Every time I see the phrase "is associated with" the first thing that comes to my mind is "does this association prove or even support the conclusion that is being made?" The association may very well be true. The conclusion drawn from it may or may not be.

Is the assumption being put forth here is that visceral fat is bad for you? The presence of visceral fat itself causes the metabolic problems? Does it? How did it get there? To have visceral fat then you must have had a diet & lifestyle that resulted in the accumulation of visceral fat. So in most people with visceral fat, that diet/lifestyle thing is also present. Perhaps this is what is bad for your metabolic health -- not the visceral fat itself. If you change your diet and lifestyle to one that does not accumulate visceral fat - but actually reduces it - does the association still hold water?

Without an actual study that looks into the "diet/lifestyle" association, I can only speculate and draw conclusions from my own experience. I changed my diet and lifestyle to one that reduces visceral fat. At my last annual checkup (2 years into changing my diet) my doctor marveled at how little visceral fat I had. I didn't have a DEXA scan, but I'm sure that I still have some visceral fat present. Still, it took 2 years to get to that point. My metabolic "risk factors" were improving from day 1 of this WOE and most were fully resolved when I still obese and still had a boatload of visceral fat. So if I were to cast a vote, I'd say the poor diet/lifestyle association is more of a risk factor than the visceral fat itself. So their conclusion that we need to shoot for zero visceral fat to be healthy may very well be based on a false assumption.