Eating fatty food, even if ou're slim, could be deadlier than you think.

Fat hinders the effect of medicine and can cause the body's invisible army of war- rior cells to mutiny and worsen heart disease, diabetes and even cancer, reveal the results of a five-year study by a group of 10 researchers headed by a US endocrinologist who began her career at an Agra medical college.

The key culprit is a gene called PAI-1, roused like a ter- rorist sleeper cell, in this case by fatty tissue or free-roaming fat molecules, which come from fatty, fried foods or from being obese, report Preeti Kishore (39) and her col- leagues in the latest edition of Science Translational Medi- cine.

"The important finding of this study is that even in lean adults, high dietary fat may in- crease the secretion of PAI-1 and alter the risk for heart dis- ease," Carey Lumeng, a Uni- versity of Michigan pediatrics professor who reviewed the re- search, told the Hindustan Times.

"Understanding these mech- anisms and identifying the fat- derived factors that activate macrophages (mutinous de- fensive cells) could lead to new targeted therapies for these conditions, which have in- creased to epidemic propor- tions globally but particularly in India," said Dr Kishore, an endocrinologist at New York's Albert Einstein College of Medicine, whose Indian part- ner is the Christian Medical College, Vellore.

With nearly 35 million dia- betics, India--spurred by a ge- netic predisposition, poor di- ets and inactivity--leads a global epidemic of the disease.
Cardiovascular disease is now the leading killer in the world and India, with diabetes being its leading cause.

The study clears what re- searchers called "the fog sur- rounding the murky relation- ship" between free fatty acids circulating in the blood and in- flammation, the body's selfdefence mechanism.

Dr Kishore and her col- leagues injected healthy, non- diabetic adults with fats typi- cally seen in obese people and those with diabetes. The ef- fects of this were: the healthy bodies stopped responding ef- fectively to insulin, the main compound against diabetes, and there was a rise in the lev- els of the PAI-1 gene, linked to heart disease and an increased risk of diabetes.

"We have found that elevat- ed levels of fat molecules cir- culating in blood, as seen in obesity and type 2 diabetes, can directly increase PAI-1 gene expression in fat," said Dr Kishore, who pursued an MBBS degree from Sarojini Naidu Medical College in her home town, Agra, before leav- ing for the US 14 years ago.

It's normal for macrophag- es--the warrior cells--to fight infection and inflame tissue, but this battle can spin out of control in obesity and its relat- ed diseases.

The cells that get inflamed congregate in fat tissue when "people became obese", she explained.

According to the World Health Organization, at least 2.6 million people die each year as a result of being over- weight or obese, which makes obesity a bigger killer than malnutrition.

Science Translational Medi- cine is published by the Ameri- can Association for the Ad- vancement of Science, the world's largest general scien- tific society.