Belly fat is usually detectible—people generally have a good idea if they tend to accumulate fat in their midsection, as opposed to their hips and bottom. But how do you know if your liver is fat? Well, abdominal fat and liver fat often go hand in hand. In fact, fat from the liver can be sent to the belly, and vice versa. Often, an underlying feature of both of these is inflammation, which may come from the gut. Nutrients and other substances—including fat, toxins and inflammatory compounds—are absorbed from the small intestine and travel straight to the liver via the portal vein.

A recent study found that obese individuals with high amounts of abdominal fat and liver fat are at increased risk for heart disease. The researchers found that liver fat is strongly associated with increased secretion of very-low-density lipoproteins (VLDL), which contain the highest amounts of triglycerides, known to increase heart disease risk.

It has long been known that abdominal fat can be dangerous. The increasing knowledge about the dangers of liver fat adds to the story, as these two go hand in hand, each setting the body up to be more susceptible to metabolic syndrome, type 2 diabetes and heart disease. Together, belly and liver fat mean trouble.

Both liver and abdominal fat can be reduced with exercise and weight loss. These steps, in addition to addressing any underlying gut dysfunction that may be contributing inflammation to the liver, can help reverse these metabolic precursors to heart disease.