Body Fat and Health Part 1

Most people are aware that being obese or overweight is bad for your long-term health. But it come as a surprise to learn that being fat is not necessarily worse from a health perspective than being a “normal” weight.

There’s two things that come into play. Due to differences in basic body shape, it’s possible for someone with a larger frame to have a lower body fat percentage than someone considerably thinner-looking of about the same height.

But general body fat percentage is actually a relatively minor issue as compared to where the individual’s fat is stored.

There’s three main areas of fat deposition: visceral fat (around your organs), abdominal subcutaneous fat (“belly fat” around your midsection just below the skin), and gluteofemoral fat (around your hips, buttocks, and thighs).

Everyone has some combination of the three, so what we’re talking about is where the majority of one’s fat is stored.

Visceral fat is by far the biggest problem and a predominance of fat in this area presents the biggest increased risk of diabetes and cardiovascular disease.

Abdominal fat is relatively neutral with a mild increased risk of diabetes in men.

Surprisingly, a predominance of gluteofemoral fat actually carries a mildly decreased risk of diabetes and cardiovascular disease.

To be clear, we’re talking about diabetes and cardiovascular risk only. Being significantly overweight, regardless of where one’s fat is deposited has other potential risks, such as negative effects on conditions like arthritis in the knees and hips.

It should be noted that the distribution of fat has health impacts even in relatively normal height to weight proportioned individuals with normal total body fat percentages.

You may be wondering how you can tell where your fat is stored. Gluteofemoral fat is pretty easy to distinguish, as it leads to proportionally bigger hips, buttocks, and thighs. If you’re thicker below the waist than above, you most likely have more gluteofemoral fat deposition.

Visceral and abdominal subcutaneous fat are a bit trickier to distinguish since they are both increase the size of the abdominal area. Ultimately, MRI and CT scans will provide the most accurate analysis, but there are some basic signs that point more towards visceral fat.

A very basic indicator of increased visceral fat is having a waist measurement of 40 inches or more in men and 35 inches or more in women. A body mass index (calculated by dividing your weight in kilograms by your height in meters squared) of 30 or higher is also an indication of higher visceral fat. But neither of these methods takes into consideration particularly large-framed nor particularly small-framed individuals.

Probably the most useful do-it-yourself assessment of potentially increased visceral fat is to divide your waist measurement by your hip measurement (at the widest point). A waist to hip ratio of more than .95 for men or .85 for women suggests excess visceral fat.

While it’s still not entirely understood why fat in one area is more problematic than in another, one thing that is known is the different areas of fat have different gene expressions which appear to relate to areas of embryological development.

Another issue is that visceral and abdominal subcutaneous fat have higher turnover than gluteofemoral, and they tend to transfer more fat to sites outside of normal fatty tissue, such as the muscles, liver, and other organs, which promotes insulin resistance and cardiovascular risk.

Visceral and abdominal fat cells also appear to be able to enlarge more easily, which allows them to release fat more easily back into the bloodstream than gluteofemoral fat cells.

While we can’t really choose where our bodies preferentially deposit fat, we do have some ability to reduce the amount of visceral and abdominal fat deposition. But that is a discussion that I’m going to reserve for next week’s newsletter.

Until next time…

George F. Best, D.C.