Mediterranean Diet and "Morbid" Tissues: History Counts, Future Counts

Pathogenic fat tissues and carotid atherosclerosis reflect past
lifestyle statusand may improve by future changes.Visceral obesity
is part of dysfunctional adipose tissue and is closely related to clustering cardiometabolic risk factors. Unlike visceral adipose tissue
(VAT), the association between subcutaneous adipose tissue (SAT)
and obesity-related morbidity is controversial. However, we found
that abdominal SAT is composed of two subdepots that associate
differently with cardiometabolic parameters. As opposed to deep
SAT (DSAT), higher absolute and relative distribution of fat in abdominal superficial SAT (SSAT) may signify beneficial cardiometabolic effects in patients with type 2 diabetes.Lifestyle interventions,
mainly including limiting trans fats, carbs and fructose and increasing mono and poly unsaturated fats, generally induce preferential
mobilization of visceral fat.The two-year DIRECT trial suggests that
weight loss diets can induce a significant regression of measurable
carotid atherosclerosis , that the effect is similar in low-fat, Mediterranean, or low-carbohydrate strategies and appears to be mediated
mainly by the weight loss-induced decline in blood pressure.A 17
years follow-up of up than 37,000 teenagers suggests that although
the risk of diabetes is mainly associated with increased BMI close to
the time of diagnosis, the risk of coronary heart disease is associated
with an elevated BMI both in adolescence and in adulthood, supporting the hypothesis that the processes causing incident coronary
heart disease, particularly atherosclerosis, are more gradual than
those resulting in incident diabetes.