Figure 1.

The channelling of surplus calories from excess dietary consumption and sedentary lifestyle into insulin-sensitive subcutaneous adipose tissue will protect against the development of metabolic syndrome. However, in the presence of dysfunctional adipose tissue, genetic predisposition and a neuroendocrine profile related to a maladaptive response to stress, the triacylglycerol surplus will be deposited at undesirable sites such as the liver, heart, skeletal muscle and visceral adipose tissue – a phenomenon known as ectopic fat deposition. Metabolic consequences of this defect in energy partitioning include visceral obesity, insulin resistance, atherogenic dyslipidemia and a prothrombotic proinflammatory profile the defining features of metabolic syndrome. Reprinted by permission from Macmillan Publishers Ltd: Després & Lemieux³⁴, copyright 2006.