Monday, October 1, 2012

Elevated Visceral Fat: "Nobody Wants That"

The language that follows is the language of observational/epidemiological studies:
"among obese adults, visceral fat was associated with more than a twofold increased risk of developing incident diabetes (odds ratio 2.42, 95% CI 1.59 to 3.68).  In addition, developing either condition was also associated with markers of insulin resistance including elevated fructosamine levels (OR 1.95, 95% CI 1.43 to 2.67) and elevated fasting blood glucose (OR 1.88, 95% CI 1.38 to 2.56).
But there were no associations with general markers of obesity, including body mass index (BMI) or total body fat."

In other words, "these are interesting correlations."

Not that I would disagree with their conclusions:
"Our study may have implications for understanding differences between metabolically healthy and pathologic obesity."

This is interesting because not everyone that's fat is insulin resistant, and those who are develop illness as much higher rates than those who are not.

This is also interesting:
"In participants without diabetes at baseline, a number of factors were significantly and independently associated with incident diabetes in obese adults:
  • Elevated visceral fat: OR 2.42, 95% CI 1.59 to 3.68 (P<0 .001=".001" li="li">
  • Elevated systolic blood pressure: OR 1.26, 95% CI 1.07 to 1.48 (P=0.006)
  • Elevated fructosamine levels: OR 1.95, 95% CI 1.43 to 2.67 (P<0 .001=".001" li="li">
  • Elevated fasting blood glucose: OR 1.88, 95% CI 1.38 to 2.56 (P<0 .001=".001" li="li">
  • Weight gain from baseline: OR 1.06, 95% CI 1.02 to 1.10 (P=0.002)
  • Family history of diabetes: OR 2.32, 95% CI 1.25 to 4.29 (P=0.008)
"There were no associations for BMI, total body fat, or abdominal subcutaneous fat, they reported." 

Many of the same factors correlated with the development of insulin resistant in those not obese when the study began.

All in all, this fits a well recognized pattern of illness - high fructosamine levels/high fructose intake, visceral fat, high blood pressure, elevated fasting glucose, weight gain, and family history of diabetes.  

Lucky for us, most of these symptoms are treatable through carb restriction - I recommend starting out at 25-50g/day to stop these symptoms, and after weight/fat/symptom normalization, many will be able to eat more carbs but maintain their wellness.  Eat meat, eggs, vegetables, nuts and seeds, little fruit or starch, no sugar/wheat.

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