Monday, October 28, 2019

Body Fat Percentage May Be Better in Identifying Prediabetes and Diabetes

Obesity is viewed as a “major risk factor for the development of prediabetes and type 2 diabetes.” Body mass index or BMI is probably the most frequently used measurement of obesity. However, BMI is also viewed as an imperfect measurement of excess body fat. Based on BMI, an individual may appear to have a normal weight -- a BMI < 25 -- but actually have a body fat percentage (BF%) that raises the individual’s risk for prediabetes and type 2 diabetes.

Therefore, accurate measurements of BF% are sought. One of the more accurate methods may be the air-displacement plethysmography, or ADP. Further, it appears that ADP for BF% may be better at identifying those with a high risk of prediabetes and diabetes.

Air-displacement plethysmography (ADP) is defined as “A technique for measuring body composition (body volume and percentage of body fat) that relies on the relative volume and pressure of gas displaced by the body when it is placed inside a plethysmograph.” A plethysmograph is “a device for measuring and recording changes in the volume of the body or of a body part or organ.”

One study looked at a total of 4,828 participants to determine the effectiveness of ADP in measuring body fat percentage for the diagnosis of diabetes and prediabetes. Three groups were created using BMI classifications for normal weight, overweight and obesity. These groups were described as follows: 587 lean participants, 1,320 overweight participants, and 2,921 obese participants.

The investigators concluded that there was “a higher than expected number of subjects with prediabetes or type 2 diabetes” in the lean and obese groups, using BF% cutoff points, than what would be expected using BMI cutoff points. The most often used cutoff points for BF% are as follows: overweight men, 20.1-24.9%; overweight women, 30.1-34.9%; obese men, >= 25% and obese women, >= 35%.

At any rate, BF% does a better job of identifying subjects with a high risk of prediabetes or type 2 diabetes than BMI.

Wednesday, October 23, 2019

The Metabolically Healthy Obese and Diabetes

Past research has shown that there are obese people who are metabolically healthy. And while the idea that one can be obese and healthy is counterintuitive, apparently, these people exist. They are referred to as metabolically healthy obese or MHO. Although MHOs do exist, there are reasons to believe that the healthy state may not be long-lasting. And recent research has shown that metabolically healthy obese individuals have a higher risk of diabetes compared to normal weight individuals.

One scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging suggested that MHOs may be healthier than one might expect because they have a healthier level of inflammation. And that this healthier level of inflammation may actually protect the MHOs from disease. This is an interesting conclusion, since one of the problems with excess body fat is inflammation. Inflammation appears to play a role in insulin resistance which can lead to type 2 diabetes.

The connection between excess body fat and diabetes was highlighted in a recent study done in China. The investigators looked at the connection between MHOs and diabetes incidence in middle-aged and elderly people. They were also interested in knowing whether or not nonalcoholic fatty liver disease (NAFLD) played a role in that Association.

The investigators looked at over 17,000 individuals who did not have diabetes at the beginning of the study. The investigators defined metabolically healthy individuals as those with a BMI of 28 and zero or one of four metabolic comorbidities. These comorbidities were high blood pressure, increased triglycerides, hyperglycemia and low-cholesterol. The healthy MHOs were compared to metabolically healthy normal weight persons.

The investigators concluded that the MHO condition “was associated with increased incidence of diabetes in a middle-aged and elderly population, and the association did not differ by the presence or absence of NAFLD.” And in another study, researchers concluded that the MHO state is relatively unstable.

So, while some obese individuals may be healthy, in general, the healthy state may not last as long as a person of normal weight. The excess, harmful body fat may be detrimental in the long run.
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