Providing independent clinical excellence since 2005
Adipose tissue—particularly visceral adipose tissue (VAT)—is not merely a passive energy store. It is metabolically active and pro-inflammatory, secreting cytokines and adipokines that drive systemic inflammation. It is therefore plausible that reducing VAT may alleviate joint pain by lowering inflammatory signalling, not just mechanical stress.
Before birth, the foramen ovale is a vital foetal opening between the right and left atria, allowing oxygen-rich placental blood to bypass the inactive lungs. After the first breath, pressure in the left atrium increases, closing the flap naturally. In around 25% of adults, the flap does not seal fully — this persistent communication is called a Patent Foramen Ovale (PFO) which is an important cause of cryptogenic stroke. All standard tests including an echocardiogram can be normal- it can be only be diagnosed using a bubble contrast study and once diagnosed, treatment with clam shell closure is high effective.
If you have ever found yourself feeling breathless climbing stairs or walking uphill — even though your lung and heart tests are “normal” — you are not alone.Many people attribute it to age or fitness. But recent research has uncovered a powerful hidden cause of breathlessness: visceral fat — the fat stored deep inside your abdomen, around your organs. In this blog, we will explore what visceral fat is, how it affects your breathing, and — most importantly — what you can do about it.
We use waist-to-height ratio (WHtR) as a screening tool, followed by low-dose CT to measure VAT index (VATI) against gender- and ethnicity-specific thresholds. Where VATI is high, patients enter a six-month digital lifestyle programme using tools like the Dr Shape food app, CGM, and body composition scales. Pharmacological therapy, including GLP-1 receptor agonists, is reserved for non-responders—making this a precise, cost-effective, and highly personalised pathway for VAT reduction.
Patients often ask about home monitoring tools — ECG devices, blood pressure monitors, glucose apps. We now also encourage people to track their waistline and visceral fat, using body composition scales alongside more traditional equipment.To support this, I have created a page of recommended home gadgets that can help patients take greater ownership of their health — a vital step towards a more proactive, prevention-focused model of care, guided by their clinical and educational team.
For years, the Mediterranean diet has been praised as one of the healthiest ways to eat. Rich in vegetables, olive oil, fish, nuts, and whole grains, it’s been linked to lower rates of heart disease, diabetes, and obesity. But why does it work so well?
For much of modern cardiology, in its battle against coronary artery disease—one of mankind’s greatest threats—the “enemy” seemed clear. When I trained, the diagnostic armoury was focused on accurately identifying flow-limiting narrowing of one or more coronary arteries. Yet in the last decade, a profound paradigm shift has unsettled these foundations—and in some respects, turned them on their head.
An article written by Dr Edward Leatham, Consultant Cardiologist Tags: VAT, LDL, Diet, Visceral Fat, CGM search website using Tags to find related stories. Introduction For decades, health advice has emphasised “low-fat” as the healthy option. Supermarket shelves are stacked with skimmed […]
An article written by Dr Edward Leatham, Consultant Cardiologist Tags: VAT, Diabetes, NH1, search website using Tags to find related stories. While everyone might think the term ‘VAT’ stands for value added tax, we all need to recognise this new health […]
VAT is the principal metabolic culprit in cardiovascular risk. BMI—while simple—fails to capture fat distribution, muscle mass, or ageing effects. Waist-based anthropometrics, particularly waist circumference and waist-to-height ratio, more closely reflect VAT and strongly predict cardiovascular outcomes.For cardiologists, this explains why a tape measure around the waist is more valuable than a BMI calculation. Where precise measurement is required—such as in high-risk patients commencing GLP-1 therapy—DEXA and low-dose CT provide direct VAT quantification.In both prevention and clinical practice, tracking waist measurements makes far more sense than relying on BMI.
An article written by Dr Edward Leatham, Consultant Cardiologist Tags: Syncope, AFib, NH1, ECG search website using Tags to find related stories. When unexplained fainting episodes (syncope) or certain types of stroke occur, the search for an underlying cause can be […]
Cardiology groups, including ours, are increasingly partnering with diabetes and weight management specialists to set up GLP-1 mimetic clinics. These clinics oversee VAT loss and improve glycaemic control for patients with diverse cardiac conditions. The goal is not only to help these patients manage their symptoms but also to provide a holistic approach to cardiovascular and metabolic health, with an emphasis on reducing the burden of visceral fat. Specialist clinics offer patients the chance to access personalised care that targets both fat loss and better glucose regulation, reducing the need for medications and potentially improving overall quality of life. In this blog and associated podcast and YouTube explainer, we set out some of the fundamental principles we care about.