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  • Q&A with Australian Health Practitioners

    Are certain cultural backgrounds more at risk for type 2 diabetes?

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  • Eric Rosario

    Exercise Physiologist

    Master of Applied Science by Research into the Effects of Strength Training on Postmenopausal women. I have been involved in strength training for 67 years … View Profile

    Cultural Background and Diabetes.Visceral fat found inside the abdominal cavity is more dangerous than subcutaneous fat. It is the fat distribution and not total amount of fat in the body that has to be used as a health indicator.MEDIA IN general and doctors in particular have always driven home the point that obesity spells danger to individuals. Imagine what health problems that the sumo wrestlers who may make any obese person look trim in comparison may suffer. Now pit the sumo wrestlers with a really trim Asian Indian and who do you say will be more prone to say Type 2 diabetes? The answer seems simple and in all probability you would have got it wrong. In all likelihood it is the trim Asian Indian who may be a diabetic already or is likely to become one.
    Shocking yet true. Studies abroad have revealed that sumo wrestlers do not suffer from Type 2 diabetes while a trim looking Asian Indian may in all probability suffer from it. The reason — subcutaneous fat which makes a person look obese is relatively benign compared to visceral fat. The trim Indian with huge visceral fat in the body is `metabolically obese'.
    Visceral fat is the amount of fat stored in the abdominal cavity and seen around many organs in the abdominal cavity. These fat cells release fatty acids when not required by the body. As a result the fatty acid is less likely to be burned and instead gets accumulated in tissues and organs. The excessive exposure of tissues to fatty acids impairs the insulin function and increases blood insulin levels. “All this ultimately results in reduced insulin sensitivity making a person insulin resistant,” said Dr. V. Mohan, Chairman and Managing Director of M.V. Diabetes Specialties Centre (P) Ltd., Chennai.

    Sumo wrestlers with more subcutaneous fat are healthier than Asian Indians with more visceral fat.
    Subcutaneous fat that makes the person appear obese is metabolically less harmful and tends to release fatty acid only when the glucose and insulin level are relatively low and fat is needed as an energy source. It is well known that women are endowed with fat thighs and buttocks only to help them tide over energy requirements especially when they are pregnant. The visceral fat is particularly ominous to Indians as we are insulin resistant compared to Caucasians.
    Coming back to the sumo wrestlers, the huge subcutaneous fat which makes them look very obese notwithstanding, their insulin sensitivity is near normal (and hence less insulin resistant). “This is because they have negligible visceral fat as they burn it by exercising daily,” Dr. Mohan pointed out.
    The link between visceral fat and insulin resistance was proved by CAT scan. Presence of huge visceral fat was found in those people who were insulin resistant than those of comparable body size. It was also found that the so-called lean type 2 diabetics had elevated visceral fat.
    In the end the message appears loud and clear. No matter what, it is the distribution of fat (the place where it is found) which is of paramount importance than the amount of body fat when it comes to assessing the health of a person particularly diabetes. `Normal weight' in all probability should then not be a measure of one's health. “This is particularly true as all my studies and those done by others have shown Asian Indians to be more insulin resistant,” Dr. Mohan said.
    What then is the remedy? “Exercise,” Dr. Mohan stressed, “as only that can help burn the visceral fat just like the sumo wrestlers.” Any shortcut to reduce weight (fat) only helps in bringing about cosmetic effect and does no good to the person's well being. This message has to be borne in mind especially at a time when health centres promising to help reduce weight are mushrooming.. Waist size reduced by 10 inches. Happy? But what about your visceral fat lady? Walk your way to health instead.
    R.Prasad in Chennai
    Trimness no guarantee to health Visceral fat found inside the abdominal cavity is more dangerous than subcutaneous fat. It is the fat distribution and not total amount of fat in the body that has to be used as a health indicator.
     
    This article by R Prasad appeared in an Indian Newspaper. Indigenous Australians are also prone to diabetes.
    Eric Rosario.

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