Demi
Thu, Dec-21-06, 02:41
The Daily Telegraph
London, UK
21 December, 2006
Research highlighting the danger of fat around vital organs could change the way we tackle obesity, reports Nic Fleming. MRI scans on four guinea pigs had surprising results
Expanded waistlines in the aftermath of mid-winter celebrations are not an invention of the modern Christian age. Over-indulgence was at least as important in the pagan Scandinavian festival of Yule and Roman holiday of Saturnalia as today's overdosing on turkey, mince pies, chocolate and sherry.
http://www.telegraph.co.uk/health/graphics/2006/12/21/ftfat21.jpg
Results suggest that four in 10 people are 'tofi' – thin outside, fat inside
But the historical pedigree of our annual bout of Christmas gluttony won't help, as we struggle to squeeze into our previously perfectly fitting garments in January. Or rather, as some of us struggle. Have you ever wondered why some people have to watch every calorie to stay in shape, while others can stuff their faces without putting on a pound?
Professor Jimmy Bell, a molecular imaging expert, has spent a long time pondering that question. And he and a team of researchers have recently discovered that, in fact, an outwardly trim person can carry a higher proportion of dangerous hidden fat than an overweight one, if that fat is around vital organs.
The team at the Medical Research Council's Clinical Sciences Centre has used a magnetic resonance imaging (MRI) scanner at Hammersmith Hospital in London to map the fat distribution of 600 volunteers. Their results suggest that up to four in 10 people could be "tofi" – thin outside, fat inside.
Previous research has shown someone with a lot of internal fat around the liver, gut, heart and pancreas, or streaked through under-used muscles, has a higher risk of heart disease, type 2 diabetes, hypertension and some cancers than someone with high levels of external fat.
Doctors and government departments currently use the body-mass index (BMI) – a person's weight in kilograms divided by his height in metres squared – to determine whether someone is over or underweight. A BMI of 20 to 25 is considered normal, 25 to 30 overweight, and more than 30 obese.
But Prof Bell's work adds to a growing volume of research suggesting BMI is too crude a measure to be of much use. "You can't predict how much internal fat you have based on whether you look lean or obese. Someone who is large but physically active can be in a perfectly healthy state," he says.
"Traditional ways of measuring body fat, such as BMI, give people the wrong idea about how much fat they have, as it says nothing about internal storage. People become obsessed by dieting, but doing this without exercise means they may be putting down fat in the wrong places. We want to get away from that and focus on maximising the health benefits of physical activity without dramatic lifestyle changes."
Earlier this week, The Daily Telegraph persuaded four volunteers to take part in Prof Bell's study and to share their results.
Simon Relph, a marketing art director from Sydenham, London, and Neil Ferguson, 23, a marketing designer from Bexley Village, Kent, provide a good example of why our current methods of evaluating weight-related health risks are so flawed. Simon, 41, has a BMI of 27.7, but admits to not doing much exercise. His MRI scan shows he is carrying 15 litres of internal fat. His colleague Neil, 23, has a BMI of 28.1. Yet he plays football three to four times a week and goes to the gym regularly. He admits to "love handles" around his waist, but has only four litres of internal fat.
A doctor or a casual observer might point to Neil's higher level of subcutaneous or external fat – 20 litres to Simon's 17 – and think he is at greater risk. In reality, he is in much better shape.
According to Prof Bell, a young, fit and healthy person of average height should have one to two litres of internal fat. "Anyone with more than five or six needs to think about making some changes. If you have above 10 litres, you should do some serious thinking about your lifestyle. Simon, with 15 litres, I'm afraid to say, is approaching a pre-diabetic state."
Dr Louise Thomas, a member of the research team, said: "Simon looks like a normal, well-built man, but he has a significant amount of fat around the heart, intestines and liver, which puts him in the high-risk category."
Eve Smith, a 25-year-old picture researcher from Hackney, admits she doesn't do much exercise and sometimes drinks a little too much wine, but eats healthily.
Both she and Cecilia Pimentel, 24, a fashion assistant, from São Paulo, Brazil, have more external body fat than the men, with 20 and 22 litres respectively. This is an entirely normal gender difference.
At 1m 79cm, Cecilia's 2.5 litres of internal fat is pretty good. Eve is also fine, but as she is shorter at 1m 57cm and carrying three litres of internal fat, she could probably do with a little more physical activity.
The researchers believe our current view of the relationship between diet, physical activity and health is far too simplistic. This is where the so-called intervention studies being carried out by Prof Bell's team come in. Groups of individuals will be put through 16-week programmes of exercise of different intensities and frequencies. Their progress will be accurately measured with MRI scans, and compared with control groups.
The ultimate objective is to be able to provide far more accurate advice on how someone should exercise, based on their gender, ethnicity and genetic make-up.
New Year resolutions will drive many to pull on their running shoes or grope in the less-frequented corners of their purses and wallets for neglected gym memberships. Recognised guidelines say we should exercise for a minimum 20 to 40 minutes three to five days a week to maintain our health.
But what is becoming clear is that this advice is far too general. While everyone will benefit to some extent from an increase in physical activity, a greater understanding of the reasons people lose and gain different types of fat at varying rates would allow far more effective advice to be given.
The research team at Hammersmith Hospital is looking for men aged 20-40 who are inactive and of either Caucasian or South Asian origin to take part in the studies. Participants will receive health and fitness advice. If you are interested in joining a study, even if you do not fulfil these criteria, email John McCarthy at john.mccarthy~imperial.ac.uk
http://www.telegraph.co.uk/health/main.jhtml;jsessionid=JLHQ1QSMYZOPTQFIQMFCFFOAVCBQYIV0?xml=/health/2006/12/21/ftfat121.xml
London, UK
21 December, 2006
Research highlighting the danger of fat around vital organs could change the way we tackle obesity, reports Nic Fleming. MRI scans on four guinea pigs had surprising results
Expanded waistlines in the aftermath of mid-winter celebrations are not an invention of the modern Christian age. Over-indulgence was at least as important in the pagan Scandinavian festival of Yule and Roman holiday of Saturnalia as today's overdosing on turkey, mince pies, chocolate and sherry.
http://www.telegraph.co.uk/health/graphics/2006/12/21/ftfat21.jpg
Results suggest that four in 10 people are 'tofi' – thin outside, fat inside
But the historical pedigree of our annual bout of Christmas gluttony won't help, as we struggle to squeeze into our previously perfectly fitting garments in January. Or rather, as some of us struggle. Have you ever wondered why some people have to watch every calorie to stay in shape, while others can stuff their faces without putting on a pound?
Professor Jimmy Bell, a molecular imaging expert, has spent a long time pondering that question. And he and a team of researchers have recently discovered that, in fact, an outwardly trim person can carry a higher proportion of dangerous hidden fat than an overweight one, if that fat is around vital organs.
The team at the Medical Research Council's Clinical Sciences Centre has used a magnetic resonance imaging (MRI) scanner at Hammersmith Hospital in London to map the fat distribution of 600 volunteers. Their results suggest that up to four in 10 people could be "tofi" – thin outside, fat inside.
Previous research has shown someone with a lot of internal fat around the liver, gut, heart and pancreas, or streaked through under-used muscles, has a higher risk of heart disease, type 2 diabetes, hypertension and some cancers than someone with high levels of external fat.
Doctors and government departments currently use the body-mass index (BMI) – a person's weight in kilograms divided by his height in metres squared – to determine whether someone is over or underweight. A BMI of 20 to 25 is considered normal, 25 to 30 overweight, and more than 30 obese.
But Prof Bell's work adds to a growing volume of research suggesting BMI is too crude a measure to be of much use. "You can't predict how much internal fat you have based on whether you look lean or obese. Someone who is large but physically active can be in a perfectly healthy state," he says.
"Traditional ways of measuring body fat, such as BMI, give people the wrong idea about how much fat they have, as it says nothing about internal storage. People become obsessed by dieting, but doing this without exercise means they may be putting down fat in the wrong places. We want to get away from that and focus on maximising the health benefits of physical activity without dramatic lifestyle changes."
Earlier this week, The Daily Telegraph persuaded four volunteers to take part in Prof Bell's study and to share their results.
Simon Relph, a marketing art director from Sydenham, London, and Neil Ferguson, 23, a marketing designer from Bexley Village, Kent, provide a good example of why our current methods of evaluating weight-related health risks are so flawed. Simon, 41, has a BMI of 27.7, but admits to not doing much exercise. His MRI scan shows he is carrying 15 litres of internal fat. His colleague Neil, 23, has a BMI of 28.1. Yet he plays football three to four times a week and goes to the gym regularly. He admits to "love handles" around his waist, but has only four litres of internal fat.
A doctor or a casual observer might point to Neil's higher level of subcutaneous or external fat – 20 litres to Simon's 17 – and think he is at greater risk. In reality, he is in much better shape.
According to Prof Bell, a young, fit and healthy person of average height should have one to two litres of internal fat. "Anyone with more than five or six needs to think about making some changes. If you have above 10 litres, you should do some serious thinking about your lifestyle. Simon, with 15 litres, I'm afraid to say, is approaching a pre-diabetic state."
Dr Louise Thomas, a member of the research team, said: "Simon looks like a normal, well-built man, but he has a significant amount of fat around the heart, intestines and liver, which puts him in the high-risk category."
Eve Smith, a 25-year-old picture researcher from Hackney, admits she doesn't do much exercise and sometimes drinks a little too much wine, but eats healthily.
Both she and Cecilia Pimentel, 24, a fashion assistant, from São Paulo, Brazil, have more external body fat than the men, with 20 and 22 litres respectively. This is an entirely normal gender difference.
At 1m 79cm, Cecilia's 2.5 litres of internal fat is pretty good. Eve is also fine, but as she is shorter at 1m 57cm and carrying three litres of internal fat, she could probably do with a little more physical activity.
The researchers believe our current view of the relationship between diet, physical activity and health is far too simplistic. This is where the so-called intervention studies being carried out by Prof Bell's team come in. Groups of individuals will be put through 16-week programmes of exercise of different intensities and frequencies. Their progress will be accurately measured with MRI scans, and compared with control groups.
The ultimate objective is to be able to provide far more accurate advice on how someone should exercise, based on their gender, ethnicity and genetic make-up.
New Year resolutions will drive many to pull on their running shoes or grope in the less-frequented corners of their purses and wallets for neglected gym memberships. Recognised guidelines say we should exercise for a minimum 20 to 40 minutes three to five days a week to maintain our health.
But what is becoming clear is that this advice is far too general. While everyone will benefit to some extent from an increase in physical activity, a greater understanding of the reasons people lose and gain different types of fat at varying rates would allow far more effective advice to be given.
The research team at Hammersmith Hospital is looking for men aged 20-40 who are inactive and of either Caucasian or South Asian origin to take part in the studies. Participants will receive health and fitness advice. If you are interested in joining a study, even if you do not fulfil these criteria, email John McCarthy at john.mccarthy~imperial.ac.uk
http://www.telegraph.co.uk/health/main.jhtml;jsessionid=JLHQ1QSMYZOPTQFIQMFCFFOAVCBQYIV0?xml=/health/2006/12/21/ftfat121.xml