In a new study, researchers found why and to what extent a large hip circumference, an estimate of increased fat mass in the lower part of the body, protects from type 2 diabetes and heart diseases (CVD).
They also provide new information that a high amount of hip and leg fat mass is very important to retain metabolic health.
In addition, they discuss lifestyle changes and medical interventions that improve body fat distribution and exemplify how a focus on lower body fat mass helps clinicians in risk assessment.
The research was conducted by a team at the University Hospital of Tübingen and the Boston Children’s Hospital.
An increased fat mass is an important risk factor for the worldwide increase in type 2 diabetes and CVD.
However, for a given fat mass, there is a large variability in the risk of these cardio-metabolic diseases.
For example, some lean people unexpectedly have a risk of type 2 diabetes and CVD that is similar to the increased risk that is observed in most people who have obesity.
What both of these people have in common is an increased upper body, and more specifically, an increased visceral (inside the belly), fat mass.
As a result, much focus has been given on the strong predictive power of upper body obesity.
However, recent research suggests that an impaired ability to expand fat in the lower part of the body is also very important for predicting the incidence of these diseases.
The team highlights mechanisms that result in energy storage in different fat depots of the body, or ectopically, in organs such as the liver, the pancreas, and the heart.
The fat in the lower part of the body is helpful to estimate the risk of type 2 diabetes and CVD.
Recently published studies provide genetic support that a low amount of estimated visceral fat and a high amount of lower body fat may be equally important to retain cardio-metabolic health.
The team then discusses mechanisms that may drive a dramatic re-distribution of fat from the lower to the upper part of the body during aging.
Changes in sex hormone levels and signaling during lifetime are considered very important, both in men and in women.
They also highlight strategies, related to changes in lifestyle, or medical treatment in diseases linked to disproportionate fat distribution, such as nonalcoholic fatty liver disease or a lipodystrophy-like phenotype, that help to hinder such fat-redistribution.
Finally, they exemplify how the focus on lower body fat mass helps health care providers to better assess the risk of cardio-metabolic diseases and to communicate this risk with their patients.
One author of the study is Norbert Stefan from the German Center for Diabetes Research.
The study is published in Lancet Diabetes & Endocrinology.
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