NY Times: The Coronavirus Attacks Fat Tissue, Scientists Find

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The Coronavirus Attacks Fat Tissue, Scientists Find

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From the start of the pandemic, the coronavirus seemed to target people carrying extra pounds. Patients who were overweight or obese were more likely to develop severe Covid-19 and more likely to die. Though these patients often have health conditions like diabetes that compound their risk, scientists have become increasingly convinced that their vulnerability has something to do with obesity itself. Now researchers have found that the coronavirus infects both fat cells and certain immune cells within body fat, prompting a damaging defensive response in the body.

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“Maybe that’s the Achilles’ heel that the virus utilizes to evade our protective immune responses — by hiding in this place,” Dr. Vishwa Deep Dixit, a professor of comparative medicine and immunology at Yale School of Medicine, said.

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“This paper is another wake-up call for the medical profession and public health to look more deeply into the issues of overweight and obese individuals, and the treatments and vaccines we’re giving them,” said Barry Popkin, a professor of nutrition at University of North Carolina at Chapel Hill, who has studied the heightened risk that Covid poses to those with obesity. “We keep documenting the risk they have, but we still aren’t addressing it,” Dr. Popkin said.

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Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016

Joana Araújo, Jianwen Cai, and June Stevens Published Online:8 Feb 2019https://doi.org/10.1089/met.2018.0105

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Background: Several guidelines for cardiometabolic risk factor identification and management have been released in recent years, but there are no estimates of current prevalence of metabolic health among adults in the United States. We estimated the proportion of American adults with optimal cardiometabolic health, using different guidelines.

Methods: Data from the National Health and Nutrition Examination Survey 2009–2016 were analyzed (n?=?8721). Using the most recent guidelines, metabolic health was defined as having optimal levels of waist circumference (WC <102/88?cm for men/women), glucose (fasting glucose <100?mg/dL and hemoglobin A1c <5.7%), blood pressure (systolic <120 and diastolic <80?mmHg), triglycerides (<150?mg/dL), and high-density lipoprotein cholesterol (=40/50?mg/dL for men/women), and not taking any related medication.

Results: Changing from ATP III (Adult Treatment Panel III) guidelines to more recent cut points decreased the proportion of metabolically healthy Americans from 19.9% (95% confidence interval [CI]: 18.3–21.5) to 12.2% (95% CI: 10.9–13.6). Dropping WC from the definition increased the percentage of adults with optimal metabolic health to 17.6%. Characteristics associated with greater prevalence of metabolic health were female gender, youth, more education, never smoking, practicing vigorous physical activity, and low body mass index. Less than one-third of normal weight adults were metabolically healthy and the prevalence decreased to 8.0% and 0.5% in overweight and obese individuals, respectively.

Conclusions: Prevalence of metabolic health in American adults is alarmingly low, even in normal weight individuals. The large number of people not achieving optimal levels of risk factors, even in low-risk groups, has serious implications for public health.

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