Are You a TOFI?
“Many people of normal weight are metabolically unhealthy because, although they look fine, their innards are choking with embonpoint.”—Sanford Rose
Dolors & Sense
By Sanford Rose
KISSIMMEE Florida—(Weekly Hubris)—3/27/2014—Most people think fat equals unhealthy. They are wrong.
It all depends on where the fat is lodged.
Lots of fat people are metabolically healthy.
Their fat is subcutaneous; it is not intra-abdominal.
In most cases, only the intra-abdominal, or visceral, fat poses a health danger.
On the other hand, many people of normal weight are metabolically unhealthy because, although they look fine, their innards are choking with embonpoint.
Doctors call these folks TOFIs: Thin Outside Fat Inside.
TOFIs are at high risk for metabolic syndrome, markers for which include insulin resistance, hypertension, and heart disease.
That’s in part because intra-abdominal fat cells have a tendency to migrate, via the portal vein, to the liver. Although the liver is a singularly forgiving organ, when it gets bogged down with more than 10 percent fat, many of its functions are compromised. And when the liver functions suboptimally, the pancreas tends to oversecrete insulin, which leads to still more intra-abdominal fat, and thus a self-feeding downward spiral of health concerns.
How to uncover TOFI-ism?
It’s difficult. Definitive information comes only from imaging the body’s internal organs, scarcely a part of a routine health exam.
But there are proxies, the easiest of which is to calculate your waist-to-hip ratio.
For men, a healthy ratio is .90 or lower; for women, a healthy ratio is .80 or lower.
If you are a TOFI, with a ratio much above unity (one-to-one), you may not be sick—yet.
To determine the state of your heart health, take a close look at the lipid panel in your blood work. Ignore the cholesterol reading. It is misleading.
Instead, focus on the ratio of your triglycerides to high-density lipoproteins.
The lower that ratio, the healthier is your heart.
If you can drive that ratio down to unity, which may come only after you’ve taken control of the other ratio, you’re practically indestructible.
Sanford Rose
Sanford Rose, of New Jersey and Florida, served as Associate Editor of Fortune Magazine from 1968 till 1972; Vice President of Chase Manhattan Bank in 1972; Senior Editor of Fortune between 1972 and 1979; and Associate Editor, Financial Editor and Senior Columnist of American Banker newspaper between 1979 and 1991. From 1991 till 2001, Rose worked as a consultant in the banking industry and a professional ghost writer in the field of finance. He has also taught as an adjunct professor of banking at Columbia University and an adjunct instructor of economics at New York University. He states that he left gainful employment in 2001 to concentrate on gain-less investing. (A lifelong photo-phobe, Rose also claims that the head shot accompanying his Weekly Hubris columns is not his own, but belongs, instead, to a skilled woodworker residing in South Carolina.)