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PubMed1995

Central adiposity and its metabolic correlates in obese adolescent girls.

To establish whether alterations in insulin action and secretion and their relationship to body fat distribution occur early in the course of developing obesity, we studied 14 obese adolescent girls [13.2 +/- 0.7 yr, body mass index (BMI) 32 +/- 1.4], 16 nonobese young women (24.0 +/- 0.6 yr, BMI 21.0 +/- 0.9). Insulin action was assessed by a sequential two-step (8 and 40 mU,m-2.min-1) euglycemic insulin clamp in combination with [1-13C]glucose and indirect calorimetry. Insulin secretion was determined by the hyperglycemic clamp technique (6.9 mmol/l). Magnetic resonance imaging was used to quantify visceral and subcutaneous abdominal fat depots. In obese girls, an impairment in glucose disposal was present with both insulin doses; at the higher dose, rates of glucose uptake were reduced by 30% in nonobese girls (240 +/- 30 vs. 340 +/- 19 mg.m-2.min-1, P < 0.05) and by an additional 29% (170 +/- 17 mg.m-2.min-1, P < 0.05) in obese girls. Insulin infusion failed to stimulate glucose oxidation and to suppress lipid oxidation only in obese girls. Suppression of free fatty acid levels, but not hepatic glucose production, was decreased in obese girls compared with controls. Fasting and glucose-stimulated insulin responses were greater in obese than in nonobese adolescents, who, in turn, had greater responses than lean women. In obese girls, visceral fat, but neither waist-to-hip circumference ratio nor subcutaneous fat, was highly correlated with basal insulin secretion (r = 0.89, P < 0.001), stimulated insulin secretion (r = 0.61, P < 0.05), and insulin resistance (r = -0.87, P < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1995

Estimation of body fat and lean tissue distribution by dual energy X-ray absorptiometry and abdominal body fat evaluation by computed tomography in Cushing's disease.

Body composition determined by dual energy x-ray absorptiometry and the abdominal visceral fat component determined by computed tomographic scanning were examined in women with Cushing's disease and compared with those in obese women with the same anthropometric parameters and those in nonobese women. Patients with Cushing's had no increase in total body fat or the trunk region (android) component, but had a higher intraabdominal fat area compared to the obese subjects. The total lean tissue mass was slightly reduced in Cushing's compared to that in the obese subjects due to a significant decrease in the muscle of the legs and arms; the reduced amounts of fat and lean tissue masses in the arms were the most significant findings in hypercortisolism. The body mineral and bone calcium contents were slightly reduced in Cushing's compared to those in the obese controls. Thus, although obese subjects had more fat and lean tissue and mineral masses than their normal weight counterparts, the Cushing's patients, with the same total fat mass and its components (except in the arms) as obese individuals, present total lean tissue and fractions, including body mineral and bone calcium contents, similar to those in nonobese subjects due to the depletion of the protein depots, as seen in hypercortisolism.

Absorptiometry, Photon↗
PubMed2006

Abdominal fat-water separation with SSFP at 3 Tesla.

The ability of the phase-sensitive steady-state free precession (SSFP) technique to distinguish subcutaneous and visceral adipose tissue in the abdomen at 3 T was evaluated. A phased array receiver radiofrequency coil and a commercially available SSFP sequence were used for imaging. The raw image data were postprocessed to generate fat-only and water-only images. A postprocessing algorithm that is computationally efficient and robust is presented. The postprocessing technique separates the fat and water pixels automatically without any user interference. The feasibility of the technique is demonstrated in vivo with breath-hold abdomen images. The short scan time and the ease of use of this technique are well suited to the quantification of body fat distribution in children.

Abdominal Fat↗
PubMed1988

Accuracy and reliability of self-measurement of body girths.

Because body fat distribution has been recognized as a disease risk factor, practical methods for the measurement of body girths are needed. In two groups of postmenopausal women aged 55-69 years in the upper midwestern United States, the authors examined the reliability and accuracy of self-measurement by mail questionnaire of waist, hip, upper arm, wrist and calf girths. Intra-class correlations for waist girth were 0.96 when two self-measurements were compared and 0.93 when self-measurement was compared with technician measurement. Other intra-class correlations were at least 0.85 for repeat self-measurements except for wrist, which had an intra-class correlation of 0.66. For comparisons of self-measurement with technician measurement, intra-class correlations ranged from 0.71 for upper arm to 0.96 for hips. There was slight overestimation of waist girths and underestimation of hip girths when self-measurement was compared with technician measurement. Accuracy of self-measurement did not seem to vary according to age or educational status, but for hip, wrist, and calf girths it appeared that self-measurement underestimated technician measurement as girth size increased. For most girths, within-person variation in girth measurement also increased as girth size increased. Overall, girth self-measurement was both repeatable when re-ascertained by mail and accurate when compared with subsequent technician measurement.

Aged↗
PubMed1994

Serum lipid responses to a eucaloric high-complex carbohydrate diet in different obesity phenotypes.

OBJECTIVE: To determine whether the eucaloric substitution of complex carbohydrates for dietary fat (15% of daily energy intake) affects plasma lipid concentrations differently in upper-body obese, lower-body obese, and nonobese women. DESIGN: We studied 23 premenopausal women before and after dietary intervention. MATERIAL AND METHODS: After the 23 subjects achieved weight maintenance on their usual high-fat diet (43% fat, 37% carbohydrates, and 20% protein), the 7 upper-body obese, 8 lower-body obese, and 8 nonobese women consumed a eucaloric, high-complex carbohydrate, low-fat diet (27% fat, 53% carbohydrates, and 20% protein) for 4 weeks in the Clinical Research Center. Before and after the high-carbohydrate diet, body composition and plasma lipids and apoproteins were measured. RESULTS: After the high-carbohydrate diet, fasting plasma triglyceride concentrations increased (from 1.50 +/- 0.14 mmol/L to 2.00 +/- 0.25 mmol/L; P = 0.04) in upper-body obese women but were not significantly changed in lower-body obese (1.37 +/- 0.28 mmol/L and 0.96 +/- 0.12 mmol/L) or nonobese (0.70 +/- 0.08 mmol/L and 0.73 +/- 0.08 mmol/L) women. The hypertriglyceridemia was present before the evening meal and throughout the night in upper-body obese women. Plasma cholesterol and high-density lipoprotein cholesterol were not significantly affected by the change in diet. No changes in plasma apoprotein concentrations or body composition occurred that could account for the dietary-induced hypertriglyceridemia in the women with upper-body obesity. CONCLUSION: The hypertriglyceridemic response to a high-complex carbohydrate, low-fat diet may be obesity phenotype specific. These findings suggest that further studies of this phenomenon should be focused on this obesity phenotype and further emphasize the importance of assessing body fat distribution when treatment outcomes are determined.

Adult↗
PubMed1993

[Transverse study of obesity: distribution of adipose tissue and correlated pathology].

The relationship between obesity and prevalence of dyslipidemia is well known. Recent studies affirm that differences in fat distribution can be predictive for differences in the prevalence of metabolic disturbances and cardiovascular disease independently of the BMI, presently the most common index of obesity. In order to verify whether body fat distribution can be associated with a higher risk of atherosclerosis, we have evaluated in a group of obese women the eventual presence of endocrine and metabolic diseases. Assessing regional fat distribution, the waist/hip ratio has been shown to be more closely correlated with these diseases than BMI. We have studied two groups of 10 women, comparable for age and BMI: group A aged 45.8 +/- 6.9 years with a BMI of 35.6 +/- 2.8 kg/m2; group B aged 48.3 +/- 3.6 years with a BMI of 38.5 +/- 2.8 kg/m2. The women were divided according to the waist-hip ratio, which was calculated by measuring the circumference of the waist, namely the smallest circumference between the xiphoid and the umbilicus, and the circumference of the hips at the point of the maximum protuberance of the buttocks. The cut-off value for the waist/hip ratio was considered as 0.80 for the reason that this variable is the most accurate cut-off value for abdominal obesity: for group A 0.76 +/- 0.02; for group B 0.89 +/- 0.02 (p < 0.01). All the women were healthy. None of them was in therapy with any kind of drugs, nor was there any restriction to diet. Nobody was a smoker, neither did anyone drink alcoholic beverages.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1992

Total body fat content and fat topography are associated differently with in vivo glucose metabolism in nonobese and obese nondiabetic women.

In this study, total body fat content and fat topography were related to glucose metabolism in the basal and insulin-stimulated states in 18 nonobese and 18 obese premenopausal nondiabetic women. All subjects received a euglycemic insulin (20 mU.min-1.m2) clamp study in combination with [3-3H]-D-glucose infusion and indirect calorimetry to quantitate total body glucose uptake, glucose oxidation, and nonoxidative glucose disposal. Total body fat content was determined with tritiated water, whereas body fat distribution was estimated from the WHR, the STR, and the VSR (measured by magnetic resonance imaging). In the postabsorptive state, total body glucose utilization, glucose oxidation, and nonoxidative glucose disposal rates were similar in nonobese and obese women, whereas during the insulin clamp all three metabolic parameters were reduced significantly in the obese group. In nonobese women, total body fat content was related inversely to both total and nonoxidative glucose disposal during the insulin clamp, whereas no relationship was found between glucose metabolism (total, oxidative, and nonoxidative) and WHR, STR, or VSR. In contrast, in obese women, no relationship was observed between total body fat content and any measure of insulin-mediated glucose metabolism. However, both WHR and VSR were related inversely to total, oxidative, and nonoxidative glucose disposal rates during the insulin clamp. These results suggest that total body fat content and body fat topography are associated differently with insulin-mediated glucose metabolism in nonobese and obese women. In the nonobese women, total body fat mass appears to be a primary determinant of tissue sensitivity to insulin, whereas in obese women, body fat topography exerts a more dominant effect.

Adipose Tissue↗
PubMed1999

Changes in sex hormones during an oral glucose tolerance test in healthy premenopausal women.

OBJECTIVE: To assess the effect of an acute elevation in circulating insulin on serum androgen levels in healthy obese women with different body-fat distributions. DESIGN: Controlled clinical study. SETTING: The Endocrinology Unit of an academic medical center. PATIENT(S): Seventy healthy premenopausal women participated: 27 women with upper-body obesity, 22 women with lower-body obesity, and 21 normal-weight women as controls. INTERVENTION(S): A 75-g oral glucose tolerance test (OGTT) was performed for all participants. MAIN OUTCOME MEASURE(S): Anthropometry and serum concentrations of glucose, insulin, free T, DHEAS, androstenedione, E2, and sex hormone-binding globulin (SHBG) at fasting, 60 minutes, and 120 minutes after oral glucose loading. RESULT(S): Although androgens and E2 levels in all three groups declined modestly, there were no statistically significant differences in response of the sex hormones to an OGTT in the two obese groups and normal-weight women. No correlation was found between changes in sex-hormone levels during an OGTT and insulin rise. Increased body mass index and more pronounced abdominal fat localization resulted in basal hyperinsulinemia, markedly exaggerated glucose-induced insulin levels, and hyperandrogenism, as was evident by significantly elevated free T and low SHBG serum levels. CONCLUSION(S): There were no statistically significant differences in androgen response to acute hyperinsulinemia during an OGTT between obese women with different regional fat distributions and lean controls.

Administration, Oral↗
PubMed2001

Pre-heparin plasma lipoprotein lipase mass: correlation with intra-abdominal visceral fat accumulation.

OBJECTIVE: To determine how lipoprotein lipase mass in the pre-heparin plasma is affected by body fat distribution, which is known to be closely related to lipid disorder, either directly or through insulin resistance. SUBJECTS: A total of 57 subjects consisting of 50 hyperlipidemic and 7 normolipidemic subjects (age 54 +/- IIy; 31 men, 26 women; body mass index 24+/- 2.5 kg/m2; serum total cholesterol 6.4+/-1.5 mmol/l; triglycerides, 2.4 +/- 1.7 mmol/l; HDL-cholesterol 1.3 +/- 0.5 mmol/l) were enrolled. MEASUREMENTS: We investigated the correlation between pre-heparin plasma LPL mass and intra-abdominal visceral fat area (or subcutaneous fat area) evaluated by computed tomography, and serum lipids and lipoproteins. RESULTS: Pre-heparin plasma LPL mass correlated inversely against intra-abdominal visceral fat area (r = - 0.51, p < 0.0001) and body mass index (r = - 0.46, p = 0.0003), but did not show any significant correlation with subcutaneous fat area. Pre-heparin plasma LPL mass had a positive correlation with serum high density lipoprotein cholesterol (r = 0.45, p = 0.0004) and a negative correlation against serum triglycerides (r = - 0.48, p = 0.0002). CONCLUSIONS: Pre-heparin plasma LPL mass is closely associated with intra-abdominal fat distribution, and the measurement of its value gives useful information concerning metabolic disorder.

Adipose Tissue↗
PubMed1982

Blood pressure and blood lipids in adolescent obesity.

The relationship of relative body weight (RBW) and adiposity to blood pressure and blood lipids was studied in a selected group of adolescents aged 15-17 years with RBW between 95 and 140 per cent and body fat tissue between 10 and 45 per cent. The increase in RBW and percentage of body fat was positively associated with systolic blood pressure in boys and girls and with diastolic blood pressure in girls. In boys, the RBW and percentage of body fat were also positively associated with total lipids, VLDL and negatively associated with HDL. In girls, there was a positive association of RBW and body fat with blood cholesterol, total lipids and LDL-cholesterol. These associations, though statistically significant, were of a rather low order when the entire range of body mass and percentage of body fat distribution were considered, but became more significant in more extreme distribution categories. The results indicate that the increase of RBW over 25 per cent of standard in both boys and girls as well as the increase in percentage of body fat over 25 per cent in boys and over 35 per cent in girls may be associated with elevated blood pressure and changes in blood lipid values in adolescents.

Adolescent↗
PubMed1999

Ultrasonography evaluation of abdominal fat in live rats.

We have developed a new noninvasive method of estimating abdominal fat volume in live rats using ultrasonography. By this method, cross sections of perirenal (retroperitoneal) fat tissue, which is an abdominal fat, at the renal vein level could be identified and the area determined. The perirenal fat in Wistar rats (wide body weight range, 111.4 to 497.3 g; limited range, 300.1 to 337.9 g) measured by ultrasonography was compared with the actual fat tissue weight. The cross-sectional area of perirenal fat tissue was significantly correlated to the actual whole tissue weight. Using this procedure, we examined the changes of perirenal fat stores during fasting. Consequently, the cross-sectional area of perirenal fat and its actual weight decreased in parallel. Total body electrical conductivity (TOBEC) is currently used to measure fat-free mass (FFM) and indirectly predicts total body fat mass of live laboratory animals. The body fat distribution, that is, the location of adipose tissue in the abdominal region, is closely associated with obesity-related diseases. Therefore, it is important to focus not only on the accumulation of total body fat, but also on that of abdominal fat. The present ultrasonographic method is considered to be useful for repeated noninvasive measurement of abdominal fat in the live rat.

Abdomen↗
PubMed2002

Trunk fat and blood pressure in children through puberty.

BACKGROUND: Fat distribution is well recognized as a cardiovascular risk factor in adults. The association between android fat distribution and cardiovascular risk factors, such as blood pressure (BP), was previously reported in an African-American and Caucasian pediatric population. The aim of the present study was to investigate the relationship between BP and body fat distribution in a large cross-sectional pediatric sample. The effects of race, sex, and puberty on this relationship were assessed. METHODS AND RESULTS: BP was measured in 920 healthy children and adolescents (African-American, Asian, and Caucasian, ages 5 to 18 years). Fat distribution was determined by skinfold thickness and dual-energy X-ray absorptiometry (DXA). Pubertal status was assessed by the criteria of Tanner. Regression analysis was used to explore the association between BP and fat distribution. Significant positive relationships between systolic and diastolic BP and trunk fat adjusted for total fat were seen in boys at all pubertal stages in all 3 races by both DXA and skinfold measurements. In girls, trunk fat was not a significant predictor of BP. CONCLUSIONS: Our results demonstrate a sex difference in the relationship between BP and trunk fat in that a significant positive relationship was present in boys only. These findings, based on 2 independent measures of fat distribution, may help identify the specific features of individuals at risk, allow earlier intervention, and suggest sex-specific determinants for BP.

Abdomen↗
PubMed1997

Meformin, plasma glucose and free fatty acids in type II diabetic out-patients: results of a clinical study.

Abnormalities in free fatty acid (FFA) metabolism are an intrinsic feature of type II diabetes mellitus and may even play a role in the development of glycaemic imbalance. This study investigated whether the anti-diabetic drug metformin can reduce FFA levels in clinical practice and whether this correlates with its anti-diabetic effect. For 6 months metformin was added to sulfonylurea therapy in 68 type II diabetic outpatients with poor glycaemic control, being administered before meals and at bed-time. Basal and daily area-under-the-curve (AUC) glucose levels dropped (both P < 0.0005) like basal and daily AUC FFA levels (P < 0.004 and P < 0.001 respectively) reductions were all correlated (P < 0.001 and P < 0.003 respectively). Reductions in fasting and daily AUC glucose correlated more closely with body fat distribution, expressed by waist-hip ratio (WHR) (P < 0.006 and P < 0.004 respectively), than with the body mass index (BMI) (P < 0.02 and P < 0.04 respectively). Similarly fasting and daily AUC FFA correlated with WHR (P < 0.007 and P < 0.01 respectively) but not with BMI (both P = ns). Subdividing male and female diabetic patients into groups with low and high WHRs, fasting and daily AUC glucose were reduced in men (P < 0.01 and P < 0.02) and in women (P < 0.02 and P < 0.04 respectively) with low WHRs less than in men and in women with higher WHRs (for each gender P < 0.0001 and P < 0.0002, respectively). Decreases in fasting and daily AUC FFA, which did not reach significance in either men or women with low WHRs, were statistically significant in men (P < 0.03 and P < 0.01 respectively) and in women (P < 0.02 and P < 0.005 respectively) with high WHRs. These findings suggest that an improvement in FFA plasma levels might contribute to metformin's anti-diabetic activity which appears to be more marked in patients with high WHRs. Moreover adding a bed-time dosage to the standard administration at meal times seems to be an effective therapeutical strategy.

Blood Glucose↗
PubMed2006

A school-based physical activity program to improve health and fitness in children aged 6-13 years ("Kinder-Sportstudie KISS"): study design of a randomized controlled trial [ISRCTN15360785].

BACKGROUND: Childhood obesity is the result of a long lasting imbalance between energy intake and energy expenditure. A major contributing factor is physical inactivity which is closely linked to bone health, cardiovascular disease risk, fitness and psychological factors. The school seems to provide an excellent setting to enhance levels of physical activity (PA). However, there is insufficient data from previous school-based intervention trials on how to enhance overall PA. It is also unknown whether an intervention aimed at increasing PA is effective in improving the children's health. The purpose of this paper is to outline the design of a school-based randomized, controlled trial (RCT) aiming to increase overall PA and to improve fitness and health in 6- to 13-year-old children. METHODS/DESIGN: 15 schools were randomized to the intervention (n = 9) or the control (n = 6) group, stratified by geographic region (urban vs. rural) and by age (1st and 5th grade). Participation was given for all children in the intervention group since in this group the intervention was part of the normal school curriculum. The intervention during one academic year consisted of: 1. two additional physical education classes per week given by trained physical education teachers adding up to a total of five PA classes per week, 2. short PA breaks (2-5 min each) during academic lessons, 3. PA home work, and 4. adaptation of recreational areas around the school. All children underwent anthropometric measurements, blood pressure assessment, fitness testing, measurement of PA and they filled out questionnaires. At least 70% of all children agreed to blood sampling and measurements of body composition and bone mineral measurements by dual energy x-ray absorptiometry. The primary endpoints of the study after one year were an increase in total PA by accelerometry, an increase in aerobic fitness measured by the 20 m shuttle run, a decrease in percent body fat derived from skinfold measurements and an increase in quality of life as assessed by the child health questionnaire in the intervention group compared to the control group. Secondary outcomes were overall fitness, differences in body composition including body fat distribution, cardiovascular risk factors, psychosocial health, bone mineral content and density of femur, lumbar spine and total body and food intake. DISCUSSION: Our preliminary data suggest that the children were representative of Swiss children with respect to sex, socio-demographic status, and body mass index. Short-term results can be expected by the beginning of 2007. We hypothesized that our intervention will lead to an increase in PA, fitness and overall health. Based on our data, we aim to provide important information regarding the influence of such an intervention on these outcome measures in school-aged children and to provide nationwide guidelines to improve PA in children.

Adolescent↗
PubMed1996

Abdominal fat distribution and metabolic risk factors: effects of race.

Previous studies have shown differences between African-American and Caucasian populations in the prevalence of obesity and obesity-related diseases such as type IIoffabetes. The purpose of this study was (1) to compare the insulin sensitivity index (SI) from the minimal model in 37 African-American and 22 Caucasian women matched for age and obesity, and (2) to determine whether the relationship between intraabdominal fat distribution and SI (and other health risk factors) was similar in both races. To address the second question, intraabdominal fat distribution was assessed by computed tomographic (CT) scans in a subset of 23 African-American and 15 Caucasian women. Despite having a similar body mass index ([BMI] weight in kilograms divided by height in meters squared) and waist to hip ratio (WHR), African-American women had a mean SI value that was approximately 36% lower than in the Caucasian women (3.45 +/- 0.42 v 5.40 +/- 0.55 x 10(-5) min(-1) / pmol x L, P = .007). Visceral fat area was smaller in African-American women (98.0 +/- 8.5 CM2) than in Caucasian women (117.3 +/- 12.4 CM2) despite similar BMI and WHR. Visceral fat area was strongly correlated with WHR in the Caucasian women (r = .76, P < .001), as previously observed, but not in the African-American women (r = .24, NS). WHR was significantly correlated with fasting insulin and serum cholesterol in the Caucasian women but not in the African-Americans. Visceral fat was correlated with metabolic risk factors in both groups, but subcutaneous abdominal fat was significantly correlated with SI and fasting insulin only in the African-American women. These results suggest that the relationship between body fat distribution and health risk factors may be different in African-Americans and Caucasians. Additionally, reduced insulin sensitivity in African-American women may in part explain the high diabetes rate in this population.

Abdomen↗
PubMed1995

Predictors of the age-related increase in blood pressure in men and women.

BACKGROUND: The age-related increase in blood pressure frequently observed in men and women may be more related to deleterious alterations in physical fitness, body composition, and diet than to a true aging phenomenon. Our purposes were to: (a) characterize the relationship between age and blood pressure in normotensive men and women; (b) identify physiological predictors of the age-related increase in blood pressure; and (c) examine whether the relationship between age and blood pressure persists after controlling for differences in these predictor variables. METHODS: Three hundred and sixty four Caucasian men (17-80 yr) and 215 Caucasian women (18-81 yr) were characterized for supine resting blood pressure, peak oxygen consumption, body composition, body fat distribution, plasma insulin and glucose concentrations, and nutritional intake. RESULTS: In men, the relationship between age and mean arterial pressure (MAP) (r = .25, p < .01) was no longer significant (partial r = .07, p = .20; 0.03 mmHg increase per year) after four predictor variables of MAP (fat mass, sum of 9 skinfolds, alcohol intake, and supine heart rate) were statistically controlled. In women, the relationship between age and MAP (r = .44, p < .01) no longer existed in women younger than 62 years of age (partial r = .06, p = .46; .04 mmHg increase per year) after three predictor variables of MAP (waist-to-thigh ratio, supine heart rate, and alcohol intake) were held constant, whereas in women older than 62 the relationship persisted (partial r = .37, p < .01; 0.9 mmHg increase per year). CONCLUSION: In healthy Caucasian men and women between 17-81 years of age: (a) The relationship between MAP and age was stronger in women than in men, primarily due to an accelerated increase in MAP in women older than 62 years of age; (b) the age-related increase in MAP in men was primarily related to an increase in body fatness, whereas in women the distribution of fat was the primary factor; and (c) after the influence of the predictor variables of MAP were controlled, the relationship between MAP and age persisted in women beyond 62 years of age, but not in women younger than age 62 or in men of any age.

Adolescent↗
PubMed1998

Diet effects on fatty acid metabolism in lean and obese humans.

The primary role of adipose tissue is to serve as a temporary storage site for energy in the form of nonesterified fatty acids. The regulation of adipose tissue lipolysis, which allows the appropriate delivery of fatty acids to meet the lipid fuel needs of lean tissue, is affected by the amount and the location of fat, as well as by the diet. Excessive accumulation of triacylglycerol fatty acids (obesity) is associated with an increased risk of insulin resistance, diabetes, hyperlipidemia, and hypertension. Some of these abnormalities may be related to dysregulation of fatty acid metabolism. Body fat distribution exerts a major influence on endogenous nonesterified fatty acid metabolism, which may in turn mediate some of the metabolic abnormalities associated with upper-body obesity. The effects of diet on fatty acid metabolism can be dramatic and are not the same in upper-body and lower-body obesity. Different obesity phenotypes may respond differently to low-fat, high-complex-carbohydrate diets, and the response is further modified depending on whether the diet is isoenergetic or restricted in energy.

Dietary Fats↗
PubMed1999

Phenotypic characteristics associated with insulin resistance in metabolically obese but normal-weight young women.

Metabolically obese, normal-weight (MONW) individuals are a hypothesized subgroup of the general population. These normal-weight individuals potentially display a cluster of obesity-related features, although this has not been systematically tested in young women. We hypothesized that MONW young women would display higher levels of total and visceral fat and lower levels of physical activity than normal women. In a cohort of 71 healthy nonobese women (21-35 years old), we identified MONW women based on cut points for insulin sensitivity (normal = glucose disposal >8 mg x min(-1) x kg(-1) of fat-free mass [FFM], n = 58; impaired = glucose disposal <8 ml x min(-1) x kg(-1) of FFM, n = 13). Thereafter, we measured body composition (dual energy X-ray absorptiometry) and body fat distribution (computed tomography), cardiorespiratory fitness (VO2max on a treadmill), physical activity energy expenditure (doubly labeled water and indirect calorimetry), glucose tolerance (oral glucose tolerance test), serum lipid profile, and dietary intake. We found a higher body fat percentage (32 +/- 6 vs. 27 +/- 6%, P = 0.01) and higher subcutaneous (213 +/- 61 vs. 160 +/- 78 cm2, P = 0.03) and visceral (44 +/- 16 vs. 35 +/- 14 cm2, P < 0.05) abdominal adiposity in the MONW group versus the normal group. The MONW group showed a lower physical activity energy expenditure (2.66 +/- 0.92 vs. 4.39 +/- 1.50 MJ/day, P = 0.01), but no difference in cardiorespiratory fitness was noted between groups. In conclusion, despite a normal body weight, a subset of young, apparently healthy women displayed a cluster of risky phenotypic characteristics that, if left untreated, may eventually predispose them to type 2 diabetes and cardiovascular disease.

Adipose Tissue↗