“The good news is that calorie restriction can reduce visceral fat, but exercise has more significant and long-lasting effects." ― Anonymous
Introduction | Body Types | TOTI | TOFI | FOTI | FOFI | Insulin Resistance | Final Thoughts | Takeaway Points | References | Disclaimer
Introduction
The human body requires adipose tissue to function properly[8]. However, both subcutaneous and visceral fat tissues, in excess, can be harmful to our health. Large amounts of visceral adipose tissue, in particular, have been linked to insulin resistance, the metabolic syndrome, type 2 diabetes, and cardiovascular disease. There are four body types that describe the accumulation of adipose tissue and indicate the state of our metabolic health. Learning about them in depth can aid in identifying some of the underlying causes of our health issues.
The 4 body types
The most abundant fat tissue in the human body is white adipose tissue (WAT). It can be subcutaneous or visceral in nature. Subcutaneous and visceral fat tissues both serve important functions in the body; however, when found in excess, they pose health risks and can lead to complications. Excess visceral adipose tissue is thought to be more dangerous than subcutaneous fat in large amounts and is linked to metabolic syndrome. Four body types emerge from the distribution of adipose tissue throughout the body[1]:
TOTI [thin outside, thin inside]
TOFI [thin outside, fat inside]
FOTI [fat outside, thin inside]
FOFI [fat outside, fat inside]
The characteristics of TOTI body type
The TOTI phenotype is thought to be the healthiest. It has a normal, healthy amount of both subcutaneous and visceral fat tissue. Those in the TOTI category typically have balanced metabolic rates and a normal weight. In men, adipose tissue accounts for 10–20% of their body weight. These percentages are higher for women in their reproductive years [before menopause] than for men. They range from 18 to 30%. After menopause, the location of white adipose tissue shifts, and women start storing fat viscerally rather than subcutaneously, as they did during the perimenopausal period. A healthy diet, intermittent fasting, and regular physical activity allow for the maintenance of the TOTI body type. Even as we age, these strategies are effective tools for preserving optimal metabolic health.
The characteristics of TOFI body type
The TOFI phenotype is also distinguished by a normal body weight and a percentage of subcutaneous adipose tissue. Nonetheless, it is regarded as an unhealthy body type due to an excessive buildup of visceral WAT. TOFI individuals are thin on the outside, but adipose tissue surrounds their internal organs on the inside, which may have negative health consequences.
"Yes, TOFI is a Trojan horse in the human body, including elegant women - some models are also TOFI because they keep low-calorie diets but do not exercise."[1]
The TOFI body type is associated with metabolic disorders. Visceral fat tissue accumulation raises the risk of developing the metabolic syndrome, insulin resistance, and type 2 diabetes[2]. It is estimated that 40% of people of normal weight are TOFI types[3]. As previously stated, women begin to store more fat as visceral adipose tissue as a result of the postmenopausal shift in fat tissue distribution. A healthy, whole-foods-based, low-carbohydrate diet combined with intermittent fasting, regular physical activity [30 minutes per day], and quality sleep can significantly reduce the risk of developing abdominal adiposity.
The characteristics of FOTI body type
The FOTI body type is characterized by excessive weight due to the large accumulation of subcutaneous fat tissue. FOTI individuals have large quantities of subcutaneous WAT but a normal amount of visceral fat.
"Epidemiological studies highlighted that [...] SAT [subcutaneous adipose tissue] expansion ameliorates insulin sensitivity and decreases type 2 diabetes (T2D) risk."[4]
In FOTI-type obese individuals, the adipose tissue maintains its normal functioning. However, the protective and insulating effects of SAT on human health do have a cap. A variety of conditions, such as hormonal imbalances, physical inactivity, poor diet, aging, and environmental factors, all impair SAT's resistance to dysfunction[5]. Eventually, excessive subcutaneous WAT accumulation may result in a range of metabolic disorders. Staying mindful of the fact that subcutaneous fat can also be detrimental to our health and doesn't always protect us from disease is a key element to maintaining our well-being. It is estimated that 20% of the obese population belongs to the FOTI phenotype[3].
The characteristics of FOFI body type
An extensive accumulation of both subcutaneous and visceral adipose tissue distinguishes the FOFI phenotype. Individuals belonging to the FOFI group are overweight or obese and carry a big risk of developing metabolic syndrome, insulin resistance, cardiovascular disease, and type 2 diabetes. Their adipose tissue is prone to dysfunction, and FOFI, therefore, is considered the most unhealthy out of all body types. It is associated with systemic inflammation, a fatty liver, lipid accumulation in skeletal muscles, the heart, the pancreas, and immune dysfunction[6]. The estimates suggest that 80% of obese individuals belong to the FOFI group[3]. In order to promote change in obesity and adipose tissue reduction, one may begin with applying lifestyle changes such as a whole-foods-based, low-carbohydrate diet combined with intermittent fasting, regular exercise [30 minutes per day], quality sleep, and stress reduction. Nonetheless, reversing obesity and obesity-related health complications is a complex process that may require support from a health care professional.
Insulin resistance
Insulin resistance is a common denominator of excessive visceral adipose tissue accumulation, and it plays a significant role in the development of metabolic syndrome, cardiovascular disease, and type 2 diabetes. It has been established that dysfunctional adipose tissue promotes systemic inflammation[9], which in turn disables the insulin action pathway [as seen in TOFI and FOFI body types].
"Enlarged adipose tissues release excess free fatty acids (FFAs), reactive oxygen species (ROS), and pro-inflammatory cytokines. Excess systemic FFAs and dietary lipids enter inside the cells of non-adipose organs such as the liver, muscle, and pancreas, and are deposited as ectopic fat, generating lipotoxicity. Toxic lipids dysregulate cellular organelles, e.g., mitochondria, endoplasmic reticulum, and lysosomes. Dysregulated organelles release excess ROS and pro-inflammation, resulting in systemic inflammation. Long term low-grade systemic inflammation prevents insulin from its action in the insulin signaling pathway, disrupts glucose homeostasis, and results in systemic dysregulation."[7]
Individuals with the FOTI body type have normal metabolic rates and are not insulin resistant, so they have not yet crossed the threshold of SAT becoming dysfunctional. If it becomes dysfunctional and these people begin to accumulate visceral fat, the process of triggering insulin resistance begins, potentially leading to additional health problems.
Final Thoughts
Adipose tissue serves a variety of important functions in the human body[8]. It is an essential component of our makeup that must be kept at normal levels in order to function properly. As a result, the TOTI body type emerges as the most desirable and healthy phenotype a person can strive for. The TOFI and FOFI body types, on the other hand, have been linked to insulin resistance, poor metabolic health, cardiovascular disease, and type 2 diabetes. Their distinctive feature is an excessive buildup of visceral fat, which is to blame for the health issues. However, the FOTI phenotype falls somewhere in the middle of the health spectrum. There is no direct link between SAT accumulation and metabolic dysfunction or insulin resistance. FOTI people are metabolically healthy, but they should be aware that they may develop visceral adiposity at some point. Visceral adiposity is the root cause of metabolic syndrome development and insulin resistance. Lifestyle strategies such as a low-carbohydrate and whole-foods-based diet, intermittent fasting, regular exercise, quality sleep, and stress reduction should be used to prevent and reduce the accumulation of subcutaneous and visceral fat tissues. In addition, in severe cases of obesity, a doctor's supervision and guidance are required to restore one's health.
Takeaway Points
There are four body types that reflect the adipose tissue distribution: TOTI, TOFI, FOTI, and FOFI.
TOTI is a healthy body type with a normal percentage of adipose tissue.
TOFI describes the hidden visceral fat accumulation that is associated with a range of metabolic diseases.
FOTI is characterized by normal visceral fat rates but a notable accumulation of subcutaneous adipose tissue.
FOFI is characterized by an extensive quantity of both subcutaneous and visceral fat tissues.
Insulin resistance arises as a result of systemic inflammation induced by dysfunctional adipose tissue.
References
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