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OVER AND UNDER NUTRITION 1 (VISCERAL ABDO FAT (VISCERAL ABDOMINAL FAT AS…

- - - - Increased number of fat cells exist throughout the body
      - tends to be associated with fewer serious health effects
        compared with other types
    - - An increase in the size of each fat cell
      - Usually the fat distribution is around the waist.
      - referred to as male-patterned or android because it
        is typically seen in the obese male.
      - If the hips are larger,
        
        a person has female-patterned or gynecoid
        obesity.
  - - - Diabetes UK recommends screening for diabetes when waist circumference is:
        • > 94cm (> 37 inches) for White and Black men
        • > 80cm (> 31.5 inches) for White, Black and Asian women
        • > 90cm (> 35 inches) for Asian men
    - - A waist-to-hip ratio is associate with increased risk of many disease
        states.
        – Men > 1
        – Women > 0.8
    - - More sensitive than BMI in predicting health risk
        • Cheaper, easier to calculate than BMI
        • Allows for same boundary values (0.5) for men and women
        • Allows for same boundary values (0.5) for different ethnic groups
        • Mounting evidence ratio can be applied to children
        • ‘Keep your waist circumference to less than half your height’
- - - - significant amount of evidence that leptin is also active in
        the periphery.
      - Leptin can modify
        
        insulin sensitivity
        
        tissue metabolism
        
        stress responses
        
        reproductive function all mediated via the hypothalamic-pituitary axis
- - - - regulation of several lipase enzymes
      - activation of glucose transport into the fat cell via recruitment of
        glucose-transport protein 4 (GLUT4).
    - - The "backbone" of triglycerides
        
        produced from
        glucose in fat cells.
        
        Storage of triglycerides after a meal depends upon insulin-stimulated
        glucose uptake and glycolysis.
        
        Fat cells take up both fatty acids and glucose simultaneously.
        • The fatty acids come from the action of lipoprotein lipase at the capillary
        wall.