as well.

01:33:55

So that's one thing that, again, the MRI can show. So the MRI has a benefit of showing fat in your liver, fat in your pancreas, the huge amount of visceral fat, defining the quantity, the quality, the fat surrounding your heart, the epicardial adipose tissue, and the amount of fat in your pancreas.

01:34:14

And the differentiation between the subcutaneous fat into superficial and deep. Superficial being good for you, releasing adiponectin and protecting your heart and your cardiovascular system. And the deep being detrimental. I think these were the images that were more important for people to really see the benefit and the value of the MRI. Connecting to your senses through the vision and allowing you to start taking action.

01:34:44

taking action with strategies that are the majority of them free. You don't have to pay for them. It's walking, sprinting, sun, eating good and drinking good water and sleeping, gratitude, journaling, mindfulness. And I would say you have this one only life for you to live. And the time is not granted to any of us, you know,

01:35:16

You don't know, I don't know if I would have one more second here with you. I'm still having them, right? So I would invite each one of you who are listening to this to take ownership of your life, to take ownership of your seconds, to claim the life that you were meant to have here. You are not meant to be suffering, to be hurting, you know, like…

01:35:44

You were wonderfully and fearfully made. You are meant to live a full life with purpose and meaning and joy. And you cannot do it

01:35:58

If you are dealing with chronic diseases, you cannot do it to the fullest. If you are having pain, if you are losing your memory, if you are not able to walk, if you are not able to enjoy the activities in your life, you know. So I would invite you, get your MRI, take action now.

01:36:21

And be the driver of your life. Decide your why. Tap into your power, your why. Before deciding your why, just start the simple strategies.

01:36:34

and start reversing chronic disease. All these problems we are having right now, diabetes type 2, dementia, mood problems, insomnia, anxiety, depression, all of these have been documented that are reversible just by burning your visceral fat.

01:36:59

So I tend to tell myself from the grief journey that I rise from the ashes, from the ashes of my dreams, from the ashes of my past life, from the ashes of my husband. And I invite you to burn your visceral fat and rise from the ashes of your visceral fat because you can do it.

01:37:20

Each one of us could do it. And we hold each other together and we help each other together. Find your community of people. Sean has the alpha group. Sean has the community. Get together with people who will support you, who will cheer on you, who will lift you up. Like, you become…

01:37:41

the five people you have around you. Make sure that at least two or three of them are willing to cheer you up and lift you up on this journey. Yes. Ana, I love that. What an inspirational way to wrap up here. One last question for you when it comes to MRIs. For somebody that is going to go and get that done, you showed a number of different images here that show different parts of the body. What is it they want to ask for?

01:38:08

to make sure they're getting all the images that would be helpful to somebody like you to see the different parts of the body and what's going on. So it's going to be an MRI of the abdomen without intravenous contrast. When you have an MRI of the abdomen without intravenous contrast, you are usually going to have eight to nine different sequences, and they are going to include

01:38:34

the sequences that I've shown you here. You're going to have the T2 without fat suppression, which is the one that we are looking right now, and shows the visceral fat white. You're going to have the in and out of phase, which was the one I showed about the liver being extremely dark. So that's going to be enough. You don't need intravenous contrast. It is not

01:38:56

done or paid by insurance if your doctor says that it's only for checking for visceral fat. In fact, your radiologist most likely is not going to report visceral fat.

01:39:08

But if your provider asks with most likely what you already have, you might have abnormal liver function. You might have elevated triglycerides and HDL. You might have diabetes. You might have abdominal pain. All these reasons could be a cause for your provider to order an MRI and get approved by insurance.

01:39:35

If by any chance your provider doesn't want to order an MRI or doesn't believe you need it, there is also Dr. Sean O'Mara who could become your doctor and you would get better even faster. But I would definitely look for metabolic doctors. And Sean O'Mara would be my go-to. And I think you are valuable enough to invest on your health.

01:40:03

And as your major asset, your body, the vessel of your soul, sacred. And also, when you have an order, you could check a website called Radiology Assist. And this website gives you a better competitive price for paying MRI out-of-pocket.

01:40:29

Or you could contact clinics or hospitals in your place, in your city, and negotiate the price too. You could say, I'm paying cash and I'm probably going to do this more than once. You need to negotiate for you, right? Be your own advocate.

01:40:46

So that's what I would say. MRI of the upper abdomen, no intravenous contrast. If you have any reasons that your provider could order, and I believe you might have because the visceral fat causes all these chronic diseases, you might get the MRI approved by insurance. If not, you could look at Radiology Assist and you could check Sean O'Mara and take ownership of your life. It's your life. It's your life.

01:41:14

Somebody applying the strategies, what kind of frequency would you recommend to have an MRI done? I'd imagine it's a balance between doing it too early and not seeing the results you expect and then waiting too long and realizing maybe you're not doing something correctly. So what would you recommend there? Well, I would say be committed to the strategies.

01:41:36

Because the exam, the MRI, is not what is going to be telling you if you are following the strategies well or not, right? You know, your own consciousness knows if you are following the strategies well or not. What you give is what you get from this life in everything, right? So I would follow my consciousness in doing the strategies well.

01:42:02

as proper as I can with commitment, compassion, and consistency. I would wait at least six to nine months to repeat the MRI because I could follow my own improvement in my own visual aspect.

01:42:21

Like I said, you're going to see decreasing of inflammation in your body. Your face is going to be less red. Your abdomen is going to be from protuberant to more oval, flat-shaped.

01:42:36

Your measurements is going to get better. You're going to feel better energy. You're going to be able to do the strategies in a better way. So I would wait for six to nine months at least. Of course, you could repeat earlier if you want. You could repeat earlier if it's not expensive for you. You could repeat earlier if you want to readjust your path. But again, readjusting your path is really being mindful and

01:43:02

and honest with you. I would say, do not lie to yourself that you are doing the strategies. If you are not be honest, and then you're going to know that you are on the right path. Uh, I repeated with a year and that's when I saw the difference from the one to the other, you know, and now I'm going to repeat again. And it's probably like nine months, you know, uh,

01:43:26

But I know that I'm getting better. I know that I'm following the strategies. I can see the difference in my abdominal shape, right? I can see the difference in my energy. So yes. And again, you could always have a doctor following you that will give you the advice, a metabolic doctor, Sean. You could always enroll with him in the alpha community and you're going to be in extreme good hands.

01:43:55

Ana, I want to thank you for this. You've been such a pleasure chatting with and so much great information. You've been so open and vulnerable with your story. We're going to link up your social media. And I just want to congratulate you on all the progress you made on your journey.

01:44:12

I'm so happy for you. Thank you. Thank you so much, Jesse, for inviting me. Thank you so much for trusting me and for your followers to trust me. And I firmly believe that each one of us can really build a life. We are able to build the life that we deserve each day a little bit more.

01:44:34

And yes, I am Ana Rosa Gratitude. And I am looking for women who want to be my clients for me to be coaching you, not with the body strategies from Sean, but with your mindset for you to have, for you to be like wealthy in a way that wealth means joy, health and independent and healthy.

01:45:00

living the life that you deserve, building the life that you deserve, avoiding burnout and having a good energy. And we can do this together. Yes. And we'll make it clear in the show notes how people can connect with you, work with you. Thanks again. Thank you. God bless you. Now that you're finished with the episode, head on over to jessichappas.com for detailed show notes, including links to everything we discussed. Thanks for listening and have a great day.

Edit:2025.07.02

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