Firstly, I am discussing this topic solely on the criteria of “moderate body fat”, which YOU defined as being “less than obesity” in the previous thread.
[quote]Professor X wrote:
Still waiting for proof that a moderate body fat percentage alone less than obesity… [/quote]
This is what I replied to initially and this is what I will continue to discuss. I am not interested in opining on the physiological nuances of, say, “12% vs. 8%” or “15% vs. 11%” or whatever else is getting tossed about in this thread. That is between you and the other posters.
Moderate body fat percentage —> Less than obesity.
Secondly, I am not discussing absolute causation. Causation is demonstrated, but it is not ironclad. I am discussing the POTENTIAL, which really works well because it dovetails elegantly with Brick’s initial comment about “risk factors” and, later, your revision to instead see “proof that moderate body fat percentage alone is a ‘risk factor’…” (this was said on page 40 at 06-10-2013, 01:37 PM)
Thirdly, I am not discussing confounding factors. I genuinely thought this went without saying, but since you seem to be confused: when saying X is a risk factor for Y, I am talking about isolating a single variable and tweaking it in a vacuum as well as can be expected when discussing multifactorial issues such as obesity or CVD.
Because of this effort, I am not discussing whether or not lifestyle modifications can attenuate the deleterious effects of excess body fat (so, no, I don’t particularly care if someone managed to build a lot of horsepower with which to lug their spare tire about) If you want discuss that, start a new thread or find a new poster.
I am making this clear now because you seem to have me confused with someone else.
[quote]Professor X wrote:
…but the first alone doesn’t say anything that hints at body fat itself being the cause of anything. They only looked at patients with ABDOMINAL OBESITY.[/quote]
You do understand, of course, that adipose tissue in the abdominal section of the body IS, about as intuitively as one can expect, fat which is contained within the body. Hence, “body fat.” I mean, it doesn’t sit on the sidelines taking a breather when DEXA, BIA or hydrodensitometry analyses are performed to gauge body fat, does it?
Find me a single credible source that states that fat within the abdominal cavity of the human body is NOT “body fat” and we’ll discuss this further.
And, you also understand, of course, that abdominal obesity is NOT the same as textbook obesity? Probably not, but that won’t stop you from insisting so consider it rhetorical.
[quote]Professor X wrote:
This doesn’t say anything we don’t already know.[/quote]
So, you already knew that abdominal obesity, aka, “fat which is contained within the abdominal cavity of the human body” is associated with CHD and T2D independent of overall adiposity? And yet, you aren’t/weren’t aware that just because it has the word “obesity” in it, it doesn’t necessarily indicate a “Walmart-eque” degree of fat accrual?
If you say so.
[quote]Professor X wrote:
This also only looked at obese patients…which again indicates lifestyle issues which the first link you posted stated, “Lifestyle modification programs have shown the benefits on cardiometabolic risk variables”…which again means that fat gain itself isn’t the issue but HOW MUCH and WHERE.[/quote]
Lifestyle modifications are, again, irrelevant. The measures taken to mitigate the detrimental effects once the disease process is in motion is not the topic we were discussing, no matter how badly you may want it to be.
What else…the fact that the participants were obese is, as well, irrelevant because you “already knew” (per above) that abdominal obesity was independently associated with an increased risk of coronary heart disease and Type 2 diabetes independent of overall adiposity. So, who cares if they were obese if their obesity didn’t influence the consequences of their intra-abdominal fat accumulation? I know where you want to run with this, but class ain’t over.
But, yeah, OF COURSE the “where” matters. That’s why you can’t just universally state that not being obese means fat can’t harm you. Jesus.
The first study was posted to demonstrate the independent association (which you admitted to knowing about) of intra-abdominal adiposity to disease; THIS one was posted to demonstrate evidence of causation:
"Intra-abdominal obesity is also unique as a cardiovascular risk state in that it contributes to or directly causes most other modifiable risk factors…
[quote]Professor X wrote:
…which means patients with high blood pressure, syndrome x and high cholesterol or low HDL…all life style indicators again.[/quote]
Well, not necessarily, because we already see evidence that intra-abdominal obesity “contributes to or directly causes most other modifiable risk factors, namely, hypertension, dysmetabolic syndrome, and type 2 diabetes mellitus.”
So, we now lean that the indicators you SAY are “lifestyle” are, in reality, perhaps actually CAUSED by intra-abdominal adiposity.
The first two diseases, you’ll notice, may result in either heart disease or hyperlipidemia (and I’m assuming they taught diabetic dyslipidemia in dental school), which incidentally are the two physiological pathologies Brick mentioned. I am not a psychiatrist and have no interest in discussing the other two.
[quote]Professor X wrote:
This does not show that someone at “12%” is healthier than someone with a higher body fat.[/quote]
Irrelevant to the discussion between you and I. I am, again, simply talking “less than obesity.”
[quote]Professor X wrote:
This means that obese patients who don’t exercise are at greatest risk…once again not pointing to any fat gain alone being a risk factor but OBESITY AND A WAIST CIRCUMFERENCE OVER 90CM.[/quote]
Um, the fact that the subjects who don’t exercise are at “greatest risk” implies that the subjects who DO exercise are still, in fact, at risk. Note that I am not quantifying risk in this discussion, merely illustrating its presence. That’s what you wanted, after all.
As well, the fact that the subjects were obese is additionally irrelevant (as we already know that intra-abdominal adiposity is harmful independent of total body fat). That the subjects had waists >36" might be a point of contention if this was presented all by its lonesome (because it would be tough reaching that circumference as an Average Joe/Jane WITHOUT being obese), but this will be attended to later. This study was merely posted to, again, show some degree of causation – how intra-abdominal adiposity “drives the progression of multiple cardiometabolic risk factors independently of body mass index.” Again, as we learned above, it is ALSO independent of total body fat.
[quote]Professor X wrote:
…which again means obese patients were looked at.[/quote]
Which, again, is irrelevant.
[quote]Professor X wrote:
This again does not show that someone is less healthy just because they are carrying more fat than someone else. It means patient with high visceral adipose tissue accumulation are at greater risk for disease…something we already know.[/quote]
First, I am NOT comparing “someone” to “someone else”.
Second, you [u]just admitted[/u] to knowing that “body fat” is a risk factor. I.e., you [u] just agreed[/u] with the very post that bunched your panties in the first place.
Too bad I didn’t notice this slip until just now, but I’ll run this into the ground anyhow.
[quote]Professor X wrote:
I likely will not go through the rest of your sources as the first FIVE did not show anything but that obese people who are inactive are at greater risk of disease and did NOT show that any fat gain at all is “unhealthy”.[/quote]
Aww, but you SHOULD.
I mean, we’ve already established that 1) intra-abdominal fat IS “body fat” (duh); 2) that you “already knew” that it is associated with various diseases independent of gross obesity; and 3) that it also DIRECTLY CAUSES various adverse states of health.
Now that we know this… what’s next? Showing that this “body fat” which you “already knew” is associated with disease states independent of gross obesity and which is also seen to “directly cause” other deleterious situations can ALSO occur in lean individuals, maybe?
Well, let’s see: we have one study that suggests it is “not obesity per se, but rather metabolic dysfunction of adipose tissue that is associated with systemic insulin resistance and the metabolic syndrome.” An insight discovered by examining NON-OBESE individuals.
And, there’s that very last reference which discusses the term “Metabolic Obesity”; it states that the term is oftentimes used to indicate to "visceral fat accumulation in either lean or obese individuals."
Either, or. Apparently, the people at risk of visceral fat accumulation are not just obese, not even at “moderate” body fat, but even the LEAN.
So, to summarize our evidence to answer the question of whether or not body fat “less than obesity” can be considered a risk factor for various diseases:
- Intra-abdominal fat IS “body fat.” It is fat within the body that affects measurements of body fat percentage.
- Intra-abdominal fat is directly associated with many adverse states of health independent of overall body fat.
- Intra-abdominal fat is associated with CHD even in the absence of classical (lifestyle??) risk factors (you skipped this one, but whatevsies).
- Intra-abdominal fat either contributes to directly causes many adverse states of health.
- Intra-abdominal fat can accumulate to a detrimental degree in the non-obese.
- I am not arguing that body fat ALWAYS CAUSES anything in EVERYONE.
- I am arguing specifically for the pathological basis of fat tissue in a key area of the body. Don’t like it? Don’t unequivocally state that body fat is not harmful so long as it is below the threshold of obesity… especially while touting your education in the subject. Taking that much time to pat yourself on the back leaves you wide open for some serious bitch slapping.
- You are quoted admitting to already knowing that individuals with “high visceral adipose tissue accumulation [read: BODY FAT] are at greater risk for disease.” So, ya know, keep trolling.
Therefore,
Moderate body fat “less than obesity” IS A RISK FACTOR for disease.
Q.E.D.
