580% Higher Diabetes and 76% Higher Risk to Die Before Your Time, if Your Trunk-To-Leg Fat Ratio is in the Highest Quartile. Plus: Below 1.5 is Where You Want to Be

Body fat: If you store it, store it here or a couple of centimeters below. To avoid metabolic disease and premature death.

580% that's the SuppVersity Figure of the Week and the increase in diabetes risk you will have if your trunk to leg fat ratio is in the top quartile.

In view of the fact that this goes hand in hand with a +290% increased risk for high triglycerides, a +80 increased risk of high blood pressure, as well as 3x higher hances to suffer from low HDL levels and 3.6x higher risk of developing metabolic syndrome, these figures from a study that was recently conducted at the University of California Berkeley-University of California San Francisco (Wilson. 2013), will be more than just the figure(s) of the week. They are also the topic of this article..

Trunk to leg fat ratio emerges as the new marker of metabolic health 

(Wilson. 2013) The actual intention of the study Joseph P. Wilson et al. conducted was to find a new and reliable anthropometric marker for metabolic risk. To this ends, they analyzed data from the National Health and Nutritional Examination Survey 1999–2004. This is a study that's not just representative of the US population, but did also use dual-energy X-ray absorptiometry to access the body composition of the participants. The Berkeley scientists did now use this data do determine the associations between DX-derived trunk to leg volume ratios and diabetes, metabolic covariates, and mortality by BMI category, gender, and race/ethnicity group.

Figure 1: Prevalence of diabetes in quartile 1-4 of trunk to leg volume ratio; data displayed by BMI category (left) and ethnicity (right; graphs from Wilson. 2013)

While I already mentioned the overall results in the introduction to todays installment of "On Short Notice", a brief glimpse at the graphs I reproduced in figure 1 will tell you that being obese is a game changer in terms of obesity, only in the first quartile, where we are probably finding people like Mr. Olympia (remember the weight classes go by BMI!) with no fat on the trunk and a little fat on their hams in the off-season, obesity doubles the risk for type II diabetes.

"Additionally, trunk to leg volume ratio was the strongest independent measure associated with diabetes (P<0.001), even after adjusting for BMI and waist circumference. Even among those with normal BMI, those in the highest quartile of trunk to leg volume ratio had a higher likelihood of death (5.5%) than those in the lowest quartile (0.2%)." (

Interestingly, enough it does have no effect if you store "all" your body fat in the trunk. After all, in the highest quartile of trunk to leg fat ratios, a normal BMI won't save your lazy *** from becoming / being diabetic. Moreover, the percentage of diabetics in the middle quartiles is much higher for African Americans than for all other ethnics groups - Caucasians in particular (see figure 1, right).

Figure 2: Results of logistic regression models to distinguish those individuals with diabetes, high TG, low HDL, high blood pressure (BP), metabolic syndrome (MetS), and mortality by trunk to leg volume ratio; (*) adjusts for gender, race/ethnicity, age, BMI, waist circumference, self-reported activity level, poverty index ratio (Wilson. 2013)

Now if you use this and the rest of the data you get what you see in figure 1, where 6.8 for diabetes for example signifies a 6.8x increased risk for type II diabetes in the subjects in the highest quartile (>1.66) over those in lowest first quartile (<1.34) of trunk-to-leg fat ratio. The perfect, life-threatening storm for those who carry the majority of their body fat on the trunk.

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So where do you want to be? Optimally in the first two quartiles, I suppose. That would mean that the volume ratios of your trunk vs. your legs would be either <1.34 (Q1) or betwen 1.34 and 1.5 (Q2). In view of the fact that it is not easy to measure the volume, I would yet recommend to simply eyeball the proportions - I guess you know what they are supposed to look like ;-)

Bottom line: With this study, not just the stupid classification by BMI, but also the as of late heavily criticized wait-to-hip-ratio could become obsolete, as it really appears as if Wilson et al, were onto something with their trunk-to-leg-fat ratio. It holds promise as a relatively easily parameter to judge the personal risk of metabolic disease and premature death and it should remind you that the trunk fat is what you whould always target first - regardless of how nasty the cellulite on your legs may look it's healthier than having liposuction and build up more body fat in the trunk instead.

Learn more about cellulite in the SuppVersity Special: "SuppVersity Cellulite Special: The Etiology of Cellulite, Genetical and Behavioural Risk Factors? Physical and Supplemental Treatment Strategies & Their Efficacy" | read it

Other noteworthy news

Hah, now you are surprised, right? Well I thought so, I have decide to skip the Saturdaily news-potpourri. Too much work for too little feedback. Since I still don't want to have you go without a couple of additional short news, here is my usual Round Up of Facebook news:

• 

  Is ice water going to lean you out? Find out in the SuppVersity Facebook News!

  Is it possible to "drink yourself lean" with Ice-Water? What do you think, how much extra-calories can you burn if you guzzle water that's 3°C? And how does that compare to sugar water? | get the answers
• Parkinson's after a steroid cycle? Not impossible, if you go by the results of a recent study that links a sudden decline in testosterone levels with the onset of Parkinson's Disease. Plus: Could DHT help? | read more
• Propionyl-L-carnitine is a potent NO booster, could it be a "pump" supplement as well? | look at the evidence
• Whole grain bread was yesterday. Beetroot bread is the future! A heart healthier future? | make up your mind
• Breast cancer killer Origanum majorana! Another herb to have in your kitchen? | decide for yourself
  

I hope you can live with this change. If not, think about it like this a news is either worth a Facebook post @ www.facebook.com/SuppVersity or a complete article @ www.suppversity.com. Back in the day, when I started the Short News, there were no Facebook News - now that you get 6-8 short news per day on Facebook, this column is basically obsolete. Wouldn't you agree? 

References:

• Wilson JP, Kanaya AM, Fan B, Shepherd JA. Ratio of trunk to leg volume as a new body shape metric for diabetes and mortality. PLoS One. 2013 Jul 10;8(7):e68716.
  

Man or Woman, Trunk or Leg Fat - Adding a Full Body Strength Workout to Your Aerobics Will Burn the Fat Off!

Image 1: "Get up and move!"

Doing cardio is better than doing nothing. In the end, aerobic training does yet rarely produce those changes in body composition most "dieters" have in mind, when they embark on their daily jogging regimen and combine those with the latest and greatest diet fad they read about in magazines or on the Internet. If these people just added a few strength workouts to the equations, though, their bodies would begin to change; and what's even more exciting, according to a soon to be published study from the Pamukkale University in Denizli, Turkey, they will do that in the absence of any dietary changes and in exactly those problem areas, men and women usually hate the most about themselves: The trunk, for men, and the legs, for women (Sanal. 2012).

"Dieting"? Why, if working out alone elicits favorable changes in body composition?

The 92 healthy, yet sedentary and overweight men and women in the study were randomly assigned to either aerobics only (AE) or the combined aerobic + resistance exercise (ARE) regimen. Dropout rates (N=12 and N=11) were identical between the two 12-week interventions, which involved

• AE: 3x per week 15 min @50-80% maximum heart rate in the 1st, 4x per week 20-30min in the 2nd and 5x per week 30-45min in the 3rd month aerobic training on the cycle ergometer
• AER: Same as AE but additionally 2x per week full-body workouts with 2 min rest between sets and 3-6 sets of 10 repetitions @50% of their 1RM in the first 6 weeks, and 2-3 sets of 10 repetitions @75-80% of the 1RM during the second 6-week phase of the study

With the resistance protocol simply being added on top of the initially light aerobic workouts, it is quite clear that aside from the fundamental beneficial effects of strength training, the subjects in the AER group would capitalize on the overall higher workload, as well. After all, it is not very likely that the formerly sedentary study participants suddenly lead a more active life outside of their scientifically prescribed duties.

Figure 1: Relative changes in BMI, waist circumeference and hip circumference during the 12-week study period (calculated based on Sanal. 2012)

Against that background it may be initially counter-intuitive that the resistance aerobics + resistance training group did not lose more weight than their lazier peers (cf. figure 1), if you look at the data in figure 2, however, it becomes obvious why doing aerobics only really is not worth it, if your goal is to look better and get healthier, which both depend mainly on reducing your body fat levels, and not your body weight!

Figure 2: Relative changes in fat (FM) and fat free mass (FFM) in the course of the 12-week study period (DEXA data; calculated based on Sanal. 2012)

The dual-energy X-ray absorptiometry (DEXA; very precise method to measure the exact body composition) data confirms what every good trainer will be telling his clients, when they complain about "not losing weight" - the highly desirable changes in body composition are oftentimes not detectable with regular scales; and as this example shows, sometimes not even with my favorite tool, the measurement tape!

Men are different women, too, and strength training works for both!

And though this may sound like yet another prejudice, my personal experience tells me that women are usually much much more focused on the non-significant figures on the scale. Against that background I feel that the detailed analysis of sex difference with respect to the relative loss in body fat and increases in lean mass are of paramount importance, because they confirm: It does not matter if you are a man or a woman. If you want to look better, you got to lift weights!

Figure 3: Additional changes in body composition in aerobic + resistance training vs. aerobic only group (data calculated based on Sanal. 2012)

And while the added bonus of resistance training may be overall larger in men, than in women. It should be noted that the decrease in fat which was present in both groups, happened to be prominent in exactly those body parts which are usually held to contain sex-specific fat depots, i.e. the pot-bellied trunks of obese men and the "they are too fat for my skinny jeans" legs of chubby women.

Get going, don't stop eating, damnit!

Image 2: Some of you may remember my previous blogpost on the superior effect of HIIT vs. classic "cardio" on appetite and energy intake in obese boys. This is also why the SBSG Fat Loss Workout relies on both LISS and HIIT training.

Aside from the sex-specificity, this study provides an even more substantial argument in favor of exercise and against the "exercise just makes you hungry" hypothesis than the previously cited study (cf. "Dr. Oz Was Right, Taubes Wrong"). The question should thus no longer be "Shall I add exercise to my diet?", but rather which diet is most appropriate to propel the exercise-induced changes in body composition I am striving for.

In view of the fact that the study participants in this study, simply continued on their regular dietary regimen, you can only speculate how profound the changes would have been if the same 5x per week aerobic + 2x strength training regimen had been combined with a revised, not even necessarily energy deficient whole foods diet!?

Pot Belly and High Triglycerides Indicative of Low LDL & HDL Particle Size

A recent study by scientists from the Mayo Clinic in Minnesota (Irving. 2011) found that the most reliable indicators of LDL & HDL particle size in 84 healthy non-diabetic men and women were a huge amount of trunk fat and high triglyceride levels.

[...] the accumulation of atherogenic lipoprotein particles (e.g. small, dense, low-density lipoprotein particles and small, high-density lipoprotein particles) was associated with low levels of insulin sensitivity, cardiorespiratory fitness, and higher levels of adiposity. However, multivariate forward-stepwise regression revealed that triglycerides, followed by truncal fat mass, were the strongest predictors of the lipoprotein particle size and concentration data.

These results are of particular interest to those who cannot afford having a comprehensive lipid panel done. Since the standard tests often do not provide any information about the size of the cholesterol particles, looking and triglycerides and truncal fat may be a useful indicator of whether or not it will be necessary to check cholesterol particle sizes, as well.

On a side note: Other than it has long been thought, current research suggests that neither the amount of total cholesterol, nor the amount of LDL cholesterol, but rather the size of the cholesterol lipo-proteins is the main determinant of how likely one is to develop arteriosclerosis: Large particle size = benign; small particle size = dangerous.