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Visceral fat shows strongest association with ICU need in patients with Covid-19 (metabolismjournal.com)
64 points by luu on April 9, 2021 | hide | past | favorite | 26 comments


No surprise there. Visceral fat has has long been associated with a higher risk of respiratory diseases. But it's good to see this confirmed for COVID-19.

https://www.webmd.com/lung/news/20090306/belly-fat-bad-for-y...


Your link is about 'belly fat', which is not visceral fat, but rather subcutaneous (under the surface of the skin, as opposed to internally around the organs).

Intuitively, it would seem that visceral (internal) fat might affect lung function more, but as the article states, the mechanism of impairment is not clear.


Seems like it's both actually, the more pronounced of which is visceral which seems to make up most of a beer belly.

https://www.mayoclinic.org/healthy-lifestyle/womens-health/i...


Your point probably stands, but COVID is not a respiratory disease. It's a vascular disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7556303/


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It's largely called SARS-CoV-2 because, surprise, it's in the coronavirus family that causes SARS. Yes, it is a respiratory disease, but what we've learned in the last year is that the worst respiratory effects from this disease aren't from it infecting pneumocytes (that's how it spreads) but from the emboli that it creates which then block the vasculature of the lungs.

I'd suggest this lecture by Dr. Seheult of MedCram which dates back to around the time we started discoverying the concerning underlying pathologies of the disease process:

https://www.youtube.com/watch?v=PlUFibXtDxQ

This is also one of the possible explanations for the appearances of rash-like lesions in the extremities of younger populations who are otherwise asymptomatic: Capillary vasculature becoming blocked by the formation of emboli creating a redness in the skin is another feature of a disease that is primarily vascular in nature. Not to mention the increased risk of stroke.

The correct answer is that it's "kind of both" but that the damaging effects from SARS-CoV-2 are less a consequence of destruction of lung cells, as was originally thought, and more a function of blocking the vasculature that carry away oxygen.


Yes, I'm sure. Continue reading, please.


Worth mentioning that one of the authors happens to be on the board of a biotech developing a stroke product.


Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment.

But then again, if it's damaging the vascular system then it's also a kidney disease.

25% of each stroke volume out of the heart goes to the kidneys. Anything that damages the vascular system will strain the heart leading to higher blood pressure, which will damage the kidneys.

Poor kidney clearance will increase the incidence of joint diseases like gout and arthritis.

COVID-19 is a joint disease.


You know what structures also have ACE2 receptors that SARS-CoV-2 attacks?

The endothelial cells.

Guess how SARS-CoV-2 causes the formation of emboli that fundamentally result in blocking the lung vasculature? By attacking the endothelium.


> An abnormal fat distribution, and in particular [Visceral Fat] expansion, is re-known to be associated with low grade inflammation and with the secretion of pro-inflammatory cytokines, such as interleukin 6 (IL-6) [[14]].


Only 150 people with 35 intubated. There are several factors that could explain (at least part of) their results and one is age. They do mention that age denotes a statistically significant difference between intubation and no intubation under Table 1.

It is not easy to tell but depends on how you read this it could be that they had some data and they went fishing. You can always find correlations by fishing through the data and looking for when does the p-value become low enough [0] but its not a valid way to do data analysis. It is also data from one hospital and one region. I don't think you can draw too many conclusion from this one study.

It is published in a journal with impact factor of 6.36 and a metabolic journal. If this was a significant finding I would think they would publish in a higher impact factor journal.

So overall it calls for some skepticism. [0]https://en.wikipedia.org/wiki/Data_dredging


So we lock down gyms, close sports facilities and chastise people for going outside.


Can't agree with you more because I fall in the demographic affected by sport restriction, but the easiest way to lose body fat quickly is simply to not eat. Exercise/diet have a 30/70% contribution to one's weight loss. Our body is so damn efficient at burning fuel that it is simply faster not to introduce it, so exercise as a fat loss tool alone is not gonna cut it. It is however encouraged for the myriad other reasons it is good to us.


COVID19 is fatshaming from Mother Nature.


But how do I lose it quickly?


You can't lose it quickly, at least not in a sustainable way. But you can lose it slowly just like other types of fat. Exercise more, eat less, and in particular reduce your sugar intake. There is some evidence that stress also causes accumulation of visceral fat so if you can find a way to relax that might help.


I always think that this idea of "losing fat quickly" is kind of interesting. If you think about it, one year of your life is, on average, barely over a percent of your entire lifespan.

If you lifted weights or ran ~5 days a week for a year and ate appropriately, most people would probably end up looking like models. And that's just one year. To me, that's pretty darn quick. Basically, anything else of value takes like way longer: playing an instrument, getting good at a sport, getting an education. If you really think about it, the time investment is actually pretty minimal.


its more complicated than that depending on your life.

You will never look like a model by just lifting weights and running. You need a propper diet plan and a life that supports it.

Going on dinner with your friend? that will be a no for a year.

Having a bussiness lunch meeting with clients or bosses? Thats a no for a year.

Skipping a week or more of lifing because of unexpected life reasons? Thats a no for a year.

Guarantee a majority of your sleep to be of good quality for a whole year? Very few can do that.

Being on a caloric deficit and maintaining a high protein intake every day for a whole year? That is really hard and requires you to have no unplanned events for a whole year.

Getting in a situation where you have no real good options for your diet plan, you need to make sure never to get there for a year.

If your goal is "just" to loose weight its a bit easier but still a lot of hard work with no compromises for a year, and if you want to look like a model then you need hard work and good genetics to support that.

The time investment depends a whole lot on external factors and its never minimal.


> Going on dinner with your friend? that will be a no for a year.

> Having a bussiness lunch meeting with clients or bosses? Thats a no for a year.

> Skipping a week or more of lifing because of unexpected life reasons? Thats a no for a year

> Being on a caloric deficit and maintaining a high protein intake every day for a whole year? That is really hard and requires you to have no unplanned events for a whole year.

All of those points are incredibly wrong. People are able to stay fit, lean, and healthy without becoming some robotic fool who survives on water and protein powder.

Tracking your TDEE and macros is very simple, and not restrictive at all. One can drink beer, eat pizza and candy, and retain a great physique with ease. It requires only that you don't go overboard when indulging. One doesn't have to be in a caloric deficit every single day. As long as one is in cal-def a majority of the time, it's fine. As long as they don't shovel enough food into their mouth on their 'bad' days, to undo all the hard work from the 'good' days, it works out fine.

One can also easily take weeks off. In fact, every athlete should take weeks off. Deloading is not what I'm referring to. I'm talking about taking an entire week, or even two, off and doing nothing. It's healthy, and even necessary for long-term consistency and success.

Why are you convinced that being fit and lean is some incredibly hard task? It's not. All you're doing is convincing people that they can't accomplish what they can; relatively easily, I might add.


> People are able to stay fit, lean, and healthy without becoming some robotic fool who survives on water and protein powder.

Yes those are often those people who dont have that big of a problem to start with. You have a lot of forces working against you when you have an weight problem especially when you are obese.

> Tracking your TDEE and macros is very simple, and not restrictive at all. One can drink beer, eat pizza and candy, and retain a great physique with ease. It requires only that you don't go overboard when indulging. One doesn't have to be in a caloric deficit every single day. As long as one is in cal-def a majority of the time, it's fine. As long as they don't shovel enough food into their mouth on their 'bad' days, to undo all the hard work from the 'good' days, it works out fine.

You are forgetting why people get overwieght from the beginning. Weight problems are mostly an psycological problem and if it where as simple as not shoveling food in their mouth on their bad days there this would not be an issue at all.

Am not trying to convince people they cannot suceed, but I think its important to tell people how hard it can be and it get harder the more weight you have to loose.

Try to loose weight when you have two/three lunch bussiness meetings where the client has payed for the lunch/dinner and then have a social life with alcohool and food during the weekend when you have a weight problem. Its a hard task and requires a decent amount of dicipline.

Am not saying its impossible to loose wieht and that you should not do it. But its important to know the challange ahead and what it will take.


Some of those are definitely a bit exaggerated, perhaps depending on your conception of model. You're not going to destroy your physique most of the time by having an impromptu lunch every so often, especially if you're already struggling to get enough calories to support muscle growth.


Fast. Pick the regimen that works for you and stick to it.


fasting, and no sugar, booze, or starchy goodies


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Why would they have dumped billions into developing these vaccines in the first place if they expected to just lose the IP rights right away anyway? You might be able to save a small number of extra people this time by screwing over the vax manufacturers, but a lot more people will die next time when no one is willing to put up the R&D money.


Many of the vaccines were developed with public funding and for those that were not, then an amount that would cover R&D and incentivize future production could easily be reached so as to save millions of lives...


> Published:July 23, 2020

In terms of covid papers, this was published an eternity ago




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