Regular readers are certainly familiar with my many posts on the limitations of BMI and on the idea that not all fat is bad and that different fat depots may have quite different effects on cardiometabolic risk.
You can now find much more on this topic in a comprehensive review article by Konstantinos Manolopoulos and colleagues at Oxford University, UK, published in this month’s issue of the International Journal of Obesity.
The review not only concludes that there is now ample evidence to support the notion that not just the amount of body fat, but rather its distribution is an important determinant of the metabolic and cardiovascular risk associated with obesity. In fact there is now increasing evidence that being too skinny may well be bad for you and that carrying a few extra pounds of fat on your hips and thighs may actually be protective.
Thus, studies show that increased hip and thigh fat is independently associated with protective lipid and glucose profiles. This protective effect may be in part due to the fact that gluteofemoral fat can absorb and store excess fatty-acids, thereby removing them from the circulation. In addition, leptin and adiponectin levels tend to be positively associated with gluteofemoral fat while the level of inflammatory cytokines is negatively associated.
As the authors point out, the loss of gluteofemoral fat, as observed in Cushing’s syndrome and lipodystrophy is in fact associated with an increased metabolic and cardiovascular risk.
This may not be good news for people seeking medical help to reduce the size of their hips and thighs - I would probably have to advise them against it - definitely not a message many of my patients want to hear.
On the other hand, if the excess fat is largely located around your midsection, then, this excess “belly” fat is probably the biggest driver of your risk for type 2 diabetes and heart disease.
So really, not much new for regular readers of my blog, but certainly a noteworthy article that nicely summarizes what is currently known about this issue.
Wonder what it’ll take to make large butts and thighs more socially acceptable?
AMS
Edmonton, Alberta
In The News
January 13th, 2010 at 9:08 am
“This may not be good news for people seeking medical help to reduce the size of their hips and thighs - I would probably have to advise them against it - definitely not a message many of my patients want to hear.
Peter Janiszewski, Jen Kuk and Bob Ross did a recent study on this very topic. Although lower body SAT is protective, reducing it did not result in any increased risk in the obese individuals in their study. If I’m not mistaken, lipodystrophy results in the loss of subcutaneous adipocytes (which could quickly lead to increased ectopic fat deposition and increased metabolic risk) whereas simply reducing the size of subcutaneous adipocytes through weight loss shouldn’t result in unintended negative consequences, at least with respect to fatty acids and markers of glucose metabolism (Peter’s paper doesn’t look at adipokines or inflammation). The full paper by Jen and Peter can be accessed at the link below:
http://www.springerlink.com/content/r436711t7483320u/
The sample for Peter and Jen’s study isn’t huge, but it’s an interesting study nonetheless. The area of body fat distribution and metabolic risk is incredibly interesting, and definitely warrants more research.
Travis
January 13th, 2010 at 10:05 am
I’m intrigued by this study and its implications.
I think we’ll see a shift in attitudes of physicians towards adiposity long before we see a cultural shift in attitude towards big butts and thighs.
The protective effect of extra body weight on older adults is an area of research I hear little about, but I think is relevant and timely.