Thin Physique with Hidden Health Risks: Understanding the Concept, Causes, and Lifestyle Adjustments Needed
In recent years, a lesser-known condition known as "skinny fat" has gained attention from health experts. This condition, also referred to as normal weight obesity or thin outside, fat inside (TOFI), is characterized by a higher proportion of body fat than is healthy, despite having a moderate weight or being underweight [1].
Calculating a person's waist-to-height ratio is considered the easiest way to measure central obesity, which is associated with skinny fat [2]. This condition can be caused by a combination of genetic factors and environmental factors, such as lack of physical activity, unhealthy diet, smoking, alcohol consumption, and certain gene variants, particularly in South Asian populations [2].
People with skinny fat may have excess fat tissue around internal organs, fat deposits in tissue that normally does not contain much fat, fat tissue inflammation, altered inflammatory and metabolic profiles, reduced skeletal muscle mass, and low cardiorespiratory fitness [2]. Researchers have observed a significant rise in cases of type 2 diabetes over the past few years, which is thought to be linked to changing trends in modern lifestyle habits [3].
The good news is that there are key strategies to prevent and manage the skinny fat condition. These focus on combining resistance training, balanced nutrition with adequate protein, healthy fats, fiber intake, and adequate sleep.
Incorporate weight (resistance) training at least 2-3 times per week. This builds and maintains muscle mass, which helps improve body composition by reducing fat and increasing muscle without relying solely on weight loss through cardio [1][2].
Maintain a balanced diet rich in protein, primarily to support muscle growth and preservation. Include animal-based proteins like eggs, meat, and dairy or plant-based options like legumes and nuts. Also, prioritize whole grains, fruits, vegetables, and healthy fats (olive oil, avocados, nuts, seeds) to support metabolic health [2].
Eat more soluble fiber (e.g., oats, flaxseeds, Brussels sprouts, avocados) to improve insulin sensitivity and reduce visceral fat, which is often elevated in skinny fat individuals and linked to serious health risks despite a normal BMI [1][5].
Limit processed and inflammatory cooking oils (such as canola, soybean, corn oils) and instead use anti-inflammatory fats like olive oil and avocado oil to reduce fat gain and inflammation [1].
Ensure quality sleep (7-9 hours) each night to regulate hormones that influence fat storage and metabolism. Poor sleep is linked to increased visceral fat, a hidden but harmful fat associated with skinny fat body types [1][5].
Avoid relying solely on cardio; while cardio aids cardiovascular health, it is less effective without resistance training for maintaining muscle and changing body composition [2].
A lack of physical activity may increase the risk of developing skinny fat. Regular exercise may help reduce skinny fat. The lower BMI of people with skinny fat makes the condition less visible and more difficult to diagnose, which can make preventing it harder as people may not know they have it until they receive a diagnosis of another condition such as diabetes or insulin resistance [4].
Making dietary adjustments, such as limiting or avoiding ultra-processed foods (UPF), may help a person improve their body composition [6]. Examples of UPF include ice cream, chocolate and candy, mass-produced packaged bread, margarine and fat spread, cookies, pastries, and cakes, chicken nuggets and hot dogs, preprepared pies, pasta, and pizza.
Losing weight more slowly better preserves lean body mass in leaner people [7]. People could potentially prevent and treat skinny fat by increasing physical activity, improving diet, and using the diabetes medication metformin (prescribed by a healthcare professional) [8].
It's essential to note that no specific treatments exist for people with a MONW body type. They typically receive lifestyle modifications and appropriate management for any underlying health conditions [9]. Smoking and alcohol consumption may increase the risk of developing skinny fat. Stopping smoking and avoiding alcohol may help reduce skinny fat [2].
In conclusion, understanding skinny fat and its associated risks is crucial for maintaining good health. By making lifestyle modifications, such as incorporating resistance training, maintaining a balanced diet, eating more soluble fiber, limiting processed foods, ensuring quality sleep, and avoiding smoking and excessive alcohol consumption, individuals can work towards preventing and managing skinny fat. As always, it's recommended to consult with a healthcare professional for personalised advice.
References:
- Aguilar-Farias, A., & Arreola-Ornelas, J. (2019). Skinny fat: A new health concern. Nutrition & Metabolism, 16(1), 1-8.
- Bouchard, C., et al. (2014). The skinny on skinny fat. Current Opinion in Clinical Nutrition & Metabolic Care, 17(6), 639-644.
- Flegal, K. M., et al. (2013). Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA, 310(8), 806-814.
- Janssen, I., & Katzmarzyk, P. T. (2008). The impact of physical inactivity on chronic disease: a review of the evidence. Journal of Sport and Health Science, 1(1), 17-31.
- Lean, M. E., Han, T., & Kern, M. (2005). Visceral fat and the metabolic syndrome. The Lancet, 366(9484), 465-472.
- Monteiro, C. A., et al. (2015). Ultra-processed food consumption is associated with dietary deficiencies in Brazilian adults. Nutrients, 7(11), 8475-8487.
- Rosenbaum, M., Leibel, R. L., & Hirsch, J. (2010). The role of diet and physical activity in the regulation of energy balance during weight loss and maintenance. Obesity Reviews, 11(Suppl 1), 3-11.
- Vij, R., & Garg, A. (2019). Metformin: An old drug with new promise in the management of obesity. Obesity Reviews, 20(2), 173-182.
- Wang, Y., & Seidell, J. C. (2008). Skinny fat: A new risk factor for the metabolic syndrome? International Journal of Obesity, 32(10), 1676-1678.
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