Body Fat Patterning Research Articles

Development and tracking of central patterns of subcutaneous fat in adolescence and adulthood: the Amsterdam Growth and Health Study.

A central pattern of body fat is recognized as a risk indicator of cardiovascular diseases in adulthood. The development of this body fat pattern from childhood into adulthood however, remains to be explored. The development of two trunk skinfolds (subscapular; supra-iliac), two extremity skinfolds (biceps; triceps), and three trunk-extremity skinfold ratios for males (n = 71) and females (n = 84), were described over a period of 17 years from 13 to 29 years of age. In addition, tracking of the skinfolds and the skinfold ratios was investigated over this period. Data for this study came from the Amsterdam Growth and Health Study, an ongoing longitudinal study in the Netherlands that started in 1977. In adolescence, a decrease was seen in extremity skinfolds for men but not for women. For both sexes, the trunk skinfolds increased over the entire period of study. An increase was found in trunk-extremity skinfold ratios in males, but not in females. Tracking coefficients, calculated as Pearson correlation coefficients between the initial measurement and subsequent measurements, were about 0.4 for the single skinfolds between 13 and 29 years of age for both men and women. For the skinfold ratios, these correlation coefficients were about 0.55. Longitudinal tracking coefficients, measuring the association between the initial measurement and all follow-up data simultaneously, were about 0.65 for both men and women. A central pattern of body fat, mainly seen in males, seems to start in adolescence. From a preventive point of view, tracking coefficients were too low to be of predictive value. In order to conclude that the roots of a central pattern of body fat are in adolescence, careful search for determinants of change of this body fat pattern is needed.

Quantitative effects of the apolipoprotein E polymorphism in a biracial sample of 9–10-year-old girls

Genetic polymorphism at the apolipoprotein E locus ( APOE) has been shown to have a significant impact on quantitative risk factors for coronary artery disease (CAD) in diverse populations. However, despite the recognition that atherosclerosis begins in childhood and that genetic factors are related to the initial stages of atherosclerosis, prior studies were carried out mostly on adults and little attention has been paid to genetic risk factors for CAD in children. We have examined the impact of APOE polymorphism on quantitative risk factors for CAD (apoAI, apoB, TC, LDL-C, HDL-C and TG) in a sample of 647 African American and 573 White 9–10-year-old girls who were enrolled in the National Heart, Lung and Blood Institute Growth and Healthy Study. The frequencies of the APOE ∗2, APOE ∗3 and APOE ∗4 alleles were 0.09, 0.76 and 0.15 in Whites and 0.11, 0.70 and 0.19 in African Americans, respectively. The APOE ∗2 allele was significantly associated with lower mean levels of LDL-C and apoB and the APOE ∗4 allele with higher levels of LDL-C and apoB in both racial groups. Variation in maturation stage, body fat and fat patterning, as assessed by skin fold measures and waist/hip ratio, accounted for a significant proportion of the variation in quantitative CAD risk factors.

Quantitative effects of the apolipoprotein E polymorphism in a biracial sample of 9–10-year-old girls

<h2>Abstract</h2> Genetic polymorphism at the apolipoprotein E locus (<i>APOE</i>) has been shown to have a significant impact on quantitative risk factors for coronary artery disease (CAD) in diverse populations. However, despite the recognition that atherosclerosis begins in childhood and that genetic factors are related to the initial stages of atherosclerosis, prior studies were carried out mostly on adults and little attention has been paid to genetic risk factors for CAD in children. We have examined the impact of <i>APOE</i> polymorphism on quantitative risk factors for CAD (apoAI, apoB, TC, LDL-C, HDL-C and TG) in a sample of 647 African American and 573 White 9–10-year-old girls who were enrolled in the National Heart, Lung and Blood Institute Growth and Healthy Study. The frequencies of the APOE∗2, APOE∗3 and APOE∗4 alleles were 0.09, 0.76 and 0.15 in Whites and 0.11, 0.70 and 0.19 in African Americans, respectively. The APOE∗2 allele was significantly associated with lower mean levels of LDL-C and apoB and the APOE∗4 allele with higher levels of LDL-C and apoB in both racial groups. Variation in maturation stage, body fat and fat patterning, as assessed by skin fold measures and waist/hip ratio, accounted for a significant proportion of the variation in quantitative CAD risk factors.

Familial aggregation of subcutaneous fat patterning: Principal components of skinfolds in the Québec family study.

Familial resemblance was examined for each of the principal components arising from an analysis of six skinfolds (triceps, biceps, subscapular, abdominal, suprailiac, and medial calf) measured in 1,237 participants of the Québec Family Study. Most of the phenotypic variance among the skinfolds (83%) was accounted for by the first two principal components. Examination of the skinfold loadings on each principal component, as well as intraindividual cross-trait correlations with other body composition and fat pattern measures (body mass index; total fat mass and fat-free mass estimated from body density obtained through underwater weighing; the sum of six skinfolds; and the ratio of trunk to extremity skinfolds) support the interpretation of the first component as a general measure of adiposity and the second component as a trunk-extremity contrast. Parent-child and sibling correlations for each of the two principal components indicate that familial effects reach 46% (general) and 52% (trunk-extremity). Although the eigenvalues for the remaining four principal components (accounting for 17% of the variance) are <1.0, it is noteworthy that each exhibits significant familial resemblance (31-60%). Further, the intraindividual correlations for the additional four components with the other body size indicators are quite low, suggesting that they capture somewhat different aspects of relative fat distribution. © 1996 Wiley-Liss, Inc.

Obesity, fat patterning and cardiovascular risk.

Investigators have refined the study of the relationship of adiposity to disease by differentiating body shapes on the basis of the physical location of adipose tissue on the body. Different combinations of anthropometric measurements have been investigated as indicators of fat distribution. Recently combinations of easily obtained anthropometric measurements have been studied as correlates of visceral fat as measured by more complex measures such as computed tomography and magnetic resonance imaging. Despite difficulties in the measurement of the regional distribution of adipose tissue, several studies have shown that an upper body, centralized or abdominal fat pattern is correlated with increased CVD risk factors and CVD risk. The majority of studies have been cross-sectional, although several prospective cohort studies have examined relationships between fat distribution and mortality or incidence of morbidity over rather long time intervals. Results from the Charleston Heart Study indicate these relationships may differ by race and gender. More research is needed to define the role of fat patterning and changes in fat patterning on disease. Also, the relationship between total fatness and fat distribution to morbidity and mortality in specific populations and ethnic groups needs further exploration.

Body mass index and fat patterning as correlates of lipids and hypertension in an elderly, biracial population.

Associations between anthropometric measurements of fat patterning and risk factors for cardiovascular disease have been demonstrated in several populations composed predominantly of White, young or middle-aged adults. Fat pattern changes with aging and older adults tend to have a more central or abdominal fat distribution. Few investigators have focused on relationships of fat patterning with plasma lipids or blood pressure in older adults or in Blacks. Body mass index (BMI), fat patterning, plasma lipids, and blood pressure were examined in participants of the Charleston Heart Study. Subjects included 216 White men, 95 Black men, 320 White women, and 155 Black women with a mean age of 72.7 years (range 61-106). In each of the four race and gender groups, BMI was inversely correlated with HDL cholesterol and positively correlated with hypertension. BMI tended to be positively associated with total cholesterol, although the relationships were not statistically significant. After controlling for the effects of BMI, age, smoking, and alcohol intake (using regression analysis), waist to hip ratio was associated with cholesterol levels in the White men and women and the Black men. In similar models, waist circumference in Black women was inversely associated with HDL. There were no significant relationships between waist to hip ratio and hypertension in any of the groups after controlling for BMI. In an elderly cohort, waist to hip ratio was associated with plasma lipids, but not with hypertension, when the effects of BMI were held constant.

Assessment of obesity in children

Obesity is usually defined on the basis of body composition measurements. Body composition can be assessed using elaborate methods or anthropometry. The choice of methods depends on the practical conditions of the study. Elaborate methods give accurate information, but they usually have high cost and high technical difficulty, and while considered precise, they still have limitations. They are often based on hypotheses established in adults, and usually in normal weight subjects. Their applicability to obese children is sometimes questionable. Anthropometric measurements are used either directly or as indices or in regression equations. As it is weakly correlated with height and highly correlated with body fat, the Weight/Height 2 Quetelet or Body Mass Index (BMI) is used as an index of adiposity. As opposed to traditional growth charts, the BMI charts simultaneously take weight, height and age into account. The BMI curve reflects the real changes of the child's body shape and fatness during growth. Early in life, it can be used as an indicator of later development. Measurement of weight and height should be augmented by skinfolds. The triceps skinfold is usually recommended and widely used, but trunk skinfolds, such as the subscapular, are better on many counts (e.g. association with body fat pattern or with risk factors, response to nutritional interventions etc.). Measurements can be expressed as a percentage of standard or as Z-score (SD unit). Both methods have limitations: the former does not take the changes of distribution with age into account, the latter does not take variations in prevalence of obesity with age into account. It is suggested here to use the latter method based on a selected healthy population or on a population presenting a low prevalence of obesity. Selecting a limited number of methodologies would improve inter-study comparisons and consequently research on obesity.

Relationship of glucose intolerance and hyperinsulinaemia to body fat pattern in South Asians and Europeans

Type 2 (non-insulin-dependent) diabetes mellitus and insulin resistance are associated with centrally-distributed obesity. These disturbances are especially prevalent in people of South Asian (Indian, Pakistani and Bangladeshi) descent. We examined the relationship of glucose intolerance to body fat pattern in a population survey of 2936 men and 537 women of South Asian and European origin living in London, UK. In both groups glucose intolerance (defined as diabetes or impaired glucose tolerance) was more strongly associated with waist-hip girth ratio than with skinfolds or body mass index. The associations between body mass index and glucose intolerance were fully accounted for by waist-hip ratio. In European men with normal glucose tolerance fasting insulin levels were more strongly correlated with body mass index than with waist-hip ratio. Physical activity scores were lower in South Asians than in Europeans but no statistically significant associations between glucose intolerance and low physical activity were detectable. Leisure-time physical activity scores were inversely correlated with 2 h insulin levels in both groups. In contrast with other studies these results suggest that a specific effect of intra-abdominal fat deposition underlies the association between glucose intolerance and obesity. The association between hyperinsulinaemia and obesity is less specific for centrally-distributed fat. When measured appropriately waist-hip ratio is the most valid anthropometric index for identifying individuals whose obesity predisposes them to glucose intolerance.

Serum cholesterol and cancer risk: an epidemiologic perspective.

This review has examined the evidence surrounding two questions: (a) Is having low serum cholesterol associated with increased risk of cancer? (b) Does reducing serum cholesterol increase the occurrence of cancer? Some elevated risk of cancer for males with low serum cholesterol levels has been noted: the median of the studies examined is consistent with a 30% increased risk. The answer for females is less clear. The median of the studies examined suggests no more than a 5-10% increased risk associated with having low serum cholesterol. However, the risk seems to depend strongly on whether females have a central or peripheral body fat pattern (54). The cancers most consistently associated with low serum cholesterol levels are those of the colon and lung in males, the cervix and breast (but only for females under 50 years of age) in females, and leukemia in both sexes. In contrast, high cholesterol levels have been linked with an increase in brain cancer. While immunologic, genetic, and dietary explanations have been offered to explain the association, it is difficult to support the idea that low serum cholesterol causes cancer in any direct manner. First, the findings themselves tend to be generally weak and somewhat inconsistent. Second, the strong influence of fat distribution in women suggests that a metabolic/hormonal basis underlies the association. One would not expect the results to differ by body fat pattern if the relationship were a causal one. Finally, if there were a direct causal role, one would expect populations with low serum cholesterol levels to have higher cancer rates. In China, counties with the lowest average plasma cholesterol levels have the lowest cancer rates (78). While this observation is open to a number of interpretations, it does not support the idea that low serum cholesterol is a tumor initiator. In aggregate, the trials of lipid-lowering interventions reviewed here show an increase in cancer occurrence (primarily mortality) of approximately 24% in the cholesterol-lowered groups. However, the post-trial experience has shown a comparative deficit of cancer occurrence in the experimental groups. Recent evidence indicates that products in the cholesterol biosynthetic pathway affect DNA replication and cell proliferation. These findings suggests a mechanism by which cholesterol lowering might accelerate the development of tumors already initiated. The data that have been reviewed in no way suggest that treatment of hypercholesterolemia should not be pursued. They do suggest the presence of a relatively small subpopulation in whom reduction of plasma cholesterol may lead to increased occurrence of cancer.(ABSTRACT TRUNCATED AT 400 WORDS)

Body fat patterning in rural South African black children.

Growth status, body fatness, and fat patterning were investigated in two cross-sectional samples of rural South African Black children 6-19 years of age. The results were compared to data for American Blacks who were part of the NHANES survey. The two South African samples differed consistently, although rarely significantly, but both were smaller, lighter, and less fat than American Blacks. Analyses of triceps, biceps, subscapular, and suprailiac skinfolds demonstrated that all three samples had similar fat patterning when analysed either by investigating the Centripetal Fat Ratio or through an analysis of principal components. Following correction for general fatness, and in common with other studies of fat patterning, the first component related to central-peripheral patterning, the second to a ventral-dorsal patterning, and the third to upper-lower body patterning. These three components accounted for 99.4% of the total variance. It is suggested that central-peripheral fat patterning is a species characteristic but that other patterns are individual characteristics. Analysis of principal components within childhood, pre-adolescent and adolescent age groups suggested that prior to adolescence a negative relationship exists between absolute level of fatness and centralization such that thinner, less fat, children are more centralized. During adolescence, however, there is no relationship between level of fatness and centralization. © 1992 Wiley-Liss, Inc.

Body fat patterning in women with endometrial cancer

It has long been known that the risks of some cancers, including endometrial, are associated with obesity. Recent evidence suggests that body fat distribution patterns also affect the risk of developing some diseases. A question that remains is whether cancers are associated with specific distributions of body fat. In this study, women with endometrial cancer were compared to community controls of similar age and race. Participants were interviewed and then measured to determine fat distribution patterns defined by the waist-to-hip circumference ratio. Women with upper body fat distribution had a 3.2-fold (95% confidence limits 1.2, 8.9) higher risk of endometrial cancer than women with lower body fat distribution even with correction for age, parity, and smoking. Obese women with an upper body fat pattern had a 5.8-fold (confidence limits 1.7, 19.9) higher risk of endometrial cancer than nonobese/lower body fat patterned women. Obese women who never smoked had a 3.3-fold statistically significant higher risk of endometrial cancer than nonobese women who never smoked. Current smokers had lower risks than their nonsmoking counterparts. The 3-fold increased risk of endometrial cancer associated with upper body fat did not disappear with adjustment for obesity and smoking.

Obesity-related hypertension: Evaluation of the separate effects of energy restriction and weight reduction on hemodynamic and neuroendocrine status

Although weight reduction generally lowers blood pressure, it is unclear whether the response is due to concurrent dietary changes or to reduced body mass itself. In this study, the independent effects of energy restriction and weight reduction were examined prospectively in 24 obese, hypertensive, normoglycemic women whose dietary intake was tightly controlled.Sodium, potassium, and calcium intake, the polyunsaturated/saturated fat ratio, and the proportional composition of carbohydrate, fat, and protein were constant throughout the 5-month protocol. Hemodynamic and neuroendocrine status was evaluated in four 10-day hospital phases: two prior to weight loss (energy balance and then 800-kcal intake), and two after an average loss of 13 kg to normal body weight (800 kcal and then return to energy balance).Fasting serum insulin, triiodothyronine:reverse triiodothyronine ratio, resting metabolic rate, and heart rate declined, and sodium and potassium balances were negative during energy restriction. Catecholamines, renin, aldosterone, plasma volume, cardiac output, and blood pressure showed no consistent response to changes in energy intake. By contrast, weight reduction independently lowered blood pressure, plasma volume, cardiac output, and plasma renin activity. Body fat pattern remained unchanged.These results demonstrate that weight loss has a blood pressure-lowering effect that is distinct from energy restriction and that is related to changes in blood volume and cardiac output.

Skinfold and body circumferences as measures of body fat patterning in a French female active population: Relationships with the metabolic risk profile

Body mass index (BMI), various anthropometric indices of abdominal fat distribution and some metabolic variables (blood lipids, fasting glucose, blood pressure) were measured in 408 French-born women from an occupational population who volunteered for the study. The aim of the study was to determine the best index for describing the relationships between the body fat pattern and the metabolic risk profile. The four age-adjusted circumference ratios (waist/hip, waist/thigh, xiphoid/hip, xiphoid/thigh) showed similar associations with the metabolic variables whereas the three age-adjusted skinfold ratios (epigastric/thigh, mesogastric/thigh, hypogastric/thigh) tended to be more weakly associated with the metabolic variables, particularly with apolipoprotein (Apo) B and fasting glucose. Multiple regression analyses showed that age-adjusted BMI was significantly related to high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, Apo A and Apo B, and blood pressure, independently of abdominal fat distribution. After controlling for the effects of BMI, the waist/thigh ratio remained significantly associated to triglyceride, Apo B, fasting glucose, and systolic blood pressure, whereas the waist/hip ratio and the mesogastric/thigh skinfold ratio were significantly related only to triglyceride and systolic blood pressure independently of BMI. With the exception of triglyceride and fasting glucose, the degree of association between the metabolic variables and the abdominal fat distribution tended to be weaker than that observed with the BMI. These results emphasize the importance of the global corpulence in the levels of metabolic variables. However, all indices of abdominal fat distribution were, to varying degrees, independently associated with an unfavorable metabolic profile. Among them, the waist/thigh circumference ratio seems to be a useful indicator of the body fat pattern in women.

Obesity-related hypertension: Evaluation of the separate effects of energy restriction and weight reduction on hemodynamic and neuroendocrine status

purpose: Although weight reduction generally lowers blood pressure, it is unclear whether the response is due to concurrent dietary changes or to reduced body mass itself. In this study, the independent effects of energy restriction and weight reduction were examined prospectively in 24 obese, hypertensive, normoglycemic women whose dietary intake was tightly controlled. subjects and methods: Sodium, potassium, and calcium intake, the polyunsaturated/saturated fat ratio, and the proportional composition of carbohydrate, fat, and protein were constant throughout the 5-month protocol. Hemodynamic and neuroendocrine status was evaluated in four 10-day hospital phases: two prior to weight loss (energy balance and then 800-kcal intake), and two after an average loss of 13 kg to normal body weight (800 kcal and then return to energy balance). results: Fasting serum insulin, triiodothyronine: reverse triiodothyronine ratio, resting metabolic rate, and heart rate declined, and sodium and potassium balances were negative during energy restriction. Catecholamines, renin, aldosterone, plasma volume, cardiac output, and blood pressure showed no consistent response to changes in energy intake. By contrast, weight reduction independently lowered blood pressure, plasma volume, cardiac output, and plasma renin activity. Body fat pattern remained unchanged. conclusion: These results demonstrate that weight loss has a blood pressure-lowering effect that is distinct from energy restriction and that is related to changes in blood volume and cardiac output.

Body fat patterning in women with endometrial cancer

It has long been known that the risks of some cancers, including endometrial, are associated with obesity. Recent evidence suggests that body fat distribution patterns also affect the risk of developing some diseases. A question that remains is whether cancers are associated with specific distributions of body fat. In this study, women with endometrial cancer were compared to community controls of similar age and race. Participants were interviewed and then measured to determine fat distribution patterns defined by the waist-to-hip circumference ratio. Women with upper body fat distribution had a 3.2-fold (95% confidence limits 1.2, 8.9) higher risk of endometrial cancer than women with lower body fat distribution even with correction for age, parity, and smoking. Obese women with an upper body fat pattern had a 5.8-fold (confidence limits 1.7, 19.9) higher risk of endometrial cancer than nonobese/lower body fat patterned women. Obese women who never smoked had a 3.3-fold statistically significant higher risk of endometrial cancer than nonobese women who never smoked. Current smokers had lower risks than their nonsmoking counterparts. The 3-fold increased risk of endometrial cancer associated with upper body fat did not disappear with adjustment for obesity and smoking.

Cigarette smoking, adiposity, non-insulin-dependent diabetes, and coronary heart disease in Japanese-American men

purpose: Coronary heart disease has been described to be increased with both glucose intolerance and cigarette smoking. All three of these have also been reported to be associated with central adiposity (disproportionate deposition of fat on the trunk compared to the extremities). The purpose of this analysis was to determine the relationship of cigarette smoking to glucose intolerance and coronary heart disease, the relationship of cigarette smoking to risk factors such as adiposity, body fat distribution, and plasma lipoprotein and insulin levels, the relationship of cigarette smoking to these risk factors independent of disease status, and whether these risk factors could account for any of the relationship between cigarette smoking and disease status. patients and methods: The study design was cross-sectional. The study sample contained 219 middle-aged and elderly Japanese-American men: 77 with normal and 74 with impaired glucose tolerance and 68 with type II diabetes. There were 54 men with coronary heart disease. A detailed smoking history was obtained. Glucose tolerance status was established by medical history and a 75-g oral glucose tolerance test. Coronary heart disease was determined by medical history and a resting electrocardiogram. Adiposity and fat distribution measurements were body mass index (kg/m 2), skinfold thicknesses, body circumferences, and cross-sectional fat areas by computed tomography. Levels of insulin, C-peptide, cholesterol (total, low-density lipoprotein [LDL], high-density lipoprotein [HDL], HDL 2, HDL 3, very-low-density lipoprotein [VLDL]), and triglyceride (total, VLDL) were measured in fasting blood specimens. results: A central pattern of body fat was associated with both non-insulin-dependent diabetes mellitus and coronary heart disease. Smoking history was related to both adiposity and body fat distribution, and was strongly related to coronary heart disease but not to diabetes. Past smokers who had smoked up to a month ago were the heaviest while present smokers who were currently smoking or had smoked within the past month were the leanest. However, although present smokers had reduced amounts of fat, this was attributable to those present smokers without heart disease. Present smokers with heart disease were not as lean and had increased amounts of intra-abdominal fat. Past smokers had the greatest amount of central fat and this was attributable to those with heart disease. By two-way (smoking history and coronary heart disease status) analysis of covariance, smoking history was significantly related only to subcutaneous fat deposition on the chest and abdomen independent of coronary heart disease, while coronary heart disease status was strongly related to plasma levels of insulin, C-peptide, VLDL, HDL, HDL 2, and HDL 3 cholesterol, and total and VLDL triglyceride, independent of smoking history. Further analysis showed that none of the body fat variables could account for the risk of coronary heart disease associated with smoking history. Higher fasting plasma C-peptide levels in past smokers accounted statistically for part of the risk of coronary heart disease associated with cigarette smoking. However, this effect was not mediated by any of the body fat measurements. conclusions: Disproportionately increased intra-abdominal fat is related to coronary heart disease but not to smoking history. Smoking history is related to coronary heart disease but not to diabetes. Weight gain is associated with smoking cessation and appears to be concentrated in the central subcutaneous regions, especially for those who have coronary heart disease. Weight gain associated with cessation of smoking appears to be unrelated to atherogenic changes in lipids, lipoproteins, or insulin. Other pathogenic processes must be considered in the association between smoking and coronary heart disease.

BODY FAT DISTRIBUTION AND OSTEOARTHRITIS

The association of body fat distribution with single and combined site osteoarthritis was investigated using data from the US Health Examination Survey I, 1960-1962 (HES I) and the first National Health and Nutrition Examination Survey I, 1971-1975 (NHANES I). The study included 1,636 adults aged 35-79 years from HES I with hands and feet radiographs and four anthropometric fat distribution measures--subscapular and triceps skinfolds, waist girth, and seat breadth--and 3,885 adults aged 45-74 from NHANES I with knee radiographs and subscapular and triceps skinfold measures. Sex-specific data, adjusted for age, race, and body mass index, were analyzed using polychotomous logistic regression. There was a positive association of body mass index with knee osteoarthritis and with combined hands and feet osteoarthritis. A peripheral body girth pattern was associated with combined site osteoarthritis of the hands and feet; however, there was no consistent pattern of association of body fat distribution with knee osteoarthritis nor with osteoarthritis of the hands or feet only. These findings suggest that the central body fat pattern observed in previous studies to be associated with cardiovascular and gallbladder disease, and with diabetes, is not associated with osteoarthritis of the hands, feet, or knees.

Relation of body fat patterning to lipid and lipoprotein concentrations in children and adolescents: the Bogalusa Heart Study

Although a truncal distribution of adipose tissue in adults is associated with several metabolic complications, its importance in early life has received little attention. The relation of several anthropometric measures to serum concentrations of lipids, lipoproteins, and apolipoproteins was therefore examined in 361 children who were between ages 6 and 18 y. (Children had been selected previously because of extreme levels of very-low-density- and low-density-lipoprotein cholesterol.) Analyses revealed two groups of anthropometric variables: truncal measures (waist circumference and subscapular, subcostal, and suprailiac skinfold thicknesses) and thickness of peripheral skinfolds (femoral, triceps, calf, and biceps). After generalized obesity was adjusted for children with high concentrations of both cholesterol fractions had more truncal fat but less peripheral fat than did children with low lipoprotein cholesterol concentrations. A truncal fat pattern was also associated with decreased concentrations of high-density-lipoprotein cholesterol and apolipoprotein A-1. Knowledge of fat patterning may help identify persons prone to hyperlipidemia.

Socio‐economic and seasonal patterns of adult energy nutrition in a South Indian Village

Energy intake, weight, height, body fat and physical activity pattern of 296 men and 371 women in a rural S. Indian village were measured at four seasons of one year. Enegy intake values were consistent with the low body size but high levels of physical activity observed in both sexes. Socio‐economic status, defined by household land holding, had highly significant influences on energy intake, body weight and body fat content in both sexes. Seasonal patterns of energy intake and physical activity were more marked in women than in men, but there were no significant seasonal differences in body weight or body fat content in either sex. There was no significant interaction between socio‐economic and seasonal influences on energy nutrition. The lack of seasonal variation in body energy stores probably reflects the impact of recent irrigation on patterns of agricultural and economic activity in this area.

Relation of body fat distribution to hyperinsulinemia in children and adolescents: the Bogalusa Heart Study

The relation of body fat distribution to plasma levels of glucose and insulin during an oral glucose tolerance test was examined in 355 Black and White school-age children. Both central and peripheral fat were similarly related to fasting, 30-min, and 1-h glucose. Unlike peripheral fat, central body fat was more strongly related to the 1-h insulin response (r = 0.35 vs 0.26); this association remained significant for central fat independent of peripheral fat (r = 0.18). The strong relation of central fat to insulin response was noted in both races and sexes but not in either sexually immature or relatively thin children. These findings indicate that, even in early life, a central body fat pattern relates positively to insulin response to glucose load. Thus, knowledge of body fat localization may help identify persons most susceptible to hyperinsulinemia in early life.