Fat Distribution:  Health risks and adaptations to exercise Paul Vanderburgh HSS 306:  Human Physiology
Agenda <ul><li>Background </li></ul><ul><li>Basic Physiology </li></ul><ul><li>Measurement </li></ul><ul><li>Links to Dise...
Background <ul><li>%Body Fat:  Fat mass/Total mass </li></ul><ul><li>BMI:  Kg/Ht 2 </li></ul><ul><li>WHR:  Waist-to-Hip Ra...
Basic Somatotypes
Basic Physiology <ul><li>Insulin Sensitivity:  the higher the better </li></ul><ul><li>Insulin Resistance:  the lower the ...
Gender and Fat Distribution <ul><li>Women: </li></ul><ul><ul><li>Have 50% more fat cells than men, mostly in the periphery...
Gender and Fat Distribution (cont.) <ul><li>Men: </li></ul><ul><ul><li>With similar levels of total fatness, show higher: ...
Genetics and Fat Distribution <ul><li>Heredity accounts for 20-25% of fat patterning in central vs. peripheral  (Bouchard ...
Direct Measurement <ul><li>Direct Measurements </li></ul><ul><ul><li>CT:  Computed Tomography </li></ul></ul><ul><ul><li>M...
Field Measurement <ul><li>WHR:  Waist-to-hip ratio </li></ul><ul><li>WC:  Waist circumference </li></ul><ul><li>WHtR:  Wai...
WHR Danger Zones <ul><li>Women:  0.80+ </li></ul><ul><li>Men:  1.0+ </li></ul><ul><li>(Bjorntorp ’89) </li></ul>
Fat Distribution and Links to Metabolic Disease and CHD Risk Factors <ul><li>Insulin resistance </li></ul><ul><li>Hyperins...
Adaptations to Exercise <ul><li>Krotkiewski ’86: </li></ul><ul><ul><li>Men and android women (WHR>0.82) gained lean mass a...
Summary <ul><li>Fat distribution (FD) is a better indicator of metabolic and/or CHD risk than %fat </li></ul><ul><li>FD is...
Conclusions <ul><li>Clinicians, teachers, and health professionals should be aware of the diagnostic value of the WHR and ...
References <ul><li>Bjorntorp P.  Sex differences in the regulation of energy balance with exercise.  American Journal of C...
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Fat Distribution: Health risks and adaptations to exercise

  1. 1. Fat Distribution: Health risks and adaptations to exercise Paul Vanderburgh HSS 306: Human Physiology
  2. 2. Agenda <ul><li>Background </li></ul><ul><li>Basic Physiology </li></ul><ul><li>Measurement </li></ul><ul><li>Links to Disease </li></ul><ul><li>Adaptation to Exercise </li></ul><ul><li>Summary and Conclusions </li></ul>
  3. 3. Background <ul><li>%Body Fat: Fat mass/Total mass </li></ul><ul><li>BMI: Kg/Ht 2 </li></ul><ul><li>WHR: Waist-to-Hip Ratio </li></ul>
  4. 4. Basic Somatotypes
  5. 5. Basic Physiology <ul><li>Insulin Sensitivity: the higher the better </li></ul><ul><li>Insulin Resistance: the lower the better </li></ul><ul><li>Lipolysis: (the breakdown of fat cells for metabolism) Higher in abdominal than peripheral, deep than subcutaneous (Smith ‘85, Bjorntorp ‘89) </li></ul>
  6. 6. Gender and Fat Distribution <ul><li>Women: </li></ul><ul><ul><li>Have 50% more fat cells than men, mostly in the periphery </li></ul></ul><ul><ul><li>Tend to store fat peripherally more than men (Bouchard ’88, Campaigne ’90, Carr ’04) </li></ul></ul><ul><ul><li>Spare gluteo-femoral (peripheral) fat except during menopause and lactation (Campaigne ’90, Lanska ’85, Carr ‘04) </li></ul></ul><ul><ul><li>Show more abdominal fat deposition after menopause (Lanska ’85, Fajardo ’04) </li></ul></ul>
  7. 7. Gender and Fat Distribution (cont.) <ul><li>Men: </li></ul><ul><ul><li>With similar levels of total fatness, show higher: </li></ul></ul><ul><ul><ul><li>Fasting glucose levels </li></ul></ul></ul><ul><ul><ul><li>TG’s </li></ul></ul></ul><ul><ul><ul><li>BP </li></ul></ul></ul><ul><ul><li>And women with male fat patterning (android) show similar risk factors </li></ul></ul><ul><ul><li>(Krotkiewski ’86) </li></ul></ul>
  8. 8. Genetics and Fat Distribution <ul><li>Heredity accounts for 20-25% of fat patterning in central vs. peripheral (Bouchard ’85) </li></ul><ul><li>Twins exercise study indicates similar change among twins but different changes between pairs of twins (Despres ‘84) </li></ul><ul><li>Same with increased feeding (Poehlman ’86) </li></ul>
  9. 9. Direct Measurement <ul><li>Direct Measurements </li></ul><ul><ul><li>CT: Computed Tomography </li></ul></ul><ul><ul><li>MRI: Magnetic Resonance Imaging </li></ul></ul><ul><ul><li>Expensive and time-consuming: For research purposes only </li></ul></ul>
  10. 10. Field Measurement <ul><li>WHR: Waist-to-hip ratio </li></ul><ul><li>WC: Waist circumference </li></ul><ul><li>WHtR: Waist-to-height ratio </li></ul><ul><li>T/E: Trunk to extremity skinfold ratio </li></ul><ul><li>All have shown better predictive quality for CHD and/or metabolic disease risk factors than %fat </li></ul><ul><li>(Tulloch ’04, Wat ’01, Despres ’01) </li></ul>
  11. 11. WHR Danger Zones <ul><li>Women: 0.80+ </li></ul><ul><li>Men: 1.0+ </li></ul><ul><li>(Bjorntorp ’89) </li></ul>
  12. 12. Fat Distribution and Links to Metabolic Disease and CHD Risk Factors <ul><li>Insulin resistance </li></ul><ul><li>Hyperinsulinemia </li></ul><ul><li>Impaired glucose tolerance </li></ul><ul><li>Diabetes </li></ul><ul><li>Hypertension </li></ul><ul><li>Low HDL cholesterol </li></ul><ul><ul><li>(Woods ’89, Lundgren ’89, Boyko ’96, Albu ’97, Bonora ’00, and Wat ’01, Emaillzadeh ’04, Mannucci ‘04) </li></ul></ul>
  13. 13. Adaptations to Exercise <ul><li>Krotkiewski ’86: </li></ul><ul><ul><li>Men and android women (WHR>0.82) gained lean mass and reduced %BF </li></ul></ul><ul><ul><li>Gynoid women did not reduce %BF </li></ul></ul><ul><li>Despres ’85: Exercise alters abdominal fat more readily than peripheral </li></ul><ul><li>Tremblay ’90: Exercise intensity was directly proportional to abdominal fat loss </li></ul>
  14. 14. Summary <ul><li>Fat distribution (FD) is a better indicator of metabolic and/or CHD risk than %fat </li></ul><ul><li>FD is easily measured by WHR or T/E skinfold ratio </li></ul><ul><li>Men are more android, women more gynoid </li></ul><ul><li>Android fat easier to lose via exercise than gynoid </li></ul><ul><li>Premenopausal women tend to spare peripheral fat even with exercise </li></ul>
  15. 15. Conclusions <ul><li>Clinicians, teachers, and health professionals should be aware of the diagnostic value of the WHR and its relationship to metabolic and/or CHD outcomes </li></ul><ul><li>WHR’s above 0.80 for women and 1.0 for men should be considered indicative of elevated risk for such diseases </li></ul>
  16. 16. References <ul><li>Bjorntorp P. Sex differences in the regulation of energy balance with exercise. American Journal of Clinical Nutrition. 49:958-961. 1989. </li></ul><ul><li>Albu J. Visceral fat and race-dependent health risks in obese non-diabetic premenopausal women. Diabetes. 46:456-462. 1997. </li></ul><ul><li>Bonora E. Relationship between regional fat distribution and insulin resistance. International Journal of Obesity. 24:S32-S35. 2000. </li></ul><ul><li>Bouchard C. Genetic factors in the regulation of adipose tissue distribution. Acta Medica Scandinavica. 723:135-141. 1988. </li></ul><ul><li>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. </li></ul><ul><li>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. </li></ul><ul><li>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. </li></ul><ul><li>Despres J. Adaptive changes to training in adipose tissue lipolysis are genotype dependent. International Journal of Obesity. 8:87-95. 1985. </li></ul><ul><li>Despres J. Health consequences of visceral obesity. Annals of Medicine. 33:534-541. 2001. </li></ul><ul><li>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. </li></ul><ul><li>Fajardo M. Hormone and metabolic factors associated with leptin mRNA expression in pre- and post-menopausal women. Steroids. 69:425-430. 2004. </li></ul><ul><li>Krotkiewski M. Muscle tissue in obesity with different distribution of adipose tissue. International Journal of Obesity. 10:331-341. 1986. </li></ul><ul><li>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. </li></ul><ul><li>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. </li></ul><ul><li>Mannucci E. Indexes of abdominal adiposity in patients with type 2 diabetes. Journal of Endocrinological Investigation. 27:535-540. 2004. </li></ul><ul><li>Poehlman E. Genotype-controlled changes in body composition and fat morphology following overfeeding in twins. American Journal of Clinical Nutrition. 43:723-731. 1986. </li></ul><ul><li>Smith U. Regional differences in adipocyte metabolism and possible consequences in vivo. International Journal of Obesity. 9:145-148. 1985. </li></ul><ul><li>Tremblay A. Sex dimorphism in fat loss in response to exercise training. Journal of Obesity and Weight Regulation. 3:193-140. 1988. </li></ul><ul><li>Tulloch MK. Both subcutaneous and visceral adipose tissue correlate highly with insulin resistance in African American. Obesity Research. 12:1352-1359. 2004. </li></ul><ul><li>Wat N. Central obesity predicts the worsening of glycemia in southern Chinese. International Journal of Obesity. 25:1789-1793. 2001. </li></ul><ul><li>Woods K. Diabetes mellitus as a risk factor of acute myocardial infarction in Asians and Europeans. British Heart Journal. 62:118-122. 1989. </li></ul>

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