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We’re inwards the abode stretch amongst all this insulin stuff, folks, I promise. Just 2 to a greater extent than posts later this, together with we’ll live done. (I also hope to teach back to the cancer series soon. I know I’ve got some readers who’ve been waiting a long fourth dimension for that to live resurrected.)
Okay, I left off last time bespeak why chronically elevated insulin causes some people to gain torso fat, but non others. I also hinted that the accumulation of adipose tissue mightiness truly live a protective mechanism. We’ll start amongst the outset issue, since it’s quicker to address. I also desire to start amongst it because it is in all likelihood the zillion-dollar question inwards all of human metabolism inwards our electrical current dietary & cultural zeitgeist. Upon consuming the same diet—the same number of calories, mayhap the same macronutrient ratios—and maybe fifty-fifty having the same bird of hyperinsulinemia/insulin resistance, why do exclusively some people teach fat?
And here, my friends, is my zillion-dollar answer:
I don’t know.
I don’t know if anyone knows. Most likely, there are genetic factors involved. After all, some people are tall; some are short. Some have got bluish eyes; some have got brownish eyes. In the human face upwards of chronically elevated insulin, some of us accumulate lots of adipose tissue, some don’t. (Lucky bastards…) How come upwards some people’s bodies are thence expert at not accumulating excess adipose? Put to a greater extent than bluntly—and inwards price most of us have got in all likelihood said to ourselves a hundred times nearly friends together with relatives who have got never had weight problems—despite eating junk together with beingness sedentary—Dammit, why don’t they always teach fat?!
My hunch is, maybe in that location are other factors that have got to come upwards together inwards a sort of “perfect storm” scenario to allow the accumulation of torso fat. Maybe it’s chronic hyperinsulinemia and any number of the following: a sluggish thyroid; skewed omega-6/omega-3 ratio; micronutrient deficiencies (perhaps specifically iodine, selenium, magnesium, chromium, together with biotin); whacked-out gut flora; heavy metallic toxicity; insufficient sleep; unremitting stress; or Saturn ascent inwards Aquarius the 24-hour interval they were conceived. Who knows? (Except that lastly one. It's non that.) In some people, elevated insulin, all past times itself, is in all likelihood plenty to Pb to an increase inwards torso fat. Other people’s bodies mightiness start to accumulate obese exclusively amongst a confluence of these factors. I do think genetics has a lot to do amongst it, though. And it’s non that whatsoever of us is “programmed” or destined to teach obese; it’s that the detail polymorphisms inwards our genes respond to the modern diet & lifestyle past times accumulating torso obese to a greater extent than readily than other people’s. Lucky bastar…but wait!
Are those people lucky?
Is it really a approbation to live able to eat refined saccharify together with starch all 24-hour interval long amongst seeming impunity?
I tell “seeming” impunity, because, the truth is, they are not eating that materials amongst impunity.
That some people care to rest thin
in the human face upwards of the same dietary & lifestyle inputs that brand the residuum of us obese does non brand them immune to the myriad other effects of these inputs.
Don’t live misled past times the size of these people’s bodies. They mightiness live thin, but that doesn’t brand them healthy. The medical profession has a coined a novel phrase to depict these people. They are the “normal weight obese,” also known every bit “metabolically obese.” In my writing for Designs for Health, I referred to this phenomenon every bit “TOFI” – sparse outside, obese inside. (A phrase I outset heard from J.J. Virgin.)
Here’s an excerpt from a weblog postal service I wrote for the company:
“That such a various grouping of clinical presentations tin live tied to the hyperinsulinemia together with inflammation probable induced past times a carbohydrate- together with grain-heavy diet depression inwards full obese and/or high inwards the wrong types of fat, shows us that excess torso obese is exclusively one final result of the misguided conventional dietary recommendations of the lastly half-century. People who sidestep the fate of gaining weight are non immune to the myriad other effects of a hapless diet upon their health—and inwards fact, a lack of visible ‘proof’ of these effects mightiness move far to a greater extent than hard to assist these patients encounter the connective betwixt their dietary choices together with suboptimal health.”
So let’s live clear: lack of excess adipose tissue does non automatically hateful someone is healthy. Nor, as Dr. Kraft's 5-hour insulin assays demonstrated thence stunningly, does it automatically hateful they are totally inwards the clear amongst regard to insulin sensitivity. The accumulation of torso obese is simply ane symptom amid many that tin final result from chronic hyperinsulinemia. High levels of insulin drive the growth of obese tissue—in some people. Kind of similar how decades of smoking drives lung cancer—in some people. The fact is, inwards the human face upwards of sustained hyperinsulinemia, some people teach overweight or obese. Some people prepare ticker disease. Some prepare Alzheimer’s, or tinnitus, or infertility, or kidney damage, or vision problems. Some hapless souls halt upwards amongst everything!
And the ones who don’t teach obese? They are what a registered nurse I know calls the “constitutionally obesity-resistant.” What a demonstrative phrase, no? Their bodies are resistant to accumulating excess adipose. We could also jail cellular telephone them the “constitutionally thin.” As in, seemingly no thing how much they eat, or how lilliputian they exercise, their bodies rest thin. We all know people similar this. (And every bit much every bit nosotros mightiness dear them, nosotros loathe them a lilliputian bit, too, right?) Researchers have got conducted overfeeding studies, wherein they sequester subjects inwards a metabolic ward, monitor them to make sure they are consuming larger amounts of calories than normal, together with they Just. Don’t. Gain. Weight. (Or, they gain significantly less than predicted, based on the caloric surplus they’re stuffing these folks with.) Likewise, inwards my ain n=1 experiments, together with in all likelihood amid many of you, simply cutting calories did non Pb to magical weight loss. Some people’s bodies similar to accumulate adipose tissue, together with some people’s don’t. Like I said, genetics in all likelihood play into this to some extent, every bit do things happening at the cellular bird that have got zilch to do amongst calories, carbs, or exercise. (More on this coming inwards part 8.)
BMI: Let’s Be More Intelligent Than This
So we’ve got people who are at a “normal” or “healthy” torso volume index (BMI), but remember: BMI is a stair out of weight inwards relation to height. That’s it. Nada más. It says nothing—absolutely nothing—about the composition of that weight. (That is, how much of it is fat, together with how much is musculus mass, bone, organs, water, etc.) This is why people like, say, Mario Lemieux together with Wayne Gretzky, inwards their hockey-god heydays, would in all likelihood have got been classified every bit obese. Can you lot i-freaking-magine? Uh, Wayne? Mario? You guys demand to eat less together with displace more, ‘cuz you’re exactly likewise darn heavy for how tall you lot are. Sorry; looks similar all those speed drills together with Stanley Cup playoff games aren’t plenty exercise for you.
So here’s the deal: Just every bit people who are quite tally together with athletic tin live mistakenly called “obese” past times the ridiculous parameter that is BMI, so, too, tin people amongst high torso obese percentages live classified every bit “normal” weight or mayhap fifty-fifty underweight. And now, nosotros come upwards to a really interesting place. It’s fourth dimension to verbalise nearly fat versus weight. Skeletal musculus tissue—metabolically active, calorically hungry skeletal muscle—is a pretty non bad thing to have got on your body. (I volition write a postal service sometime nearly why. Just trust me for now. Or, if you lot don't desire to trust me, trust Jamie Scott, founder of the Ancestral Health Society of New Zealand.) Adipose tissue, non thence much. Some adipose, yes, definitely. It’s in that location for a argue together with you lot would give-up the ghost without it. But you lot don’t demand fifty, a hundred, 2 hundred extra pounds of it.
People who are “TOFI” tend to have got a high torso obese percentage. They have got a small-scale torso size, but they have got a lot of fat, relative to someone of the same size who is leaner. Here’s an example: Let’s tell nosotros have got 2 women who both weigh 140 pounds. One adult woman has 22% torso fat, together with the other has 40% fat. If you lot had to gauge which of these women was metabolically healthier together with at far lower jeopardy for a multitude of gnarly issues, which would you lot guess? (Yes, you’re right.) We could also jeopardy a gauge every bit to which ane looks improve naked, but that is NOT WHAT THIS IS ABOUT.
There are lots of people out in that location who are at a “healthy” weight, notwithstanding are at far greater risk for pretty much all of the atmospheric condition associated amongst insulin resistance, or diabetes in-situ. These people mightiness have got many of the hallmarks of metabolic syndrome, insulin resistance, and/or type-2 diabetes, minus beingness overweight. (They aren’t overweight, but they mightiness live overfat.)
According to the modern Western beauty ideal, these folks are cruisin’ along happily. But what’s going on “under the hood,” every bit Robb Wolf calls it? High triglycerides? Hypoglycemia? Mood swings? Brain fog? Hypertension? Can’t move upwards a flying of stairs without getting winded? Can’t conceive? Can’t teach it up? Yep, sure sounds similar these people are doing just great, since they’re non overweight, right?
“Excess” Body Fat: Physical Cushion and Physiological “Protection?”
Finally, nosotros come upwards to the second large enquiry of this post: is an increase inwards torso fat—total fat, non exactly every bit a percentage—the body’s way of protecting itself from something worse that could occur if torso obese were not increasing? After all, nosotros know darn good non all T2 diabetics are overweight. Nor is everyone amongst ticker disease, or Alzheimer’s, or kidney problems.
Let’s live a fleck politically incorrect, shall we? In an strange way, the accumulation of torso obese mightiness live a good thing, together with those amid us who respect ourselves a lilliputian softer & squishier than we’d similar mightiness truly live lucky. (Say what?!) It’s true. Stay amongst me here.
See, when someone’s torso starts to accumulate fat, it’s pretty slow for them to recognize something has gone awry. Whether it’s diet, sleep, stress, physical activity, environmental "toxin" exposures, or another factor, the evidence is clear. It’s clear in the mirror, inwards the pants nosotros tin no longer button, inwards the rings that no longer fit—that something ain’t right. On the other hand, it’s hard for the constitutionally obesity resistant to connect their acne, erectile dysfunction, encephalon fog, fatigue, chronic pain, vertigo, migraines, together with more, to a harmful diet & lifestyle.
I am sure non the outset someone to propose that the accumulation of adipose tissue mightiness live a protective machinery inwards the body. (I wishing I was; it’s brill.) And it’s non the exclusively wacky-seeming thing the torso does to mayhap protect itself. (I wrote something similar nearly cancer.) The argue it mightiness live protective is, rather than have got blood glucose rest at, say, 200 or 300mg/dL for an extended menses of time, the liver converts this massive pile of glucose into obese acids (a procedure called de novo lipogenesis, which way “making novel fat”). So, obese acids are beingness created, and, amongst insulin elevated (thanks, inwards part, to a ceaseless influx of carbs), the activeness of lipoprotein lipase is stimulated, thence an enzyme is standing at the laid upwards to assist escort those obese acids into adipose cells. (Or to proceed them right in that location inwards the liver, resulting inwards obese liver.)
You’ll recall from part 2 of this series that the effects of chronic hyperglycemia are pretty disastrous. So, rather than allowing all that glucose to rest inwards the bloodstream indefinitely, where it volition motility a tempest of glycation that tin touching on exactly nearly every organ together with tissue nosotros tin think of, the liver takes some of that glucose out of the bloodstream, converts it into triglycerides, together with the torso stores these triglycerides wherever it can: our hips, bellies, thighs, upper arms, nurture ends (all of which is called “subcutaneous fat,” because it’s nether the skin), every bit good every bit surrounding our organs (called “visceral fat,” because it’s deeper within us, inwards together with around the viscera). Since chronic hyperglycemia tin motility such fun together with benign things every bit stroke, blindness, together with renal failure, it makes feel that a human torso would rather have got some to a greater extent than cushioning on its frame than run the jeopardy of these serious wellness complications.
So the conversion of glucose to triglyceride, together with its storage every bit adipose tissue, is truly the body’s way of protecting against the gnarly effects of sustained hyperglycemia. Because the torso has thence kindly together with efficiently gotten that glucose out of the blood together with stored it away for safekeeping, the blood glucose remains normal. (Or, if non "normal," then, say, to a greater extent than similar 150-185mg/dL, rather than 200+.) And here, my friends, nosotros come upwards to a crucial, crucial question:
Did the accumulation of adipose tissue Pb to hyperglycemia & hyperinsulinemia, or did hyperglycemia & hyperinsulinemia Pb to the accumulation of adipose tissue? Or, inwards layman’s terms, do people teach T2 diabetics because they’re fat, or do they teach obese because they first have dysregulated blood refined saccharify together with insulin? Like I’ve said before: which is the chicken, together with which is the Cadbury crème egg?
And every bit I have got also said before, in that location is no error that adipose tissue is an endocrine apparatus. It is non physiologically inert. It doesn’t exactly sit down there. It secretes together with absorbs things, sends together with receives. So yes, once excess adipose tissue has begun to accumulate, it tin wreak plenty of havoc on wellness all throughout the body. But what is causing it to accumulate inwards the outset place? That is the existent question. And I think, amongst all this insulin stuff, nosotros have got at to the lowest degree part of the answer. Not the whole answer, hear you, but definitely part of it. (There’s a argue this serial is called “It’s the Insulin, Stupid.”)
So, we’re on the same page here, right? It seems to a greater extent than probable that blood refined saccharify & insulin dysregulation come upwards first, together with the accumulation of adipose tissue is the result. As I have got written ranted nearly before, the accumulation of excess adipose tissue—whatever nosotros mightiness define “excess” to be—is most oftentimes an EFFECT of underlying hormonal together with metabolic disturbances, rather than their causative factor. And even though obesity is “associated” amongst a long listing of nasty wellness outcomes, that does non hateful obesity causes them.
There are many putative causes of obesity. Hyperinsulinemia/insulin resistance is simply ane of them. (And in that location are many putative causes of insulin resistance. And no, it’s non all nearly the carbs! Even I, every bit a LCHF-friendly nutritionist, tell that loud together with clear. After all, I called this serial “It’s the Insulin, Stupid,” together with non “It’s the Carbs, Stupid.” Because it’s not exactly the carbs. Excess saccharide consumption is a large factor, for sure. Maybe fifty-fifty the biggEST. But it’s non the only one. Details inwards the 8th together with terminal installment. We’ve got ane to a greater extent than postal service earlier that, where we’ll tackle this question: Does insulin touching on "calories inwards together with calories out?" And if so, how?
In the meantime, if you’re non already reading Dr. Jason Fung’s weblog on a regular basis, what are you lot waiting for? Check out his latest, where you’ll teach additional information on this beingness an insulin issue, together with non necessarily a carbohydrate issue.
Remember: Amy Berger, M.S., NTP, is non a physician together with , LLC, is non a medical practice. The data contained on this site is non intended to diagnose, treat, cure, or forestall whatsoever medical condition.
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