Almost every second German aged 18 to 79 is overweight, and up to a quarter of this age group are even obese (adipose). Therefore, overweight is becoming more and more important with regard to cardiovascular risk. But: too much weight is not equally dangerous for everyone.
Distribution of body fat is crucial
Body mass index (BMI) indicates the ratio of body weight to height. It is a measure of body fat mass and is used to classify people as overweight (BMI over 25) or obese (BMI over 30). It does not take into account where the fat is located. Yet it is the distribution of body fat that is important in assessing both the risk of cardiovascular disease and diabetes.
Just a few years ago, the importance of abdominal obesity, with too much “inner belly fat,” was often underestimated. Now it is clear that excessive inner abdominal fat increases the risk of developing cardiovascular disease and diabetes. In contrast, vascular disease and metabolic disorders occur only slightly more frequently with bulky fat deposits on the buttocks, hips and thighs than with normal weight.
Weight alone is therefore not sufficient to determine the risk for cardiovascular disease. Fat distribution should also be recorded.
Fat distribution: apple type and pear type.
In apple type (abdominal obesity), fat accumulates in three areas of the body: 1. abdominal skin, 2. back and sides, and 3. internal organs (for example, stomach, intestines, liver).
The main risk factor for heart and circulation in this case is the fat on the internal organs, the so-called intra-abdominal fat (internal abdominal fat). An externally visible sign of the inner abdominal fat is the abdominal girth. In many cases, men are affected – but also women at an older age.
In the pear type (peripheral obesity), the fat cells fill up mainly in the area of the hips, buttocks and thighs. With this fat distribution, vascular diseases and metabolic disorders occur only slightly more frequently than with normal weight.
However, diseases occurring due to the higher static load, such as degenerative diseases of the knee joint, are just as common as in the abdominal fat distribution type. The pear type is particularly common in obese women.
Fat cells affect metabolism
The different health risk associated with different fat accumulations is based on their metabolic activity. In the past, adipose tissue was considered an inactive mass, but today we know that adipose tissue is not simply a passive store of fat.
Particular fat cells actively participate in metabolism, which is especially true of fat located in the abdomen. This internal abdominal fat is subject to special biochemical, hormonal and molecular biological processes and has an unfavorable effect on fat metabolism.
