Apple or Pear? Body Shape Not Determined Just by Fat

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MedicalResearch.com Interview with: Kalypso Karastergiou, MD, PhD Assistant Professor, Medicine, Endocrinology, Diabetes and Bone Disease Diabetes, Obesity and Metabolism Institute Icahn School of Medicine at Mount Sinai     MedicalResearch.com:  What is the background for this study?   Response: Multiple studies, epidemiological as well as clinical, have established that body shape is an important and independent predictor of cardiovascular and metabolic disease risk and ultimately total mortality. Subjects that preferentially store weight in the abdominal area (often described as android, upper-body or apple-shape obesity) are at increased risk, whereas those who preferentially store weight in the lower body, in the gluteofemoral area (gynoid, lower-body or pear-shape), appear to be protected. The former is more common in men, whereas the latter in women, especially premenopausal women.   The overarching questions in the field are:  •What factors determine body shape?  •	Why are subjects with lower-body shape protected?  •	Can we exploit the physiological and pathophysiological mechanisms involved to improve stratification, prevention or treatment of obesity and related diseases?   MedicalResearch.com: What are the main findings?   Response: Up to date, studies in body shape have focused on the distribution of the adipose (fat) tissue.  This report seeks to expand the investigation to other tissues as well. During the period from 1999-2006, 14,005 participants in the National Health and Nutrition Examination Survey (which represents the United States population), 20-69 years old, had a DXA test that allows total and regional estimation of fat, lean and bone tissue mass.   This preliminary analysis shows that body shape is determined by coordinated changes in the head, trunk and limbs that involve the fat, as well as the other tissues.     MedicalResearch.com: What should readers take away from your report?  Response: This is an observational study that doesn’t allow us to draw conclusion as to cause and effect or prediction of future risk. It does suggest that body shape is a whole-body feature with systematic, coordinated changes in all body compartments and tissues.   The observations should be replicated in other populations and in prospective studies.      MedicalResearch.com: What recommendations do you have for future research as a result of this work?  Response: This report generates more questions than it answers.   •	First of all, are there differences in the function of tissues that determine body shape between subjects with upper- versus lower body shape?   •	Which tissues drive differences in physiology and disease risk?   •	Can we identify the underlying molecular pathways?   •	Does any of these pathways represent a viable mechanistic target to prevent or treat disease and improve quality of life?     Dislosures The study is partly funded by grants from the MSHS Translational Science Hub at Icahn School of Medicine at Mount Sinai (KL2TR001435) and the Einstein-Sinai Diabetes Research Center in New York City.     Citation: ADA 2019 abstract  277-OR: Lean Tissues as Novel Determinants of Pear vs. Apple Body Shape and Metabolic Health in Humans KALYPSO KARASTERGIOU Diabetes 2019 Jun; 68(Supplement 1): -.https://doi.org/10.2337/db19-277-OR      [last-modified]    The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

Dr. Karastergiou

Kalypso Karastergiou, MD, PhD
Assistant Professor, Medicine, Endocrinology, Diabetes and Bone Disease
Diabetes, Obesity and Metabolism Institute
Icahn School of Medicine at Mount Sinai 

MedicalResearch.com: What is the background for this study?  

Response: Multiple studies, epidemiological as well as clinical, have established that body shape is an important and independent predictor of cardiovascular and metabolic disease risk and ultimately total mortality. Subjects that preferentially store weight in the abdominal area (often described as android, upper-body or apple-shape obesity) are at increased risk, whereas those who preferentially store weight in the lower body, in the gluteofemoral area (gynoid, lower-body or pear-shape), appear to be protected. The former is more common in men, whereas the latter in women, especially premenopausal women.

The overarching questions in the field are:

  • What factors determine body shape?
  • Why are subjects with lower-body shape protected?
  • Can we exploit the physiological and pathophysiological mechanisms involved to improve stratification, prevention or treatment of obesity and related diseases? 

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Fetal and Early Infant Growth Linked to Persistent Body Fat Patterns

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Vincent W. V. Jaddoe, MD, PhDAdjunct Professor of EpidemiologyDepartment of Epidemiology

Dr. Jaddoe

Vincent W. V. Jaddoe, MD, PhD
Adjunct Professor of Epidemiology
Department of Epidemiology

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Childhood body fat may be affected by patterns of fetal and infant weight change. Children born small for gestational age (SGA) tend to have infant growth acceleration, whereas those born large for gestational age (LGA) tend to have infant growth deceleration. Little is known about fetal and infant growth patterns affecting visceral, liver, and pericardial fat, which are strongly associated with cardiometabolic disease in later life.

We assessed in a large population cohort study whether fetal and infant weight change was associated with not only general, but also organ fat at school age. We observed that fetal and infant weight change patterns were both associated with childhood body fat, but weight change patterns in infancy tended to have larger effects. Fetal growth restriction followed by infant growth acceleration was associated with increased visceral and liver fat.  Continue reading

Interval Training: Time-Efficient Body Fat Management

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"Colnago M10 Campagnolo Record Custom Bike 067" by Glory Cycles is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0

Dr Paul Gentil
Faculty of Physical Education and Dance
Federal University of Goias
Goiania, Brazil 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Although being overweight and/or obese are associated with numerous health risks, the prevalence of both are continuing to increase worldwide. The treatment would include anything that results in an increase in energy expenditure (exercise) or a decrease in energy intake (diet). However, our metabolism seems to adapt to variations in physical activity to maintain total energy expenditure. Although lower-than-expected weight loss is often attributed to incomplete adherence to prescribed  interventions, there are other factors that might influence the results, such as, metabolic downregulation.

So, instead of making people spend more calories, maybe we have to think on how to promote metabolic changes in order to overcome these physiological adaptations above-mentioned. In this regard, high intensity training might be particularly interesting as a strategy to promote fat loss. Irrespective the amount of calories spent during training, higher intensity exercise seems to promote many physiological changes that might favor long-term weight loss. For example, previous studies have shown that interval training is able to promote upregulation of important enzymes associated with glycolysis and beta oxidation pathways, which occurs in a greater extent than with moderate intensity continuous exercise.

Our findings suggest that interval training might be an important tool to promote weigh loss. However, I t might be performed adequately and under direct supervision in order to get better results.

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High Chocolate Intake and Lower Body Fat

Magdalena Cuenca García, PhD University of Granada Department of Physiology, School of Medicine Avd. Madrid 12; 18012 Granada (Spain)MedicalResearch.com Interview with:
Magdalena Cuenca García, PhD
University of Granada
Department of Physiology, School of Medicine
Avd. Madrid 12; 18012 Granada (Spain)


MedicalResearch.com: What are the main findings of the study?

Answer: In conclusion, the results of the present study showed that a higher chocolate consumption was associated with lower levels of central and total fatness in European adolescents. Of note is that the observed association was independent of total energy intake and saturated fat intake as well as objectively measured physical activity. In addition, results remained unchanged after adjusting for foods with high catechins concentration as fruit, vegetables and tea; as well as other products such as coffee that could influence the observed association between chocolate consumption and markers of total and central body fat.
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