The three numbers are the right three, and there is a fourth one already sitting in most people's blood work that costs nothing to add.
Alanine aminotransferase. it turns up on almost every routine panel, and it is the liver reading of the same visceral fat a dexa scan charges you to see. fat around the organs and fat inside the liver travel together.
Which is where thin outside sick inside stops being a phrase and picks up a number. a meta-analysis of 53 studies, 65,029 people with fatty liver and 249,544 without, put lean fatty liver at 11.2% of the general population. a quarter of everyone who has fatty liver is lean. their scale is fine. their liver is not.
And the wider version of your point is worse than it sounds. the nhanes analysis of 8,721 american adults found 12.2% of them in optimal metabolic health, on five criteria, none of which is body weight. being metabolically healthy is the unusual outcome, not the default one.
The catch on alt is that the number your lab prints as normal is too generous. the conventional ceilings, 40 for men and 30 for women, came out of reference groups that quietly contained people with subclinical fatty liver. rebuild the range with those people excluded and it drops to 30 for men and 19 for women. so a woman with an alt of 28 gets told she is fine, and by the cleaner definition she is not.
A tape measure, a lipid panel and alt get you most of the way to the same answer as a dexa scan, at the price of the tape measure.
The scan tells you how much there is. the blood tells you whether it has started doing anything.
The 29:44 What If You Could Be Thin on the Outside and Sick on the Inside and Never Know It? The three numbers that tell you more than your scale ever will, and the habits that actually change them. PUBLISHED A DAY AGO 1 LIKES 0 framing is the part I keep coming back to. Most takes on this skip the underlying mechanism and try to win on vibes.
The three numbers are the right three, and there is a fourth one already sitting in most people's blood work that costs nothing to add.
Alanine aminotransferase. it turns up on almost every routine panel, and it is the liver reading of the same visceral fat a dexa scan charges you to see. fat around the organs and fat inside the liver travel together.
Which is where thin outside sick inside stops being a phrase and picks up a number. a meta-analysis of 53 studies, 65,029 people with fatty liver and 249,544 without, put lean fatty liver at 11.2% of the general population. a quarter of everyone who has fatty liver is lean. their scale is fine. their liver is not.
And the wider version of your point is worse than it sounds. the nhanes analysis of 8,721 american adults found 12.2% of them in optimal metabolic health, on five criteria, none of which is body weight. being metabolically healthy is the unusual outcome, not the default one.
The catch on alt is that the number your lab prints as normal is too generous. the conventional ceilings, 40 for men and 30 for women, came out of reference groups that quietly contained people with subclinical fatty liver. rebuild the range with those people excluded and it drops to 30 for men and 19 for women. so a woman with an alt of 28 gets told she is fine, and by the cleaner definition she is not.
A tape measure, a lipid panel and alt get you most of the way to the same answer as a dexa scan, at the price of the tape measure.
The scan tells you how much there is. the blood tells you whether it has started doing anything.
The 29:44 What If You Could Be Thin on the Outside and Sick on the Inside and Never Know It? The three numbers that tell you more than your scale ever will, and the habits that actually change them. PUBLISHED A DAY AGO 1 LIKES 0 framing is the part I keep coming back to. Most takes on this skip the underlying mechanism and try to win on vibes.