The Overflow Tank

The idea

Your body has a preferred strategy for storing excess energy: subcutaneously, just under the skin, where it is relatively harmless. South Asian biology tends to come with a smaller safe parking lot. When that lot fills, the overflow goes deeper, wrapping around organs, embedding in muscle, filling the liver. This happens at weights standard medicine calls normal, which is why the scale and the BMI chart keep reassuring people whose organs are already storing what their skin could not.

Deep dive: The Overflow Tank: On Ectopic Fat — The depot tour: liver, pancreas, muscle, heart, kidney, and vessel-wall fat.

How the evidence grades it

Every study is labeled by what it does to this concept. Counting the counterevidence is the point.

Key studies

• landmark · 2008Vitamin B12 and folate concentrations during pregnancy and insulin resistance in the offspring: the Pune Maternal Nutrition Study. PMID 17851649
• landmark · 2013The relationship between metabolic risk factors and incident cardiovascular disease in Europeans, South Asians, and African Caribbeans: SABRE (Southall and Brent Revisited) -- a prospective population-based study. PMID 23500273
• landmark · 2019Effects of dietary and physical activity interventions on the risk of type 2 diabetes in South Asians: meta-analysis of individual participant data from randomised controlled trials. PMID 31201437
• landmark · 2011Adipocyte hypertrophy, fatty liver and metabolic risk factors in South Asians: the Molecular Study of Health and Risk in Ethnic Groups (mol-SHARE). PMID 21829446

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