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Obesity, Fat Patterning and Cardiovascular Risk

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Nutrition and Biotechnology in Heart Disease and Cancer

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 369))

Abstract

The hypothesis that where adipose tissue is located on the body is an important predictor of health has been the subject of intense research over the past 10 to 15 years. The concept of an “apple shaped” body being associated with higher risk than a “pear shaped” body has appeared in the lay literature, and as a result, questions concerning fat distribution are being directed to physicians and other health care professionals. The purpose of this paper is to summarize the history and major findings in the area of fat distribution, and to point out current controversies and future directions of research.

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References

  • Ashwell, M., Cole, T., and Dixon, A., 1985, Obesity: new insight into the anthropometric classification of fat distribution shown by computed tomography, Br. Med. J. 290: 1692–94.

    Article  CAS  Google Scholar 

  • Baumgartner, R., Heymsfield, S., Roche, A., and Bernardino, M., 1988, Abdominal fat depots measured with computed tomography: effect of degree of obesity, sex and age., Am. J. Clin. Nutr. 48: 936–45.

    CAS  Google Scholar 

  • Bergstrom, R., Newell-Morris, L., Leonetti, D., Shuman, W., Wahl, P., and Fujimoto, W., 1990, Association of elevated fasting C-peptide level and increased intra-abdominal distribution with development of NIDDM in Japanese-American men, Diabetes 39: 104–11.

    Article  CAS  Google Scholar 

  • Bjorntorp, P., 1990, Portal adipose tissue as a generator of risk factors for cardiovascular disease and diabetes, Arterioscler. 10: 493–6.

    Article  CAS  Google Scholar 

  • Bjorntorp, P., 1991, Visceral fat accumulation: the missing link between psychosocial factors and cardiovascular disease?. J. Intern. Med. 230: 195–201.

    Article  CAS  Google Scholar 

  • Bjorntorp, P., 1993, Visceral obesity:A “civilization syndrome”, Obes. Res. 1: 206–22.

    Article  CAS  Google Scholar 

  • Bouchard, C., and Tremblay, A., 1990, Genetic effects in human energy expenditure components. Int. J. Obes. 14: 49–58.

    Google Scholar 

  • Busetto, L., Baggio, M., Zurlo, F., Carraro, R., Digito, M., and Enzi, G., 1992, Assessment of abdominal fat distribution in obese patients: Anthropometry versus computerized tomography. Int. J. Obes. 16: 731–6.

    CAS  Google Scholar 

  • Despres, J., Prud’homme, D., Pouliot, M., Tremblay, A., and Bouchard, 1991, Estimation of deep abdominal adipose-tissue accumulation from simple anthropometric measurements in men. Am. J. Clin. Nutr. 54: 471–7.

    CAS  Google Scholar 

  • Donahue, R., Abbott, R., Bloom, E., Reed, D., and Yano, K., 1987, Central obesity and coronary heart disease in men. Lancet 1: 821–23.

    Article  CAS  Google Scholar 

  • Ducimetiere, P., Richard, J., and Cambien, F., 1986, The pattern of subcutaneous fat distribution in middle-aged men and the risk of coronary heart disease: the Paris Prospective Study. Int. J. Obes. 1986: 229–40.

    Google Scholar 

  • Ferland, M., Despres, J., Tremblay, A., Pinault, S., Naddeau, S., Moorjani, S., and PJ, L., 1989. Assessment of adipose tissue distribution by computed axial tomography in obese women: association with body density and anthropometric measurements. Br. J. Nutr. 61: 139–48.

    Article  CAS  Google Scholar 

  • Gillum, R., 1987, The association of body fat distribution with hypertension, hypertensive heart disease, coronary heart disease, diabetes and cardiovascular risk factors in men and women aged 18-79 years. J Chronic Dis. 40: 421–28.

    Article  CAS  Google Scholar 

  • Haffner, S., Stern, M., Hazuda, H., Pugh, J., and Patterson, J., 1987, Do upper-body and centralized adiposity measure different aspects of regional body-fat distribution? Relationship to non-insulin-dependent diabetes mellitus, lipids and lipoproteins, Diabetes 36: 43–51.

    CAS  Google Scholar 

  • Hartz, A., Rupley, D., and Rimm, A., 1984, The association of girth measurements with disease in 32,856 women, Am. J. Epidemiol. 199: 71–80.

    Google Scholar 

  • Jensen, M., Haymond, M., Rizza, R., Cryer, P., and Miles, J., 1989, Influence of body fat distribution on free fatty acid metabolism, J. Clin. Invest. 83: 1168–77.

    Article  CAS  Google Scholar 

  • Kalkhoff, R., Hartz, A., Rupley, D., Kissebah, A., and Selber, S., 1983, Relationship of body fat distribution to blood pressure, carbohydrate tolerance and plasma lipids in healthy obese women, J. Lab. Clin. Med. 102:621–27.

    CAS  Google Scholar 

  • Kannel, W.B., and Gordon, T., 1979, Physiological and medical concomitants of obesity: the Framingham Study in “Obesity in America”, G.A. Bray, ed. US Department of Health, Education and Welfare, Public Health Services, National Institutes of Health Publication: 79-359, Bethesda.

    Google Scholar 

  • Keil, J., Sutherland, S., Knapp, R., Lackland, D., Gazes, P., and Tyroler, H., 1993, Mortality rates and risk factors for coronary disease in black as compared with white men and women, New Eng. J. Med. 329: 73–8.

    Article  CAS  Google Scholar 

  • Kirschner, M., Samojlik, E., Drejka, M., Szmal, E., Schneider, G., and Ertel, N., 1990, Androgen-estrogen metabolism in women with upper versus lower body obesity, J. Clin. Endoc. Metab. 70: 473–79.

    Article  CAS  Google Scholar 

  • Kissebah, A., Freedman, D., and Peiris, A., 1989, Health risks of obesity, Med. Clin. North Am. 73: 111–38.

    CAS  Google Scholar 

  • Kissebah, A., Vydelingum, N., Murray, R., Evans, D., Hartz, A., Kalkhoff, R., and Adams, P., 1982, Relation of body fat distribution to metabolic complications of obesity, J. Clin. Endocrinol Metab. 54: 254–60.

    Article  CAS  Google Scholar 

  • Koester, R., Hunter, G., Snyder, S., Khaled, M., and Berland, L., 1992, Estimation of computerized tomography derived abdominal fat distribution, Int. J. Obes. 16: 543–54.

    CAS  Google Scholar 

  • Krotkiewski, M., and Bjorntorp, P., 1986, Muscle tissue in obesity with different distribution of adipose tissue effects of physical training. International J. of Obes. 10: 331–341.

    CAS  Google Scholar 

  • Krotkiewski, M., Björntorp, P., Sjöström, L., and Smith, U., 1983, Impact of obesity on metabolism in men and women. Importance of regional adipose tissue distribution, J. Clin. Invest. 72: 1150–62.

    Article  CAS  Google Scholar 

  • Kvist, H., Chowdhury, Grangard, U., Tylen, U., and Sjostrom, L., 1988. Total and visceral adipose-tissue volumes derived from measurements with computed tomography in adult men and women: predictive equations. Am. J. Clin. Nutr. 48: 1351–61.

    CAS  Google Scholar 

  • Lapidus, L., Bengtsson, C., Larsson, B., Pennert, K., Rybo, E., and Sjostrom, L., 1984, Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden, Br. Med. J. 289: 1257–61.

    Article  CAS  Google Scholar 

  • Larsson, B., Seidell, J., Svardsudd, K., Welin, L., Tibblin, G., Willhelmsen, L., and Bjorntorp, P., 1989, Obesity, adipose tissue distribution and health in men. The study of men born in 1913. Appetite 13: 37–44.

    Article  CAS  Google Scholar 

  • Larsson, B., Svardsudd, K., Welin, L., Wilhelmsen, L., Bjorntorp, P., and Tibblin, G., 1984, Abdominal adipose tissue distribution, obesity and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. Br. Med. J. 288: 1401–4.

    Article  CAS  Google Scholar 

  • Lundgren, H., Bengtsson, C., Blohme, G., Lapidus, L., and Sjostrom, L., 1989, Adiposity and adipose tissue distribution in relation to incidence of diabetes in women: results from a prospective population study in Gothenburg. Sweden, Int. J. Obes. 23: 413–423.

    Google Scholar 

  • Marin, P., Holmang, S., Holm, G., Jonsson, L. and Bjorntorp, P., 1992, The effects of testosterone treatment on body composition and metabolism in middle-aged, obese men, Int. J. Obes. 16: 975–81.

    Google Scholar 

  • Mueller, W., Deutsch, M., Malina, R., Bailey, D., and Mirwald, R., 1986, Subcutaneous fat topography: age changes and relationship to cardiovascular fitness in Canadians, Human Biol. 58: 955–73.

    CAS  Google Scholar 

  • Ohlson, L., Larsson, B., Svardsudd, K., Eriksson, H., Wilhelmson, L., Bjorntorp, P., and Tibblin, G., 1985, The influence of body fat distribution on the incidence of diabetes mellitus: 13.5 years of follow-up of the participants in the Study of Men Born in 1913, Diabetes 34: 1055–58.

    Article  CAS  Google Scholar 

  • Ohlsson, L., Larsson, B., Svardsudd, K., Selin, L., Eriksson, H., Wilhelmsen, L., Bjorntorp, P., and Tibblin, G., 1985, The influence of body fat distribution on the incidence of diabetes mellitus, Diabetes 34: 1055–8.

    Article  Google Scholar 

  • Peiris, A., Aiman, E., Drucker, W., and Kissebah, A., 1989, The relative contributions of hepatic and peripheral tissues to insulin resistance in hyperandrogenic women, J. Clin. Endocrinol. Metab. 68: 715–20.

    Article  CAS  Google Scholar 

  • Rebuffé-Scrive, M., Andersson, B., Olbe, L., and Björntorp, P., 1989, Metabolism of adipose tissue in intraabdominal depots of nonobese men and wornen, Metabolism 38: 453–58.

    Article  Google Scholar 

  • Rebuffe-Scrive, M., Enk, L., Crona, N., Lonnroth, P., Abrahamson, L., Smith, U., and Bjorntorp, P., 1985, Fat cell metabolism in different regions in women. Effect of mentrual cycle, pregnancy and lactation J. Clin. Invest 75: 1973–6.

    Article  CAS  Google Scholar 

  • Reichley, K., Mueller, W., Hanis, C., Joos, S., Tulloch, B., Barton, S., and Schull, W., 1987, Centralized obesity and cardiovascular disease risk in Mexican Americans, Am J Epidemiol. 125: 373–86.

    CAS  Google Scholar 

  • Seidell, J., 1992, Regional obesity and health, Int. J. Obesity. 16: S31–S34.

    Google Scholar 

  • Seidell, J., Bjorntorp, P., Sjostrom, L., Kvist, H., and Sannerstedt, R., 1990, Visceral fat accumulation in men is positively associated with insulin, glucose, and c-peptide levels, but negatively with testosterone, levels. Metabolism 39: 897–901.

    Article  CAS  Google Scholar 

  • Seidell, J., Cigolini, M., Deslypere, J., Charzewska, J., Ellsinger, B., and Cruz, A., 1991, Body fat distribution in relation to physical activity and smoking habits in 38-year-old European men, Am. J. Epidemiol. 133: 257–65.

    CAS  Google Scholar 

  • Seidell, J., Oosterlee, A., Deurenberg, P., Hautvast, J., and Ruijs, J., 1988, Abdominal fat depots measured with computed tomography: effects of degree of obesity, sex, and age, Eur. J. Clin. Nutr. 42: 805–15.

    CAS  Google Scholar 

  • Seidell, J., Oosterlee, A., Thijssen, M., Burema, J., Deurenberg, P., Hautvast, J., and Ruijs, J., 1987, Assessment of intra-abdominal and subcutaneous abdominal fat: relation between anthropometry and computed tomography. Am. J. Clin. Nutr. 45: 805–15.

    Google Scholar 

  • Shimokata, H., Muller, D., and Andres, R., 1989, Studies in the distribution of body fat III. Effects of cigarette smoking. JAMA. 261: 1169–73.

    Article  CAS  Google Scholar 

  • Stern, M., Patterson, J., Mitchell, B., Haffner, S., and Hazuda, H., 1990, Overweight and mortality in Mexican Americans, Int. J. Obes. 14: 623–29.

    CAS  Google Scholar 

  • Stevens, J., Keil, J., Rust, P., Tyroler, H., Davis, C., and Gazes, P., 1992a, BMI and body girths as predictors of mortality in black and white women, Arch. Intern. Med. 152: 1257–62.

    Article  CAS  Google Scholar 

  • Stevens, J., Keil, J., Rust, P., Verdugo, R., Davis, C., Tyroler, H., and Gazes, P., 1992b, Body mass index and body girths as predictors of mortality in black and white men, Amer. J. Epidemiol. 135: 1137–46.

    CAS  Google Scholar 

  • Stevens, J., Knapp, R., Keil, J., and Verdugo, R., 1991, Changes in body weight and girths in black and white adults studied over a 25 year interval, Int. J. Obes. 15: 803–8.

    CAS  Google Scholar 

  • Stevens, J., Plankey, M., Keil, J., Rust, P., Tyroler, H., and Davis, C., 1993. Black women have smaller abdominal girths than white women of the same relative weight. Am. J. Clin. Epidemiol. in press.

    Google Scholar 

  • Stokes, J., and Garrison, R. K., 1985, The independent contribution of various indices of obesity to the 22-year incidence of coronary heart disease: The Framingham Heart Study, in “Metabolic Complications of Human Obesities”, J.E.A. Vague, ed. Elsevier Science Publishers. New York. New York: Elsevier Science Publishers J.

    Google Scholar 

  • Terry, R., Page, W., and Haskell, W., 1992. Waist/hip ratio, body mass index and premature cardiovascular disease mortality in US Army veterans during a twenty-three year follow-up study. Int. J. of Obes. 16:417–23.

    CAS  Google Scholar 

  • Tremblay, A., Despres, J., Leblanc, C., Craig, C., Ferris, B., Stephens, T., and Bouchard, C., 1990, Effect of intensity of physical activity on body fatnes and fat distribution, Am. J. Clin. Nutr. 51: 153–7.

    CAS  Google Scholar 

  • Vague, J., 1956, The degree of masculine differentiation of obesities, Am. J. Clin. Nutr. 4: 20–33.

    CAS  Google Scholar 

  • Weits, T., VanDerBeek, E., Wedel, M., and TerHaarRomeny, B., 1988. Compputed tomography measurement of abdominal fat deposition in relation to anthropometry. Int. J. Obes. 12: 217–25.

    CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Departments of Epidemiology and Nutrition, School of Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7400, USA

    June Stevens

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  1. June Stevens
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Editor information

Editors and Affiliations

  1. University of North Carolina, Chapel Hill, North Carolina, USA

    John B. Longenecker

  2. Wistar Institute of Anatomy and Biology, Philadelphia, Pennsylvania, USA

    David Kritchevsky

  3. Duke University Medical Center, Durham, North Carolina, USA

    Marc K. Drezner

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Stevens, J. (1995). Obesity, Fat Patterning and Cardiovascular Risk. In: Longenecker, J.B., Kritchevsky, D., Drezner, M.K. (eds) Nutrition and Biotechnology in Heart Disease and Cancer. Advances in Experimental Medicine and Biology, vol 369. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1957-7_3

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  • DOI: https://doi.org/10.1007/978-1-4615-1957-7_3

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-5804-6

  • Online ISBN: 978-1-4615-1957-7

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