& Joannie Dobbs Monday,
Fat that lies beneath carries more risk
Having a body shaped more like an apple than a pear is associated with increased health risks. But this generalization is too simple, according to recent research on body-fat distribution. In fact, more fat in some locations might even be a good thing.
Question: Why does the location of body fat matter?
Answer: Those who carry excess fat in the belly have a greater risk of cardiovascular disease and diabetes than those who carry most of it in the hips and legs. Simply put, those built more like apples generally have more signs of risk such as elevated blood cholesterol, triglycerides and glucose than those shaped more like pears. But, it is turning out that the apple/pear story is not quite so simple.
Abdominal fat is stored in two very different places -- internally, around the internal organs; and subcutaneously, or just beneath the skin. The most noticeable form of belly fat is subcutaneous, showing up as love handles and belly rolls. Research shows that this subcutaneous fat is not as "bad" as "visceral" internal fat.
Q: How is abdominal visceral fat measured?
A: There is no easy way. Subcutaneous fat can be estimated from simple caliper measurements of skinfolds -- pinches of the skin and subcutaneous fat beneath the skin. Estimating internal fat is more complicated. Researchers use sophisticated scanning techniques, such as computed tomography.
Q: Does extra lower-body fat have some risk?
A: The answer is not entirely clear. A study conducted by Dr. Rachel Van Pelt at the University of Colorado indicates that having more fat in the hips and legs might be a good thing. Her study of 166 post-menopausal women found that regardless of the amount of abdominal fat, women with the most fat in their hips and legs also had blood values associated with a lower risk of diabetes and cardiovascular disease compared with women with less lower-body fat. A couple of other studies support Van Pelt's observation that hip and leg fat actually might be protective.
Q: How would hip and thigh liposuction affect the health risk equation?
A: After lower-body liposuction, it is possible that future fat gain would be greatest in the belly. But genetic control is thought to determine where fat will be stored, and the answer is currently unclear.
Regular physical activity after liposuction recovery might help prevent gaining visceral fat. During aerobic exercises such as jogging, cycling, swimming and dancing, internal abdominal fat is used more rapidly than subcutaneous fat.
Q: Are there any ways to change the apple shape?
A : Decrease stress. Higher levels of the stress hormone cortisol, smoking and excess alcohol all tend to increase belly fat, especially the fat surrounding internal organs. The solution includes making overall lifestyle changes that incorporate adequate sleep, exercise, relaxation and a balanced diet.
Alan Titchenal, Ph.D., C.N.S. and Joannie Dobbs, Ph.D., C.N.S.
are nutritionists in the Department of Human Nutrition, Food and Animal Sciences,
College of Tropical Agriculture and Human Resources, UH-Manoa.
Dr. Dobbs also works with the University Health Service
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