Obesity is associated with a number of diseases including type 2 diabetes and cardiovascular disease. These diseases represent a metabolic dysfunction that centres on the development of insulin resistance. The insulin resistant state defines the metabolic syndrome and increases the risk of obesity significantly. Obesity is therefore generally accompanied and characterised by a series of serious metabolic dysfunctions that cause a gradual decline into disease. However, not all obesity is related to an underlying metabolic dysfunction, and there have been suggestions that obesity be classified based on the presence or absence of underlying metabolic dysfunction. Analysis of obese individuals shows that the adiposity profile present in healthy obese individuals is not the same compared to obese individuals with underlying metabolic dysfunction. Those with metabolic dysfunction tend to have large stores of deeper visceral fat, whereas the healthy obese have a higher proportion of subcutaneous fat.
Subcutaneous fat is not a risk factor for serious disease as it is not associated with metabolic dysfunction. Difference may therefore exist between the aetiologies of obesity defined by the degree of metabolic disturbance. A number of studies have been performed in order to analyses associations between the different forms of obesity with food intake. The metabolically healthy obese, who possess a large amount of subcutaneous fat, might be assumed to have obtained their larger body weights from eating excessive amounts of food, however, the association between overeating and metabolically healthy obesity are not clear. Generally, the metabolic dysfunction associated with obesity is thought to be caused by the consumption of low quality foods, particularly fructose. While there is some degree of overeating and appetite dysfunction associated with this type of obesity, generally it is the quality of the food that is the defining driver of weight gain, not the quantity of food.
Obesity can be classified as healthy or associated with an underlying metabolic disorder. Obese black men are more likely to be free of metabolic dysfunction compared to obese white men. Both metabolically deficient and metabolically normal obesity is associated with an intake of poor quality food.
Evidence also suggests that black men are more likely to be obese but metabolically healthy, compared to white men. For example, when, researcher analysed the diets of a number of obese male individuals, 44 % of white men and 58 % of black men were obese, but did not have signs of metabolic dysfunction, suggesting that development of metabolic syndrome was not a requirement for the development of obesity. Therefore insulin resistance and the presence of the metabolic syndrome may not be useful criteria when discussing obesity, particularly amongst black men. This study also showed that in both metabolically healthy and unhealthy men, body weight was associated with lower whole grain intake, suggesting a lower quality refined grain diet was consumed in both groups. Whole grains have been consistently shown to provide health effects to those that regularly consume them. Some of these health benefits may come from their ability to reduce weight gain, that latter being significantly associated with ill health.
Eat Well, Stay Healthy and Protect Yourself
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