Providing independent clinical excellence since 2005
In cardiometabolic medicine, muscle is not a cosmetic tissue but a metabolic organ. Evidence consistently shows that strength, not muscle mass, predicts insulin resistance, cardiovascular risk, and survival. Many older adults are not losing muscle tissue — they are losing muscle function, and that is the pathology that matters.
Raised visceral fat quietly disrupts thyroid chemistry, increasing reverse T3 and lowering active T3 inside tissues. This pushes the body into metabolic “conservation mode” — slowing energy, mood and fat loss despite normal blood tests. Reducing VAT gradually restores healthy thyroid activation and metabolic resilience.
HIIT interrupts this cycle by dramatically improving insulin sensitivity and glucose uptake in skeletal muscle — particularly in the large lower-limb muscles of the thighs and glutes. A single 20-minute session of HIIT can activate GLUT-4 transporters in muscle cells for up to 24–48 hours, drawing glucose out of the bloodstream and away from storage in the liver and visceral fat depots.
Visceral fat (VAT) is the dangerous, hidden fat stored around your organs that accumulates. when caloric intake exceeds energy demand, since glucose and fats that can’t be used gets stored as adipose tissue. This blog explains how ageing, muscle loss, glucose spikes and genetic factors all drive VAT accumulation — and how reversing the cycle requires restoring mitochondrial health, increasing muscle mass, and in many people, by reducing glycaemic overload.
Mitochondria are the power stations inside every cell, converting food into energy. But in modern life, with constant carbohydrate intake and low energy demand, they become overwhelmed. Just like solar panels producing too much electricity for full batteries, mitochondria have nowhere to send surplus fuel. This triggers oxidative stress, inflammation, and early ageing. Insulin is meant to divert excess glucose to safe storage — but when that system fails, metabolic chaos follows. In this article, we explore how your mitochondria manage energy, what causes them to overload, and how lifestyle changes can help restore balance and protect long-term health
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.
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.
Thanks to digital health technology, many of the tools needed to correct low protein intake are now in the hands of patients. Food tracking apps can analyse the macronutrient breakdown of meals, allowing users to make informed adjustments. AI-based platforms can even suggest personalised meal plans that hit protein targets while remaining aligned with caloric needs and dietary preferences.