Providing independent clinical excellence since 2005
At Surrey Cardiovascular Clinic, we move beyond detecting risk to delivering a tiered, personalised framework for metabolic and cardiovascular prevention. Using real-time tools like CGM, the DoctorShape app, imaging, and nurse-led coaching, we help patients reduce visceral adipose tissue, improve insulin sensitivity, and restore metabolic health through lifestyle-first, data-guided care.
At Surrey Cardiovascular Clinic, we focus on preventing heart disease by tackling its metabolic roots early. Using advanced imaging, metabolic phenotyping, CGM, and tailored lifestyle or pharmacological interventions, we help patients reduce visceral adipose tissue (VAT), improve insulin sensitivity, and shift from risk to resilience through precision, feedback-driven cardiometabolic care.
Small dense LDL (sdLDL) particles are the most atherogenic type of LDL. They are smaller and heavier, stay in the bloodstream longer and more likely to oxidise and enter artery walls. High sdLDL is typical of metabolic syndrome, diabetes, and high triglyceride states linked to visceral fat.Because sdLDL testing is specialised, the ApoB level and the LDL-C : ApoB ratio can be used to estimate particle size predominance:
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
Carbohydrate Sensitive Phenotype (CSP) is not a diagnosis of diabetes or obesity. Rather, it’s a biologically driven pattern of visceral fat accumulation and carbohydrate intolerance which is highly prevalent in those with a raised waist-to-height ratio (WHtR > 0.5), triggered by aging, Western-style diet and lifestyle. More importantly, CSP gives individuals a name for their experience—one that invites support instead of judgement, and allows them to engage with food and health choices free from social shame.
When most people think of a cooked breakfast, they picture something indulgent — bacon, eggs, toast, maybe pancakes or juice. But my version of a cooked breakfast is carefully designed to help reduce visceral fat (VAT), improve satiety, and support stable energy levels throughout the morning. Here's how I do it — and why it works.
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.
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.
Traditional upper limits for ALT (often ≤55 U/L in UK labs) were derived decades ago, before the epidemic of obesity and steatosis. Current evidence suggests these ranges are too high — and that values above 30 U/L may already indicate liver injury in people with metabolic risk. The British Society of Gastroenterology (BSG) guidelines emphasise that a result within the “normal range” may not be reassuring if the patient is metabolically high-risk
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?
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 […]