Welcome to Straight Talk on Health. I’m your host Dr. Chet Zelasko. Straight Talk on Health is a joint production with WGVU in Grand Rapids MI. With a PhD in exercise physiology, I’ve been teaching people how to improve their health through diet, exercise, and supplementation for over 30 years. I look at the science behind all the headlines and social media and let you know whether it’s something to consider or not. You can check out other things that I do on my website Drchet.com and sign up for my free emails.
I was listening to a podcast last week from when I wrote this script, and the speaker, an expert in body composition as it relates to degenerative disease, mentioned in passing that a hippopotamus has less body fat than most humans. He also said that the typical super model could potentially be at more risk for those diseases, even more than a sumo wrestler. That’s something that I just had to find out more about so let’s take a look.
Let’s begin with a little bit about body fat. Besides being in locations that most people are not happy about, just like real estate and business, it’s location, location, location. What’s that all about? Fat is stored in many isolated locations including the joints, the face, and the weight bearing areas like the heels of the feet. That’s a relatively minor contribution to overall body fat as it would take extreme weight loss to impact those areas.
The other areas that store the bulk of the fat are the subcutaneous and the visceral fat. Subcutaneous fat is found underneath the skin and seems to be more a storage facility for fat. It is also believed to be less hazardous than the other form of fat found in the body although that is still open for debate. The other storage of fat is called the visceral fat/ VF is worse because it’s packed in and around our organs like the liver, kidneys, and intestines. It’s also metabolically active and not in a good way. It causes the release of inflammatory hormones which contribute to all sorts of diseases such as CVD, type 2 diabetes, and cancer. But is it hazardous to every person who is obese as assessed by BMI or even DEXA, even morbidly obese? Maybe. Maybe not. Here’s what I found out.
Beginning with the hippopotamus, it’s estimated to contain no more than 5% body fat. What they also have is a lot of muscle. Doesn’t seem to fit what a hippo looks like but under a thick skin, it’s all muscle. This has to be data from a necropsy, an autopsy on a non-human animal, because there is no machine large enough to assess the body fat in any conventional way. Besides that, given their rather nasty and territorial disposition, are you going to try to get it in some machine to measure body fat? I don’t think so and therefore, we’ll accept the 5%.
That brings us to assessing body fat in humans. As I’ve mentioned in past STOH, I was a self-proclaimed king of underwater weighing during my graduate studies. I measured thousands of subjects, sport teams, and consumers who wanted an accurate assessment of body fat. What came after like air-displacement, impedance analysis, and even DEXA were no better than what a person could find out from underwater weighing. I found an area of BC research I had missed entirely: using magnetic resonance imaging (MRI) to assess body fat. The reason it rules and should be the current gold standard is that it can separate the visceral fat from the subcutaneous fat. When you look at the images, the fat clearly shows up.
The research group in the UK assessed a large group of people from data collected during MRI scans taken for diagnostic reasons. They separated them by gender and degree of BMI body fatness. One of the most revealing slides was a comparison of nine men, all with the same BMI, but varying levels of VF. The difference between them ranged from .3 liter VF to 3.7 liters of VF. Absolutely astounding. You can find the reference to read for yourself in the notes.
The problem would be cost; no insurance will pay for an MRI body scan for assessing body fat, the only way to know the VF versus SF content. The neck to ankle scan would cost between $1,000 to $2500 in the West MI area. I love the concept but I would have to be really motivated to purchase one. I can only see its benefit one way; for someone who has been diagnosed as being obese via BMI who refuses to accept that diagnosis. It's a lot of money and you could be wrong. But today it is an option.
Let’s get back to the model and the sumo wrestler. Based on the data in the aforementioned study, the data clearly show that even in men and women with a normal amount of body fat, they can have too much visceral fat. The used the phrase ‘thin-on-the-outside fat-on-the-inside’ or TOFIOn the other side of the spectrum, they tested individuals that were obese by BMI standards but had low VF; it was mostly SF. They identified them as ‘metabolically healthy obese’ or fat-fit. While the data have not been absolutely clear about the risk that can pose, there may be an explanation for the results.
Could there be models who have the appearance of being thin but who are medically at risk due to high VF? Absolutely even though there are no specific data on that subgroup of the population. On the other end of the spectrum, there are some data on sumo wrestlers that have massive bodies. Research shows that the can be classified as morbidly obese but have low to normal body fat—the essence of fat-fit. How?
The top sumo wrestlers weigh an average of 355 pounds. There was a brief time I watched a little wrestling when Konishiki, a Hawaiian sumo, was popular. He had been the heaviest sumo up to that time weighing over 600 lbs. The question is with weighing so much, are sumo wrestlers at risk for weight-related disease? It comes down to the VF issue. As I said, they fall into the fat-fit category—as long as they are active sumo wrestlers.
The sumo train for 5-6 hours first thing in the morning. Think about moving your body weight or more for that long every day. This isn’t just lifting weights. You’re trying to grab, hold on, and move 300-400 pounds for hours per day. The sumo have massive core, hip, thigh, and calf muscles. No doubt they have massive amounts of body fat but most is subcutaneous fat. The visceral fat is much lower than the 300-400 pound North American obese individual and lower than those with those with a normal weight BMI.
What protects the sumo is the excessive exercise they get every day. True, they often eat 5,000-10,000 calories per day to gain weight but they don’t suffer the issues with sedentary people of the same weight. The problem begins when they retire and they no longer train. Due to their massive size, the risk of increasing visceral fat and disease accelerates. Unfortunately, many succumb to those diseases. The greatKonishiki developed kidney failure within the past two years of this recording. and required a kidney transplant. As of this writing, he is still alive at 62 years.
The lesson for all of us, until we can lose the excess body fat, we have to stay as active as we can with regular exercise especially weight training. Preventing the age related loss of muscle due to sarcopenia, and building as much as we can through weight training, together with aerobic exercise can help reduce visceral fat. It is not a permanent solution but doing as much as we can to reduce the risk is significant. Until we can master the eating less and eating better component, moving more is critical to healthy VF. Exercise rules!
That’s all the time I have for this episode. If you like this podcast, hit the share button and tell your friends and colleagues about it. Until next time, this is Dr. Chet Zelasko saying health is a choice. Choose wisely today and every day.
Reference: Nutrition Research Reviews (2012). doi:10.1017/S0954422412000054
