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Medscape
7 days ago
- Health
- Medscape
Intermuscular Fat Is the New Red Flag for CV Disease
Intermuscular fat plays a significant role in the development of cardiovascular disease, said Vicente Javier Clemente-Suárez, PhD, professor of sports sciences at the European University of Madrid, Spain. He urged the scientific community and the public to look beyond traditional metrics like BMI and waist circumference. A recent study published in The Journal of Clinical Endocrinology & Metabolism highlights the risks associated with 'patients with apparent normal weight but hidden metabolic risk,' as emphasized by Clemente-Suárez in this interview with El Médico Interactivo, a Medscape Network platform. What does the article published in The Journal of Clinical Endocrinology & Metabolism contribute regarding the distribution of body fat and cardiovascular risk? This article provides an innovative view on how not only the total amount of body fat but its specific location affects cardiovascular risk. Traditionally, we have focused on abdominal visceral fat as the most dangerous, but this study shows that intermuscular fat also plays a key role in the development of cardiovascular diseases. This finding opens new research lines and highlights the importance of looking beyond BMI and abdominal circumference. In other words, it's not just about how much weight we have, but how it is distributed within the body, especially in tissues like muscle. Why could fat accumulated between muscles be more dangerous? It's a 'hidden' type of fat that cannot be seen, but it works very actively at a metabolic level. This fat infiltrating the muscle fibers interferes with muscle function, reduces efficiency, promotes a chronic inflammatory state, and contributes to insulin resistance. Unlike subcutaneous fat, which is more passive, intermuscular fat has a pro-inflammatory effect and is associated with deeper and more silent health deterioration, particularly in metabolic and cardiovascular health, all without necessarily reflecting visible obesity. What mechanisms explain the possible relationship between fat in the thighs and cardiometabolic risk? Several key mechanisms could explain this association: Chronic low-grade inflammation : Intermuscular fat produces inflammatory cytokines that impair endothelial function and promote atherosclerosis. : Intermuscular fat produces inflammatory cytokines that impair endothelial function and promote atherosclerosis. Insulin resistance : By infiltrating the muscle, this fat affects glucose uptake, potentially triggering glucose metabolism alterations and the development of type 2 diabetes : By infiltrating the muscle, this fat affects glucose uptake, potentially triggering glucose metabolism alterations and the development of type 2 diabetes Muscle dysfunction : A muscle infiltrated by fat loses contractile efficiency, reducing physical activity and perpetuating the vicious cycle of physical inactivity and metabolic decline : A muscle infiltrated by fat loses contractile efficiency, reducing physical activity and perpetuating the vicious cycle of physical inactivity and metabolic decline Alteration in hormonal and metabolic signaling: This fat acts as a dysfunctional endocrine organ, disturbing lipid, glucose, and blood pressure balance Who would benefit the most from this finding? It may be particularly useful for patients who appear to have normal weight but are at risk of hidden metabolic issues, such as sedentary individuals, those with a family history of diabetes or cardiovascular disease, or those with sarcopenia. It is also relevant for older adults, patients with metabolic syndrome, and postmenopausal women, where intermuscular fat may increase without noticeable changes in body weight. This helps us identify patients who might seem healthy based on conventional measures but have accumulated fat in areas where it has a negative impact on their health. Could this study influence how cardiovascular risk is evaluated during consultations? Absolutely. This research reinforces the need for a more holistic view of cardiometabolic risk that isn't limited to measuring weight, waist size, or cholesterol. In clinical practice, this could translate into: Giving more importance to body composition, assessing lean mass and fat mass using bioimpedance or densitometry Encouraging functional evaluation of muscles, especially in older individuals Considering less visible factors like actual physical activity and loss of muscle mass As this evidence becomes more established, it's likely that in the future, we will incorporate more precise tools to assess this hidden fat, such as MRI or muscle scanning, for certain risk profiles. What practical recommendations can be offered from medical consultations to prevent the accumulation of this fat? From the perspective of a physician or sports sciences professional, we can recommend: Strength and resistance training : Working on large muscle groups, especially in the legs, is key to preventing fat infiltration in muscles. When activated, it burns fat and keeps the muscles healthy : Working on large muscle groups, especially in the legs, is key to preventing fat infiltration in muscles. When activated, it burns fat and keeps the muscles healthy Follow an anti-inflammatory diet : Rich in vegetables, omega-3, fruits, legumes, and avoiding excessive simple sugars and ultra-processed foods : Rich in vegetables, omega-3, fruits, legumes, and avoiding excessive simple sugars and ultra-processed foods Avoid sedentary behavior : Daily walking, using stairs, staying active during work — small daily habits make a big difference : Daily walking, using stairs, staying active during work — small daily habits make a big difference Monitor sarcopenia in older adults: Maintaining muscle mass with tailored training and adequate protein intake is crucial after the age of 60 As you say, looking beyond BMI and abdominal circumference… Indeed, studies like this remind us that cardiovascular and metabolic health cannot be assessed using just a scale or a tape measure. There is fat that isn't visible but may be silently working to increase our risk. That's why it's crucial to move toward personalized medicine, based on muscle tissue quality and active prevention through lifestyle changes. This article was translated from El Medico Interactivo.
Time of India
01-08-2025
- Politics
- Time of India
Trump tells Russian official to 'watch his words,' but he bites back instead
Donald Trump (AP file photo) In a midnight social media post, President Donald Trump called Dmitry Medvedev a "failed former President of Russia" who had better "watch his words." Less than three hours later -- morning by then in Moscow -- Medvedev responded. He said Trump should picture the apocalyptic television series "The Walking Dead" and referred to the Soviet Union's system for launching a last-ditch, automatic nuclear strike. "Russia is right about everything and will continue to go its own way," said Medvedev's post on the Telegram messaging app. It was the second time this summer that Trump and Medvedev, Russia's head of state from 2008 to 2012, traded blows on social media. The exchanges have been striking not only for the verbal brinkmanship on display between the world's nuclear superpowers, but also for the mismatched stature of the figures involved. While Trump commands the world's most powerful military, Medvedev is widely seen as a social-media attack dog relegated to the periphery of President Vladimir Putin's inner circle. The viciousness of the overnight exchange highlighted the volatility and opacity of a geopolitical relationship in which Trump and Putin set policy largely on their own. And it put on display the combustible mix that can occur when the Kremlin's long-standing willingness to use nuclear threats meets Trump's penchant for late-night diatribes on the internet. Hanging in the balance is the future of Ukraine, three years into Russia's full-scale invasion. "In wars, traditionally diplomatic messaging is something that's done with a lot of care and discipline," said Michael Kimmage, a professor at Catholic University in Washington who specializes in the U.S.-Russia relationship. "The consequences of screwing up can be so huge." Grigorii Golosov, a professor of political science at the European University in St. Petersburg, Russia, said there was something symbiotic about Trump and Medvedev fighting on social media. Medvedev, who had styled himself as a pro-Western liberal when he served as president more than a decade ago, has recast himself as an uncompromising soldier in Russia's showdown with the West. But attacking Medvedev may also be useful to Trump, Golosov posited, by allowing him to show he's getting tough on Russia without attacking Putin directly. In June, Trump attacked Medvedev for saying countries could send nuclear warheads to Iran, adding: "I guess that's why Putin's 'THE BOSS.'" This article originally appeared in The New York Times.
Boston Globe
31-07-2025
- Politics
- Boston Globe
Trump tells Russian official to ‘watch his words,' but he bites back instead
It was the second time this summer that Trump and Medvedev, Russia's head of state from 2008 to 2012, traded blows on social media. The exchanges have been striking not only for the verbal brinkmanship on display between the world's nuclear superpowers, but also for the mismatched stature of the figures involved. While Trump commands the world's most powerful military, Medvedev is widely seen as a social-media attack dog relegated to the periphery of President Vladimir Putin's inner circle. Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up The viciousness of the overnight exchange highlighted the volatility and opacity of a geopolitical relationship in which Trump and Putin set policy largely on their own. And it put on display the combustible mix that can occur when the Kremlin's long-standing willingness to use nuclear threats meets Trump's penchant for late-night diatribes on the internet. Hanging in the balance is the future of Ukraine, three years into Russia's full-scale invasion. Advertisement 'In wars, traditionally diplomatic messaging is something that's done with a lot of care and discipline,' said Michael Kimmage, a professor at Catholic University in Washington who specializes in the US-Russia relationship. 'The consequences of screwing up can be so huge.' Advertisement Nuclear saber-rattling by Medvedev and by Putin himself was a common feature earlier in Russia's invasion, as the Kremlin sought to deter the Biden administration from supporting Ukraine. Putin tamped down that rhetoric after Trump took office, hoping to take advantage of his Russia-friendly stance. But as Trump grew frustrated with Putin's unwillingness to budge on Ukraine, the language from Moscow has begun to shift again. Putin himself has said nothing about Trump's recent threats of new sanctions, and the Russian president's spokesperson has said little but acknowledged that the Kremlin is paying attention. Others, like Medvedev, have taken a harder line. 'Each new ultimatum is a threat and a step towards war,' Medvedev posted on the social platform X on Monday, in English, after Trump warned that he could impose new sanctions in as little as 10 days. Evoking the US presidential campaign, in which Trump criticized President Joe Biden as risking World War III, Medvedev added: 'Don't go down the Sleepy Joe road!' The use of Trump's derogatory moniker for his predecessor reflects what some analysts believe to be the Kremlin's bet that Trump's core supporters will prevail on him to avoid escalating America's conflict with Russia. Grigorii Golosov, a professor of political science at the European University in St. Petersburg, Russia, said there was something symbiotic about Trump and Medvedev fighting on social media. Medvedev, who had styled himself as a pro-Western liberal when he served as president more than a decade ago, has recast himself as an uncompromising soldier in Russia's showdown with the West. But attacking Medvedev may also be useful to Trump, Golosov posited, by allowing him to show he's getting tough on Russia without attacking Putin directly. In June, Trump attacked Medvedev for saying countries could send nuclear warheads to Iran, adding: 'I guess that's why Putin's 'THE BOSS.'' Advertisement 'Trump wants to criticize someone in Russia,' Golosov said, but is still hoping to make a deal with Putin over Ukraine. Medvedev, he added, 'is the perfect target.' Medvedev is active on social media in a way that Putin and most other senior Russian officials are not. Medvedev set up a Twitter account in 2010 on a visit to Silicon Valley, when he was president and positioning himself as a tech-forward, reformist leader. Long a loyal ally of Putin, Medvedev ceded the presidency back to him in 2012. Putin removed Medvedev from the prime minister post in a government reshuffle in 2020 and gave him the largely symbolic role of vice chair of the Russian Security Council. After Putin invaded Ukraine in 2022, Medvedev accelerated his reinvention as a far-right hawk, often threatening nuclear apocalypse more explicitly than did Putin and his spokesperson, Dmitry Peskov. Analysts of Russian politics say that Medvedev's reinvention came in part out of necessity because his past reputation as a liberal made him vulnerable amid the wartime power struggles within the ruling elite. But his social-media hostility is almost certainly blessed by the Kremlin, analysts say, because it amplifies the threat of Russia's nuclear arsenal and helped Putin style himself as a relative moderate. This article originally appeared in
New York Times
25-04-2025
- Politics
- New York Times
Putin Keeps Pummeling Ukraine, Convinced Trump Is on His Side
President Vladimir V. Putin is, brutally, walking a tightrope. The Russian leader appears eager to keep up talks with President Trump as Moscow brims with optimism that energy deals, direct flights and the lifting of sanctions could all be in the offing. He is expected on Friday to host the White House envoy Steve Witkoff for their fourth meeting in three months. But Mr. Putin has cast aside Mr. Trump's calls for a quick peace in Ukraine, with the ferocity of Russia's airstrikes on civilian targets seemingly increasing. Mr. Putin openly admitted this week that Russia had bombed a restaurant because, he claimed, people 'deserving the most serious punishment' were 'drinking vodka' there. The result is a game-of-chicken negotiation with Mr. Trump, as the American president threatens to walk away while Mr. Putin keeps testing his patience. The Kremlin is still exuding calm confidence, even with Mr. Trump posting on social media, 'Vladimir, STOP!' on Thursday in response to Russia's deadliest missile attack on Kyiv, the Ukrainian capital, in nearly a year. 'We are ready to reach a deal,' Sergey V. Lavrov, Russia's foreign minister, said in an interview aired late Thursday by CBS News. 'But there are still some specific points, elements of this deal, which need to be fine tuned, and we are busy with this exact process.' Overnight, Russia continued its airstrikes. The Ukrainian authorities said on Friday that a large-scale drone attack had killed three, including a child, in the eastern city of Pavlohrad. In Russia, experts and people close to the Kremlin say that Mr. Putin's calculus is simple: Until now, the Russian president has been convinced that he has more to gain on the battlefield than by accepting the deal Mr. Trump appears to be offering. Even taking a temporary cease-fire, Mr. Putin believes, would mean surrendering so much negotiating leverage that it would only make sense to do so after major concessions from Ukraine and the West. At the same time, Mr. Putin — a leader who likes to keep his options open and hedge his bets — doesn't want to foreclose the possibility of a war-ending settlement. And Mr. Trump, given his obvious sympathy for Mr. Putin and distaste for President Volodymyr Zelensky of Ukraine, has given the Russian leader plenty of reason to think he can push the envelope. 'For him, it is still important to leave a window of opportunity open, but not to force the process,' Grigorii Golosov, a professor of political science at the European University in St. Petersburg, Russia, said in a phone interview. Mr. Putin believes, Professor Golosov added, that as long as he has the battlefield advantage, 'He can gain benefits not only in terms of seizing territory, but also in terms of undermining Ukraine's defense capability and demoralizing the Ukrainian population.' In Europe and the United States, the Trump administration was widely criticized this past week for outlining a potential peace deal that seemed heavily skewed toward Russia. Mr. Trump and Vice President JD Vance expressed a readiness both to recognize Russia's annexation of Crimea and to freeze the current front line, a de facto acceptance of Russia's occupation of nearly one-fifth of Ukrainian land. Mr. Trump said on Thursday that Mr. Putin would be making concessions simply by 'stopping taking the whole country' — a goal that analysts don't believe Russia has any chance of accomplishing. The current deal being floated by the Trump administration would fall well short of Mr. Putin's stated war aims. The concessions offered by Trump administration officials do not provide for Russian control of all of the Ukrainian land that Mr. Putin has claimed to be part of Russia, nor do they limit the size of Ukraine's army, something that Mr. Putin has demanded since the early weeks of the war. While Mr. Trump has made clear that Ukraine will not join NATO on his watch, Mr. Putin's designs on a renewed Russian sphere of influence in Eastern Europe go much further. Weeks before he invaded Ukraine in 2022, Mr. Putin called on NATO to halt all further expansion eastward and to withdraw military infrastructure placed in Eastern European states after 1997. As if to make his point, Mr. Putin's military in recent weeks has launched fierce strikes on Ukrainian cities. Mr. Putin acknowledged on Monday that Russia had struck civilian targets because, he claimed, they were being used by Ukrainian soldiers and 'nationalists,' as well as by their 'international curators.' 'They're holding gatherings, conferences, meetings in a restaurant, celebrating something, drinking vodka,' Mr. Putin said, an apparent reference to a Russian missile strike on a restaurant in central Ukraine on April 4 that killed nine children. Security footage showed that the restaurant had been filled with women attending a beauty industry event. The Kremlin is also signaling that, despite the brutality of the fighting, Mr. Putin could still make a deal by coming down from some of his most far-reaching demands. In such a nod, a Moscow newspaper editor with Kremlin connections, Konstantin Remchukov, published a column over the weekend arguing that the fine print of Mr. Putin's annexation of four Ukrainian regions in the fall of 2022 gave him the wiggle room to accept an armistice freezing the fighting at the current front lines. The reason Mr. Putin is continuing to fight, Mr. Remchukov wrote, is that he wants to fully expel Ukrainian forces from the Russian border region of Kursk, a push that Russia's top military commander said last week was 99.5 percent accomplished. 'As soon as the last half percent is liberated, the troops can stop where the news finds them,' Mr. Remchukov wrote. In a phone interview, Mr. Remchukov said that Mr. Putin would be ready for a Ukraine deal because doing so would unlock the vast benefits of cooperating with Mr. Trump, including sanctions relief, the return of frozen Russian assets, renewed direct flights to the West and joint energy projects in the Arctic. 'Why shouldn't Putin stop fighting,' Mr. Remchukov asked, 'if the foreign policy preconditions for doing so have been created in the form of the new president of the United States?'
