TOFI[1][2] (thin-outside-fat-inside) is used to describe lean individuals with a disproportionate amount of fat (adipose tissue) stored in their abdomen. The figure to illustrate this shows two men, both 35 years old, with a BMI of 25 kg/m2. Despite their similar size, the TOFI had 5.86 litres of internal fat, whilst the healthy control had only 1.65 litres.
Subjects defined as TOFI with body mass index (BMI) <25 kg/m2 have increased levels of many of the risk factors associated with the metabolic syndrome. This phenotype is a further refinement of "metabolically-obese normal-weight"[3][4][5] (MONW).
Subjects defined as TOFI have been described as being at higher risk of developing insulin resistance and type II diabetes due to the fact that they have reduced physical activity/VO2max, reduced insulin sensitivity, higher abdominal adiposity, and a more atherogenic lipid profile. Another important characteristic observed in this cohort is elevated levels of liver fat. It is shown that overconsumption of fructose can lead to TOFI by inducing inflammation associated cortisol release.[6]
^Thomas, E. Louise; Frost, Gary; Taylor-Robinson, Simon D.; Bell, Jimmy D. (2012). "Excess body fat in obese and normal-weight subjects". Nutrition Research Reviews. 25 (1): 150–161. doi:10.1017/S0954422412000054. PMID 22625426.
^Thomas, E. Louise; Parkinson, James R.; Frost, Gary S.; Goldstone, Anthony P.; Doré, Caroline J.; McCarthy, John P.; Collins, Adam L.; Fitzpatrick, Julie A.; Durighel, Giuliana; Taylor-Robinson, Simon D.; Bell, Jimmy D. (2011). "The Missing Risk: MRI and MRS Phenotyping of Abdominal Adiposity and Ectopic Fat". Obesity. 20 (1): 76–87. doi:10.1038/oby.2011.142. PMID 21660078. S2CID 22489848.
^Ruderman Neil B.; Schneider, S. H.; Berchtold, P. (August 1981). "The "metabolically-obese," normal-weight individual". American Journal of Clinical Nutrition. 34 (8): 1617–1621. doi:10.1093/ajcn/34.8.1617. PMID 7270486.
^Conus, Florence; Rabasa-Lhoret, Rémi; Péronnet, François (2007). "Characteristics of metabolically obese normal-weight (MONW) subjects". Applied Physiology, Nutrition, and Metabolism. 32 (6): 4–12. doi:10.1139/H07-926. PMID 17332780.
^De Lorenzo, A.; Martinoli, R.; Vaia, F.; Di Renzo, L. (December 2006). "Normal weight obese (NWO) women: an evaluation of a candidate new syndrome". Nutrition, Metabolism & Cardiovascular Diseases. 16 (8): 513–523. doi:10.1016/j.numecd.2005.10.010. PMID 17126766.
^DiNicolantonio, James J.; Mehta, Varshil; Onkaramurthy, Neema; O'Keefe, James H. (2017-12-07). "Fructose-induced Inflammation and Increased Cortisol: A New Mechanism for How Sugar Induces Visceral Adiposity". Progress in Cardiovascular Diseases. 61 (1): 3–9. doi:10.1016/j.pcad.2017.12.001. ISSN 1873-1740. PMID 29225114.
TOFI (thin-outside-fat-inside) is used to describe lean individuals with a disproportionate amount of fat (adipose tissue) stored in their abdomen. The...
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