People who appear to be slim could have hidden issues with visceral fat, says the Zoe professor
Many of us are quick to assume that ‘slim’ and ‘thin’ individuals are always healthy. Yet experts warn this isn’t necessarily the case, pointing to one invisible factor that’s linked with a heightened risk of type 2 diabetes.
Jonathan Wolf – CEO of ZOE – shed light on his personal health journey in a recent podcast episode with Professor Tim Spector and Dr Suzanne Devkota. The business co-founder explained that he once never really thought about his body shape and was often told by others that he should probably ‘put some weight on’.
But one hospital visit revealed some ‘very bad news’. DEXA scan results told him that he was ‘thin on the outside and fat on the inside’ – something that Professor Spector nicknamed ‘a toffee’.
“Thin on the outside, fat on the inside,” Professor Spector said in the January episode. “Which a lot of people are in a way. They don’t realise that they have poor metabolic health because of that.”
To which, Jonathan chimed in: “…I know we’re going to talk a little bit about your own experiences, but actually, that had pushed me to eat this very classic Western diet, huge amounts of sort of refined carbohydrates. And I’d assumed that it was having no impact on me.”
Believe it or not, ‘TOFI’ – meaning Thin on the Outside, Fat on the Inside – is a real term used to describe people with a ‘normal’ BMI but higher-than-average levels of visceral fat. This generally refers to the ‘invisible’ fat surrounding our internal organs, rather than the more obvious ‘subcutaneous fat’ you might see on our arms and legs.
As Professor Spector suggests, being TOFI is a significant indicator of ‘poor metabolic health’, or metabolic syndrome, which is generally defined by high blood pressure, high blood sugar and lower levels of the ‘good’ HDL cholesterol. Unfortunately, many of these factors are associated with a higher risk of numerous serious conditions, including type 2 diabetes and cardiovascular disease.
“Metabolic syndrome is the name for a group of health problems that put you at risk of type 2 diabetes or conditions that affect your heart or blood vessels,” NHS guidance states. “It’s different from metabolic disorders which are rare genetic conditions.
“…It is linked to insulin resistance. This is when your body does not respond to the hormone insulin properly. It may also be linked to having too much fat around your tummy.”
While genetic factors can amplify your risk of poor metabolic health, several lifestyle choices can play a part too. Lack of exercise, excessive alcohol intake and poor diet choices are among them, in addition to smoking cigarettes.
The NHS recommends the following tips to steer clear of poor metabolic health:
- Quit smoking
- Eat more fruit, vegetables and wholegrains
- Eat less saturated fats, meat and dairy products
- Lose weight if you’re overweight
- Do at least 150 minutes of moderate to intense exercise per week spread across four to five days
Its guidance adds: “You may not have any symptoms of metabolic syndrome. You usually find out you have it after a blood test or check-up.”
