The answer to this seemingly obvious question is often confused by trying to define what fat and fit means. Over the years the measurement of fat and indeed its distribution has raised some interesting questions. I’m very aware of the muscular athletic awesome looking Crossfit athlete who comes back from their annual medical having been told they are obese according to their BMI. These are people, who when their body fat is checked(using callipers or some sort of science fiction machine) are down into the enviable category!. The next interesting “quickie” fat measure came when the discussion of abdominal obesity became fashionable The waist to hip ratio measurement was quick and easy and it certainly measured the tummy fat that showed. Today, we should all be about visceral fat. But, It’s a hard thing to measure without a CT scan . The problem with visceral fat (the fat inside your visceral cavity, or around your organs) , is that skinny people can have visceral fat and that people with a big tummy don’t necessarily have visceral fat. It can sometimes be all subcutaneous! Basically we can have obvious fat and/or visceral fat. Now we need to ask what is healthy or what is metabolically unhealthy. According to Ortega (2012) . If you crave the “metabolically unhealthy” crown, you must have one or more of these readings
- high blood pressure (≥130/85 mmHg)
- high blood triglycerides (≥150 mg/dL)
- low HDL “good” cholesterol (<40 and 50 mg/dL in men and women, respectively)
- high fasting blood sugar level (≥100 mg/dL)
- “Metabolically healthy” obese participants had a better baseline fitness level on the treadmill test compared with “metabolically abnormal” obese participants (adjusting for age, sex, examination year, smoking and alcohol consumption, and when using either BMI or body fat percentage to define obesity). The difference was the same for men and women.
- “Metabolically abnormal” obese participants had significantly increased risk of dying from any cause during follow-up compared with “metabolically healthy” obese participants (adjusting for confounders and using either BMI or body fat percentage to define obesity).
- When looking at cardiovascular disease outcomes, “metabolically abnormal” obese participants only had increased risk of a fatal or non-fatal cardiovascular disease event compared with “metabolically healthy” obese participants when using body fat percentage to define obesity. There was no difference in risk when using standard BMI definitions.
- “Metabolically healthy” obese participants had no difference in risk of dying from any cause, or of fatal or non-fatal cardiovascular disease events compared with “metabolically healthy” normal-weight or fat participants.