Investigative Analysis

Where Is Your Fat?

March 2003

It's a crisis of fact. America is overweight. You've heard it many times in the past year or so, and it's just not going to go away until we change our habits and improve the statistics. But more than the obesity issue, the effect of excess body weight on our health is the important matter.

Now, new research shows that hitting the right weight goal is only part of the equation; where the fat is distributed throughout your body may be as influential as the amount of fat itself. We've known for ages that obesity increases the risk for cardiovascular disease, joint problems, and diabetes. But it seems that even those who maintain healthy weight may also increase their health risks if they store the fat they have in certain areas of the body.

New research, new goals

The latest study, which appeared in February's edition of the journal Diabetes Care, suggests that men and women who store their fat in the abdomen and thighs, even if they maintain a "healthy" normal weight, are at greater risk of developing diabetes as they age.

The study follows earlier work demonstrating that young adults who carry fat around the middle are more likely to develop insulin resistance and/or diabetes. This time, researchers turned their attention to nearly 3,000 men and women with an average ate of 74, finding that those with diabetes or impaired glucose tolerance (a pre-diabetic condition) carried more fat in their thigh muscles and abdomens than those without the conditions.

It's just one more in a spate of studies that are changing the way we look at our bodies and our weight. It's not just total body weight or the percentage of body fat we must be concerned about when determining our health risks, but where the fat we carry is located that could make the difference.

Another recent study shows that fat distribution may also influence the progression of cardiovascular disease. Measuring the thickness of carotid artery walls in 310 Italian women, researchers found that those with central fat distribution (abdominal obesity) had greater risk factor profiles and higher intima-media thickness (IMT, a marker of preclinical atherosclerosis) than their more smaller counterparts. A measure of the waist-to-hip ratio was used as a marker for central fat distribution, which proved to be a significant risk factor independent of all others.

What to do

We know what you're thinking: Great, first it's the fat, now it's where the fat is at. I just got used to that body mass index (BMI) stuff! The fact of the matter is, it's all the same thing. Sure, there's a lot to think about when it comes to your health, but it all really comes down to a wholistic approach to wellness.

This new research confirms other well-known but often ignored truths such as dieting is not enough; exercise is essential. The older you get, the truer and more important this statement becomes. If you've taken comfort in your normal weight while overlooking the "beer belly" or the flabby thighs, you may want to reconsider your activity level.

With all the fitness magazines, the internet, and private centers available out there, we certainly don't have a lack of assistance. Within minutes you can find advice on special exercises to help trim those thighs and tummy, build cardiovascular strength and endurance, and eat wisely for better health. Don't think about it as an aesthetic pursuit-you're not out to impress anyone with your buff physique—but think of it as essential to your future health, your longevity, and your overall well-being.

Sources

Goodpaster BH, et. al.: Association between regional adipose tissue distribution and both type 2 diabetes and impaired glucose tolerance in elderly men and women. Diabetes Care 26:372-379, 2003.

De Michele M, et. al.: Association of obesity and central fat distribution with carotid artery wall thickening in middle-aged women. Stroke 33(12):2923-2928, 2002.

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