It’s open enrollment time at work, so you make an appointment to get a physical and a blood test. You think you’ve got this in the bag. You live healthy right? You exercise daily and eat (what you think is) a healthy diet. You have cold cereal for breakfast every morning, only fruit and vegetables at lunch, a sensible dinner and dessert. Always dessert.
You feel great, you think you look pretty good, but then the blood test results come back. Your blood glucose reading shows diabetes symptoms. You're TOFI: “Thin on the outside, fat on the inside.”
Professor Jimmy Bell, a British researcher, coined the phrase TOFI. It’s now being called a fast-growing health concern in the United States. Basically, from the outside, everything seems normal and “healthy.” But your healthy appearance is only skin-deep because the inside of your body is telling a different story.
So, let’s look at why TOFI is a word you need to know.
TOFI People Have Organ Fat
TOFIs do a lot healthy things like:
- Count Calories
- Eat a balanced diet
But if you’re a TOFI, you have a lot of what is called visceral fat, or fat around your organs. It is stored within the abdominal cavity, around your liver, pancreas and intestines.
Professor Bell and some colleagues studied visceral fat using MRI scans of the body. They found it is not always noticeable, so you could have lots of it, but still look thin.
In fact, 45 percent of the women Bell and his colleagues scanned, and 60 percent of the men, had excessive levels of internal fat. What’s scary is they all had normal BMI scores (20 to 25) What’s scarier is organ fat is directly linked to metabolic syndrome and type-2 diabetes, so in other words, a TOFI is metabolically obese.
TOFI People Eat Sweets
If you’re a TOFI, you’re probably eating too many fatty, sugary foods, not exercising enough to burn it off, but not eating enough to actually be fat. If you’re reading this and think you may be a TOFI, take a hard look at your sugar consumption. That’s because a study in The Journal of Nutrition points to sugar, more specifically fructose, as a cause of visceral fat.
A review of over 3,000 studies backs up the theory and researchers at the American Diabetes Association found similar results—that excess sugar consumption leads to the development and worsening of metabolic syndrome.
To decrease your risk, if you’re a woman you should limit your daily sugar consumption to 25 grams. Men should get no more than 38 grams of sugar per day.
Are You TOFI?
To find out for sure, you’ll need to get a CT scan or an MRI. You can also use a tape measure to get an idea. Here’s how:
- Use the tape measure to take the circumference measurement of both your waist and your hips at their largest point.
- Next, divide your waist measurement by your hip measurement.
- If the ratio is higher than 1.0 for men and 0.85 for women then the amount of fat is considered excessive, i.e. for men a ratio of 36/40 is good, but some of this fat may still be subcutaneous.
- To get a greater accuracy of visceral fat, measure your stomach while standing up and then measure it again when lying down. Subcutaneous fat will settle out to the sides of your stomach but visceral fat will not move.
- The difference between your standing up and lying down measurement tells you how much of your stomach fat is visceral fat.
One large study published in the Annals of Internal Medicine used the waist-to-hip ratio to examine the effects of visceral fat.
How Not To Be TOFI
If you think you’re a TOFI there is hope. You can burn off visceral fat through exercise and improving your diet. A diet high in whole grains, fresh fruits and vegetables and lean protein. Restricting calories and increasing physical exercise have been shown to have positive effects.
Are you really living a healthy lifestyle? Or are you just fooling yourself? Talk to your doctor or a dietitian about the foods you’re eating. Find out which ones can unknowingly be putting you at risk for diabetes. You can also get a blood test to find out where your numbers stand.
Don’t become one of the millions of people living with diabetes or diabetes symptoms. If you need more information you can download our free interactive infographic. Here you’ll find answers to a lot of the questions you may have about prediabetes and diabetes.