Type-2 (adult-onset) diabetes and other diseases related to the obesity epidemic depend on how the body stores excess energy, according to evolutionary biologist Mary Jane West-Eberhard, emeritus scientist at the Smithsonian Tropical Research Institute.
Fat inside the abdominal cavity—visceral adipose tissue or VAT—the “VAT prioritization hypothesis. “Pathogenic obesity is an advantageous process gone awry,” said West-Eberhard. “Very early in life the body makes decisions about where to store fat. It makes sense for poorly nourished fetuses to invest in VAT rather than in fat under the skin because VAT evolved to protect us from infections, but this choice sets us up for disaster if we have access to too many calories later in life.”
In the past, the role of visceral fat as part of the immune system may have been more widely important than it is today because starvation and infections were more common. West-Eberhard proposes that in fetuses subject to nutritional stress, more energy may be stored as fat around the abdominal organs rather than as fat under the skin (subcutaneous fat or SAT). She notes that childhood catch-up growth, a better predictor of obesity-associated disease than low birth weight, may be a sign of the mistake the body has made as it assigns energy to VAT producing the apple shape of abdominal obesity, rather than the pear shape of lower body fat distributed in the hips, buttocks or thighs or more evenly under the skin.
In overweight individuals, a dangerous feedback loop may develop: increased VAT leads to increased chronic inflammation, which, in turn, leads to increased insulin resistance leading to further VAT storage and increased susceptibility to disease. Eventually, the ability to produce insulin is reduced and these individuals may need injected insulin to control type-2 (adult onset) diabetes. Malnutrition early in life coupled with modern diets of saturated and trans-fats and high-fructose foods available on a global scale is leading to a situation that is toxic for individuals in many different cultures.” West-Eberhard said.