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Does Skin Fat Protect From Diabetes?

Regular readers will be aware that there is a rather poor relationship between the total amount of body fat and health, which, indecently, is why I am not a big fan of the term ‘healthy weight’ and why we had to come up with the Edmonton Obesity Staging System.

In fact, we have known for a long time that it is visceral fat or the fat deposited ‘ectopically’ in organs like the liver, pancreas, heart, or skeletal muscle that tends to cause the cardiometabolic problems.

Indeed, there are good reasons to believe that the safest place to store any excess calories is in your subcutaneous or skin fat.

This notion is once again supported by new data by Smith and colleagues published in the latest issue of the Journal of Clinical Endocrinology and Metabolism, suggesting that skin fat may, at least in women, reduce the risk of developing diabetes.

Thus, data from the The INternational Study of Prediction of Intra-abdominal adiposity and its RElationships with cardioMEtabolic risk/Intra-Abdominal Adiposity (INSPIRE ME IAA), a cross-sectional computed tomography imaging study with data collected from 4144 (51.8% men) in 29 countries, shows that while cardiovascular disease increased with visceral adiposity tertles, diabetes risk was inversely related with subcutaneous adipose tissue in women [0.76] and not associated with type 2 diabetes in men [0.97].

Good enough to remind us that using rather crude measures of obesity like weight, BMI, or even total body fat, is certainly not enough to decide on who needs obesity treatment and who doesn’t.

Washington, DC

ResearchBlogging.orgSmith JD, Borel AL, Nazare JA, Haffner SM, Balkau B, Ross R, Massien C, Alméras N, & Després JP (2012). Visceral Adipose Tissue Indicates the Severity of Cardiometabolic Risk in Patients with and without Type 2 Diabetes: Results from the INSPIRE ME IAA Study. The Journal of clinical endocrinology and metabolism PMID: 22337910



  1. So, I have several questions:

    1) How does a lay person know where their fat is deposited?
    2) Is there any proven way for the average person, who cannot make weight reduction and weight loss maintenance a part- or full-time job (as is the case currently) to reduce and keep off visceral fat?
    3) If the answer to question #2 is “no” (which I suspect), are there ways to maintain one’s weight (rather than yo-yo up and UP the scale) and improve one’s health? I suspect the answer to this question is “yes”, but certainly the diet industry will try to keep them secret.

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  2. Very interesting post, although as NewMe points out, it is probably not possible for people to control where their fat is deposited.

    Anyway, I must congratulate you on what I think qualifies as a subversive use of a standard “headless fattie” image.

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  3. I agree wholeheartedly with the restriction of use of medical resources (Canadian public health insurance paid for by taxpayers) to treat only real medical problems, not just overweight or obesity.

    Many commercial weight loss programs advise their clients to “check with your doctor before starting any weight -loss program”. That means nothing to them, it must be some cover-their-a** legal thing. But if anybody goes to their family doctor to get approval to go on a diet, DIY or commercial, they should pay for this service themselves because it’s medically not necessary.

    I recently had a doctor’s visit required by my employer, so I had to pay for it myself. (no complaints about that)
    My friend went to see her doctor because that’s what a commercial weight-loss program suggested – they didn’t require it, so she didn’t even have to go – and her doctor’s visit was covered under public health care, no questions asked.

    There are many doctors visits which are not covered by public health insurance – my doctors office posts a list. Seeing a doctor for weight control which is NOT REQUIRED for MEDICAL reasons according to the obesity staging system should not be covered. If you don’t have medical problems which are affected by weight (under or over weight), it’s a cosmetic issue, not a medical one, and the cost should be paid personally, not by taxpayers. (At least, not until the system has taken care of everything medically necessary for everybody and has extra money).

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  4. Sharma@ Thank you for putting this post, as it supports some of our rat data in recent times, which I was hesitant to publish due to lack of a possible explanation.As I wrote to you earlier, we are maintaining two obese mutant rat strains in our institute ,WNIN/Ob and WNIN/GR-Ob ,the former with euglycemia and the other with IGT (becomes diabetic,on purified starch/sucrose diets)Between these strains, we found differences in genders with respect to skin and visceral fat and was unable explain why it is is so .Based on the above information we will have another look on the same data and am sure we will come out with something interesting to share with the public.

    Secondly, with respect to New me question, I would like to say ,based on our rat studies, that while some amount of skin fat is essential for every body , it is the visceral fat which keep increasing in response to diets and age , and as the latter reaches a saturation, fat spreads to other organs including skin later.With respect to keeping off the visceral fat, the best strategy would be to have 75% succulent natural food ( veggies and fruits) and 25% processed food with an average exercise of half an hour or at least three days of one hour exercise.

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