Beyond the brewery: the hidden role of intermuscular fat in health

When we think of body fat, the abdominal fat usually comes to mind, the star that monopolizes all attention when we talk about cardiovascular risks. But, although in a football game the striker takes the light of the reflectors, the real control of the game can fall to a midfielder that goes unnoticed.

In the field of fat distribution, that midfielder is the Intermuscular adipose tissue (IMAT), a discreet but decisive player in our metabolic and cardiovascular health. Recent studies indicate it as a key factor in systemic inflammation and insulin resistance, highlighting its relevance in the appearance of cardiovascular pathologies.

IMAT is not just one more fat: its accumulation is directly linked to aging, physical inactivity and metabolic disorders such as obesity.

Located among muscle fibers, which makes it so peculiar is that, unlike subcutaneous fat, it works as an “endocrine organ” that releases inflammatory mediators capable of altering both the local and systemic metabolic environment. And as infiltrates in muscle tissue, its quality and strength decreases, which significantly increases the risk of falls and injuries, especially in older people.

In addition to its structural effects, IMAT contributes to a chronic inflammatory state that has direct implications for cardiovascular health. An investigation showed that this fat is associated with high levels of inflammatory cytokines, such as interleucin-6 (IL-6) and the alpha tumor necrosis factor (TNF-α), molecules known for its role in the development of atherosclerosis. This constant inflammatory state feeds pathological processes that increase the risk of heart attacks and other cardiovascular diseases.

Something that makes the imat especially worrying is that its effects are less visible and, therefore, more difficult to detect and treat.

Even in people with a body mass index (BMI) within normal ranges, high levels of imat can double the risk of cardiovascular diseases. This finding challenges the conventional idea that only visible obesity is dangerousunderlining the need for more precise indicators that consider internal factors such as intermuscular fat.

In addition, a study links it to insulin resistance, a key precursor of type 2 diabetes, pointing out that this fat interferes with insulin signaling and hinders the use of glucose, exacerbating hyperglycemia.

Its accumulation tends to accelerate from the age of 40, although it is also observed in younger people with sedentary lifestyles or pre -existing metabolic conditions. This phenomenon underlines the importance of addressing the problem in a preventive and systematic way, since adverse effects are cumulative and affect both muscle and cardiovascular health.

More movement, less imat

As for prevention, physical exercise is one of the most effective weapons: moving the body, especially with strength training and aerobic activity, helps significantly reduce intermuscular fat and improves the quality of our muscles. Combining these two types of training not only reduces imat, but also improves muscle functionality. The recipe? At least 150 minutes of moderate physical activity a week, including weights if possible.

In any case, it is about fleeing the sedentary lifestyle, the main ally of the IMAT. Some studies highlight that small changes, such as getting up every hour from the seat or taking a walk after eating, can already improve insulin sensitivity and reduce systemic inflammation. The movement, even if it is minimal, is a declaration of war against intermuscular fat.

Also what we eat helps to keep it bay. A diet rich in fruits, vegetables, healthy fats such as olive oil and lean proteins not only fights inflammation, but reduces IMAT -associated markers. The Mediterranean diet is the best option in this field, showing a significant reduction in inflammatory markers such as C-reactive protein and IL-6.

How to bring it to light

IMAT is the type of enemy that works in the shadow, but medical checkups are like a focus that exposes it. Regularly evaluating indicators such as glucose, insulin and lipid profile can help identify problems before they become serious. It is not complicated science: an annual blood test can be the first step to advance the IMAT before goals to our health.

And finally, as far as solutions are concerned, not all bodies are the same and, therefore, the strategies must be personalized. In individuals with sarcopenic obesity or metabolic disordersworking with health professionals to design a specific exercise and nutrition plan is key. Some authors recommend multidisciplinary approaches that address both physical state and metabolic factors.

In short, the IMAT, that silent midfielder, has a decisive impact on our health. Its accumulation negatively affects systemic metabolism, muscle function and cardiovascular risk, making it a player we cannot ignore.

The good thing is that, like any rival, it can be defeated with the correct strategies: regular exercise, a balanced diet, constant movement and proactive medical care.

Jose Francisco Tornero-Aguilera. Doctor of Biomedical and Health Sciences / Applied Psychophysiology, European University

Article published in The conversation.