June 12, 2007
Kamloops Daily News

Inner fat is dangerous. Outer fat just hangs around.

All body fat used to be lumped together but now doctors and
scientists realize that we have two kinds of fat. Each acts
like a separate organ with distinct functions.

Inner fat, called visceral fat, is potentially nasty stuff.
Too much of it can cause life threatening problems.
"Visceral obesity," says one expert, "does seem to be truly
evil."

In contrast, outer fat is relatively benign. It doesn't
improve our looks when it collects around our hips, buttocks
and thighs but it's not as dangerous. One of the most
harmful consequences of outer fat, called peripheral fat, is
that it relegates clothes that used to fit to the closet and
leads to a new wardrobe.

But if you're going to put on weight, outer fat is where it
should go. It's nature's storehouse for excess caloric
energy. Jean-Pierre Després from the Laval Hospital in
Quebec City calls peripheral fat "an expandable metabolic
sink."

Inner fat is dangerous, even in small amounts. Inner fat
collects deep around vital organs like the liver, heart,
intestines and kidney.

Hidden in our guts, inner fat goes to work reducing
sensitivity to insulin (a precursor to diabetes), increasing
the risk to cardiovascular disease and high blood pressure.

Because inner fat has privileged access to our intestines,
it provides a quick source of energy storage. It's an
energy reserve that is meant to be used up quickly.

Even thin people can have too much inner fat because in
small amounts it doesn't show. Those who stay thin through
diet rather than exercise can accumulate unsafe deposits of
dense inner fat. While outer fat is flabby, inner fat is
pasty and hard.

Inner fat cells sometime rupture as they become large and
dysfunctional. Low level infection can result from this
rupture as the immune system tries to clean up debris.
Chronic low-level infection contributes to cardiovascular
disease and diabetes.

Excess inner fat is also implicated in the development of
Alzheimer's disease, colon cancer, gallstones, ovarian
cystic disease, breast cancer and sleep apnea.

Scientists used to think that all fat was just excess
baggage. Anatomical charts didn't even show it. Now they
now realize that inner fat is especially an active.
Visceral fat is an organ similar to the pancreas. Hormones,
enzymes and lipids are released by fat cells.

Your fat twins keep in touch. Each of our fat organs senses
the condition of the other. This complicates liposuction.

Liposuction surgically removes outer fat. It's an easy
target because it's so readily available. But its removal
triggers a response that causes inner fat to increase.
Liposuction may improve appearances but increases health
risks through more inner fat.

Men pile on inner fat more than women. The connection
between health risks and the distribution of body fat has
been known for decades. Men typically develop apple shapes
whereas women become pear-shaped. It's still better to be
pear-shaped because it indicates an excess of outer fat.
Neither shapes are flattering but it's healthier to have
thunder thighs than a beer belly.

We may have inherited fat distribution from our prehistoric
ancestors. Male hunters in the heat of the chase for game
needed quick access to energy stored close to vital organs
whereas women needed long-term external reserves to survive
between meals.

Because excess inner fat accumulates around the abdomen, it
can be easily determined with a tape measure. Waist
measurement is quick and easy compared to CT scans or MRIs.

As part of an international experiment, Dr. Després had
6,400 doctors in 63 countries participate in the study. To
ensure that waist measurements were properly done, he sent
instructional videos showing doctors exactly where the waist
measurement was to be made. The study, called the
International Day for the Evaluation of Abdominal Obesity,
confirmed that waist size was as good as more complex tests
in determining risks of heart disease and diabetes.

The results of this low-tech measurement were
"overwhelmingly clear," said Després with a 97 per cent
correlation between waist size and disease. As a result,
physicians recommend that women have waists less than 35
inches and men, 40 inches.

The discovery of good and evil fat cells may lead to a
treatment of obesity. If scientists can find what makes
outer fat cells innocuous, maybe toxic inner cells could be
made to behave like their benign neighbours.
 

David Charbonneau is the owner of Trio Technical.
He can be reached at dcharbonneau13@shaw.ca

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