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

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Presentation on theme: "Fat Distribution: Health risks and adaptations to exercise Paul Vanderburgh HSS 306: Human Physiology."— Presentation transcript:

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/Ht 2  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 1.Bjorntorp P. Sex differences in the regulation of energy balance with exercise. American Journal of Clinical Nutrition. 49:958-961. 1989. 2.Albu J. Visceral fat and race-dependent health risks in obese non-diabetic premenopausal women. Diabetes. 46:456-462. 1997. 3.Bonora E. Relationship between regional fat distribution and insulin resistance. International Journal of Obesity. 24:S32-S35. 2000. 4.Bouchard C. Genetic factors in the regulation of adipose tissue distribution. Acta Medica Scandinavica. 723:135-141. 1988. 5.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. 6.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. 7.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. 8.Despres J. Adaptive changes to training in adipose tissue lipolysis are genotype dependent. International Journal of Obesity. 8:87-95. 1985. 9.Despres J. Health consequences of visceral obesity. Annals of Medicine. 33:534-541. 2001. 10.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. 11.Fajardo M. Hormone and metabolic factors associated with leptin mRNA expression in pre- and post-menopausal women. Steroids. 69:425-430. 2004. 12.Krotkiewski M. Muscle tissue in obesity with different distribution of adipose tissue. International Journal of Obesity. 10:331-341. 1986. 13.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. 14.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. 15.Mannucci E. Indexes of abdominal adiposity in patients with type 2 diabetes. Journal of Endocrinological Investigation. 27:535-540. 2004. 16.Poehlman E. Genotype-controlled changes in body composition and fat morphology following overfeeding in twins. American Journal of Clinical Nutrition. 43:723-731. 1986. 17.Smith U. Regional differences in adipocyte metabolism and possible consequences in vivo. International Journal of Obesity. 9:145-148. 1985. 18.Tremblay A. Sex dimorphism in fat loss in response to exercise training. Journal of Obesity and Weight Regulation. 3:193-140. 1988. 19.Tulloch MK. Both subcutaneous and visceral adipose tissue correlate highly with insulin resistance in African American. Obesity Research. 12:1352-1359. 2004. 20.Wat N. Central obesity predicts the worsening of glycemia in southern Chinese. International Journal of Obesity. 25:1789-1793. 2001. 21.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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