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Fat Distribution: Health risks and adaptations to exercise

Fat Distribution: Health risks and adaptations to exercise. Paul Vanderburgh HSS 306: Human Physiology. Agenda. Background Basic Physiology Measurement Links to Disease Adaptation to Exercise Summary and Conclusions. Background. %Body Fat: Fat mass/Total mass BMI: Kg/Ht 2

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Fat Distribution: Health risks and adaptations to exercise

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  1. Fat Distribution: Health risks and adaptations to exercise Paul Vanderburgh HSS 306: Human Physiology

  2. Agenda • Background • Basic Physiology • Measurement • Links to Disease • Adaptation to Exercise • Summary and Conclusions

  3. Background • %Body Fat: Fat mass/Total mass • BMI: Kg/Ht2 • WHR: Waist-to-Hip Ratio

  4. Basic Somatotypes

  5. Basic Physiology • Insulin Sensitivity: the higher the better • Insulin Resistance: the lower the better • Lipolysis: (the breakdown of fat cells for metabolism) Higher in abdominal than peripheral, deep than subcutaneous (Smith ‘85, Bjorntorp ‘89)

  6. Gender and Fat Distribution Women: • Have 50% more fat cells than men, mostly in the periphery • Tend to store fat peripherally more than men (Bouchard ’88, Campaigne ’90, Carr ’04) • Spare gluteo-femoral (peripheral) fat except during menopause and lactation (Campaigne ’90,Lanska ’85, Carr ‘04) • Show more abdominal fat deposition after menopause (Lanska ’85, Fajardo ’04)

  7. Gender and Fat Distribution (cont.) Men: • With similar levels of total fatness, show higher: • Fasting glucose levels • TG’s • BP • And women with male fat patterning (android) show similar risk factors (Krotkiewski ’86)

  8. Genetics and Fat Distribution • Heredity accounts for 20-25% of fat patterning in central vs. peripheral (Bouchard ’85) • Twins exercise study indicates similar change among twins but different changes between pairs of twins (Despres ‘84) • Same with increased feeding (Poehlman ’86)

  9. Direct Measurement Direct Measurements • CT: Computed Tomography • MRI: Magnetic Resonance Imaging Expensive and time-consuming: For research purposes only

  10. Field Measurement • WHR: Waist-to-hip ratio • WC: Waist circumference • WHtR: Waist-to-height ratio • T/E: Trunk to extremity skinfold ratio All have shown better predictive quality for CHD and/or metabolic disease risk factors than %fat (Tulloch ’04, Wat ’01, Despres ’01)

  11. WHR Danger Zones Women: 0.80+ Men: 1.0+ (Bjorntorp ’89)

  12. Fat Distribution and Links to Metabolic Disease and CHD Risk Factors • Insulin resistance • Hyperinsulinemia • Impaired glucose tolerance • Diabetes • Hypertension • Low HDL cholesterol (Woods ’89, Lundgren ’89, Boyko ’96, Albu ’97, Bonora ’00, and Wat ’01, Emaillzadeh ’04, Mannucci ‘04)

  13. Adaptations to Exercise • Krotkiewski ’86: • Men and android women (WHR>0.82) gained lean mass and reduced %BF • Gynoid women did not reduce %BF • Despres ’85: Exercise alters abdominal fat more readily than peripheral • Tremblay ’90: Exercise intensity was directly proportional to abdominal fat loss

  14. Summary • Fat distribution (FD) is a better indicator of metabolic and/or CHD risk than %fat • FD is easily measured by WHR or T/E skinfold ratio • Men are more android, women more gynoid • Android fat easier to lose via exercise than gynoid • Premenopausal women tend to spare peripheral fat even with exercise

  15. Conclusions • Clinicians, teachers, and health professionals should be aware of the diagnostic value of the WHR and its relationship to metabolic and/or CHD outcomes • WHR’s above 0.80 for women and 1.0 for men should be considered indicative of elevated risk for such diseases

  16. References • Bjorntorp P. Sex differences in the regulation of energy balance with exercise. American Journal of Clinical Nutrition. 49:958-961. 1989. • Albu J. Visceral fat and race-dependent health risks in obese non-diabetic premenopausal women. Diabetes. 46:456-462. 1997. • Bonora E. Relationship between regional fat distribution and insulin resistance. International Journal of Obesity. 24:S32-S35. 2000. • Bouchard C. Genetic factors in the regulation of adipose tissue distribution. Acta Medica Scandinavica. 723:135-141. 1988. • Boyko E. Visceral adiposity, fasting plasma insulin, and lipid and lipoprotein levels in Japanese Americans. International Journal of Obesity and Metabolic Disorders. 20:801-808. 1996. • Campaigne B. Body fat distribution in females: metabolic consequences and implications for weight loss. Medicine and Science in Sports and Exercise. 22:291-297. 1990. • Carr D. Intra-abdominal fat is a major determinant of the national cholesterol education program adult treatment panel III criteria for the metabolic syndrome. Diabetes. 53:2087-2094. 2004. • Despres J. Adaptive changes to training in adipose tissue lipolysis are genotype dependent. International Journal of Obesity. 8:87-95. 1985. • Despres J. Health consequences of visceral obesity. Annals of Medicine. 33:534-541. 2001. • Esmaillzadeh A. Waist-to-hip ratio is a better screening measure for cardiovascular risk factors than other anthropometric indicators in Tehranian adult men. International Journal of Obesity. 28:1325-1332. 2004. • Fajardo M. Hormone and metabolic factors associated with leptin mRNA expression in pre- and post-menopausal women. Steroids. 69:425-430. 2004. • Krotkiewski M. Muscle tissue in obesity with different distribution of adipose tissue. International Journal of Obesity. 10:331-341. 1986. • Lanska D. A prospective study of body fat distribution and the prognosis for weight reduction: preliminary observations. International Journal of Obesity. 12:133-140. 1988. • Lundgren H. Adiposity and adipose tissue distribution in relation to incidence of diabetes in women: results from a prospective population study in Gothenburg, Sweden. International Journal of Obesity. 13:413-423. 1989. • Mannucci E. Indexes of abdominal adiposity in patients with type 2 diabetes. Journal of Endocrinological Investigation. 27:535-540. 2004. • Poehlman E. Genotype-controlled changes in body composition and fat morphology following overfeeding in twins. American Journal of Clinical Nutrition. 43:723-731. 1986. • Smith U. Regional differences in adipocyte metabolism and possible consequences in vivo. International Journal of Obesity. 9:145-148. 1985. • Tremblay A. Sex dimorphism in fat loss in response to exercise training. Journal of Obesity and Weight Regulation. 3:193-140. 1988. • Tulloch MK. Both subcutaneous and visceral adipose tissue correlate highly with insulin resistance in African American. Obesity Research. 12:1352-1359. 2004. • Wat N. Central obesity predicts the worsening of glycemia in southern Chinese. International Journal of Obesity. 25:1789-1793. 2001. • Woods K. Diabetes mellitus as a risk factor of acute myocardial infarction in Asians and Europeans. British Heart Journal. 62:118-122. 1989.

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