The deposition of fat varies among individuals. The amount of fat and the storage sites are influenced by heredity and gender. After puberty, women generally deposit fat in the buttocks, hips, breasts, and thighs. These preferential sites are largely dictated by the female hormone estrogen. This is known as the gynoid, or feminine, pattern of fat deposition. Gynoid fat is not confined exclusively to women, a few men deposit fat in this configuration as well.Because they produce very little estrogen, men usually deposit minimal amounts of fat in the female pattern. Instead they primarily store fat in the abdomen, lower back, chest, and nape of the neck. Some women store fat this way as well. After menopause, estrogen production decreases and the prevalence of android fat deposition increases.

The masculine, or android, pattern of fat deposition is related to an increase in the risk for heart disease, stroke, type II diabetes, and some forms of cancer. There are several reasons for this increased risk. First, enzyme activity in abdominal adipose cells is very active, so fat moves in and out easily. For sedentary individuals, abdominal fat enters the blood­stream and is routed directly to the liver, where it becomes the raw material for the manufacture of very low-density lipoprotein triglycerides (VLDL).

Later these are converted to low-density lipoprotein cholesterol (LDL-C) and this increases the risk for cardiovascular disease. On the other hand, active people direct abdominal fat to the muscles, where it is used as fuel for physical work.

The second reason is that abdominal fat cells are large compared with other fat cells. Large fat cells are associated with blood glucose (sugar) intolerance and excessive amounts of insulin in the blood. Such an environment is conducive to the development of type II diabetes because the cells’ receptor sites become resistant to insulin. Higher than normal amounts of insulin must be secreted to transport sugar from the blood to the cells, but excessive insulin remains in the blood. The body’s cells continue to resist insulin therefore blood sugar also remains high. This sequence of events is characteristic of glucose intolerance or poor regulation of sugar. Over the years these factors will lead to type II diabetes. One does not have to be excessively overweight if fat is concentrated in the abdominal region. This pattern of fat deposition increases the risk of developing type II diabetes by 10 to 15 times compared with a more even distribution of fat. Extra fat that accumulates in the hips (gynoid pattern) also increases the risk but only by 3 to 4 times.

Third, excessive insulin in the blood interferes with the removal of sodium by the kidneys, possibly leading to hypertension. Concurrently the high circulating level of insulin stimulates the overproduction of epinephrine and norepinephrine, both of which raise the blood pressure. This cluster of disorders-high blood pressure, high blood sugar (glucose intolerance), high blood lipids (cholesterol and triglycerides), and abdominal obesity-has deadly consequences. Researchers refer to this combination as “syndrome X” or “metabolic syndrome.

The good news about android fat is that it is more easily removed from the body than fat stored in the gynoid pattern. People who store fat in the masculine pattern can usually lose it through exercise. Dietary restriction, although helpful, often is not necessary. Fat stored in the feminine pattern is highly resistant to removal from its storage depots. Losing gynoid fat usually requires calorie restriction and exercise. Even the best effort may not result in the removal of enough fat from the lower half of the body to suit the dieter. Lowerextremity fat is recalcitrant and much more difficult to lose than upper-body fat. Complete to determine your fat distribution.