J Stevens and K P Truesdale, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
© 2005 Elsevier Ltd. All rights reserved.
In 1956, the French physician, Jean Vague, noted that an upper body, or masculine, fat distribution was associated with adverse health consequences. It has now been clearly demonstrated that obesity-related chronic diseases are associated with the location, as well as the amount, of adipose tissue on the body. Although the relative importance of total adiposity versus type of adiposity continues to be debated, the notion that an 'apple-shaped' (or android) body is associated with greater obesity-related health risks than a 'pear-shaped' (or gynoid) body is well accepted (Figure 1). Imaging techniques such as computed tomography (CT) allow measurement of visceral adipose tissue and layers of subcutaneous fat. Anthropometric studies do not provide precise measures of fat depots but nevertheless have provided clues to the causes and consequences of differences in fat distribution. Guidelines are being developed for the use of anthropometric assessments of fat distribution in clinical and public health settings.
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