LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Abdominal Fat

Which Comes First? Abdominal Fat or Prediabetes?

by

Which comes first?  The insulin reistant chicken or the egg with abdominal fat?

To a certain degree, the answer doesn’t really matter all that much because the answer (lifestyle changes) is the same in either case.  But it may change the perspective on which we view the condition of obesity and diabetes.  Diabetics and overweight people are constantly being told they need to take off weight to be healthier.

Unfortunately, the reality of the way our bodies work is the opposite of this common misconception.

I have always told patients that taking off weight is a side effect of taking better care of yourself.  The key is to not focus on the weight.

This particular study supports this idea, AND shows just how fast the fecal matter hits the physiological fan.

In just 28 days of taking in too many calories (1250 extra calories / day) in healthy adults set up prediabetes / insulin resistance without accompanying inflammation in the abdominal tissue.  The insulin resistance in the abdominal fat will then lead to more fat and subsequent inflammation.  THEN things get progressively, rapidly worse.

In other words, excess fat in the abdominal region is the secondary consequence of taking in too many calories.  It is only later that inflammation and abdominal fat starts to accumulate.

Critical Difference in Lazy Versus Healthy Abdominal Fat

by

Your first thought may be that you didn’t know we had “healthy” abdominal fat. In general, you would be correct. But abdominal fat DOES serve a purpose.

Just ask an Inuit Eskimo or a hibernating polar bear if there is a healthy use for abdominal fat. Abdominal fat is designed as a storage depot for excess calories to be used under times of hardship. So it actually has a purpose. I Just got back from seeing Disney’s new movie Bears. It is about a mama bear’s (Sky) struggle to put on fat to make it through the winter to keep her two baby cubs alive. At no point in the movie did the narrator point out that Sky was looking a little too plump and needed to cut back on her calories and exercise a little more.

Nope. She needed the fat.

The rest of us? Or at least the rest of us that have some 8,000 calories available in a mere 25 foot walk to the fridge? This fat has moved beyond storage to disease causing. Most of the abdominal fat present in todays’ society is the bad kind; a result of too many calories with too little nutrient quality. Ultimately the fat runs out of a decent blood supply and goes rogue. This abdominal fat takes on a life of its own and becomes its own organ system, kicking out inflammation-causing hormones that lead to heart attacks, strokes, diabetes and cancer. All things that we would all arguably like to avoid.

Generally, we think in terms of visceral (bad) and subcutaneous (not bad) fat. However, the dividing line is not all that clear. This particular study takes a more in-depth look at the antioxidant status present within both types of fat in a group of 50 women. These women were divided into two groups: normal weight and obese.

But here’s where it gets interesting. The then further divided these two groups into two subgroups: metabolically healthy and metabolically obese. Just because someone does not appear to be at risk for heart disease, diabetes and cancer on the outside based on body fat does not mean that blood work tells a different story.

The term “metobolically obese” refers to those (regardless of how much fat they have) who are insulin resistant / prediabetic based on insulin levels (HOMA-IR), triglyceride levels, total cholesterol as well as LDL- and HDL-cholesterol levels. In other words, you can have a skinny person who is still at great risk of diabetes and heart disease (referred to a normal weight, metabolically obese).

In these four groups, certain antioxidants (glutathione/GSH and GSH-dependent enzyme activities) and markers of oxidative damage (specifically NADPH oxidase protein and 4-hydroxynonenal levels) were measured. Here’s what they found:

  • Visceral fat had higher levels of antioxidants (glutathione/GSH and GSH-dependent enzyme activities).
  • However, obese women had less of the antioxidants in both types of fat.
  • However, in the obese women, oxidative damage levels were higher and there were lower levels of antioxidants only in the visceral fat.

Basically, when we are at a more ideal weight, the fat that is present in our bodies, regardless of where it is, has the ability to protect itself.  As more and more fat collects in the abdominal region, this tissue becomes metabolically stressed out (more and more oxidative stress).  This change is not for the better and leads to all the problems associated with abdominal fat like heart disease, strokes, diabetes and cancer.

Interestingly, laser “liposuction” may be just what the doctor ordered.  This tool has the potential to improve the health of abdominal fat cells and lower the risk of chronic disease.  In our office, we have seen reduction in the volume of the the abdominal fat in just a few short treatments.  It would be interesting to see what would happen if medicine increased the use of this tool for those with excessive abdominal fat.

Abdominal Fat Cells: 2 Reasons Why Bigger is NOT Better

by

Ever since our office discovered the laser lipo unit, it seems like the research supporting this approach to curb inflammation has been everywhere.

Or maybe, just like the new car you just bought you thought no one else had that you now see everywhere, I’m just looking for research along this avenue more.

Either way, it’s interesting, to say the least.  It is becoming more and more clear that inflammation coming from that extra fat you are carrying around your middle is setting your body and health on fire.  And not in a good way.  This inflammation is driven by hormones released by the fat cells when they become angry from the wrong lifestyle choices.

This particular study requires a wee bit of background.  First, there are a few major depots of fat in the human body.  Visceral fat is the fat around your organs, sometimes referred to as omental fat (the omentum is the fascial tissue acting like a web connecting all of your internal organs, loaded with fat and blood vessels).  There is no doubt that visceral adipose tissue is not a good thing.

Subcutaneous fat is the fat found just under your skin that serves to keep you warm and cushion you when you fall back onto your buttocks.  In general, this type of fat has been thought to be less related to chronic diseases like heart disease and diabetes as visceral fat.

Or, at least, that’s what I thought before I delved into some basic background research for this post.  About 3 hours later (who needs sleep??)  I’ve come to the conclusion that we still have no idea whatsoever about the human body.  Why?

Because there is a growing body of research that suggests that our subcutaneous fat may actually help us keep our visceral fat in check.  In particular, subcutaneous fat produces more of a compound called caveolin-1 (CAV-1).  CAV-1 has been shown to protect against diabetes.

As I read through this, a blog article I did several years ago made much more sense.  In the article, I reviewed the findings that, after liposuction that removed subcutaneous fat, there was a bounce-back 10% increase in visceral adipose tissue.

With this in mind, I need to get back to the article.  In it, researchers looked at fat removed during surgery from 44 women (average age 47 years old).  They were looking at two characteristics of the fat from both the omental (visceral) and subcutaneous fat:

  1. Larger fat cells than expected (termed adipocyte hypertrophy).
  2. Smaller fat cells, but more of them (termed adipocyte hyperplasia).

Here’s what they found.  When compared to smaller fat cells (hyperplasia):

  • Women with larger omental fat cells had a worse ability to manage blood sugar (as measured by GLUT4 mRNA expression) as well as more inflammation (as measured by CEBPB mRNA, OM PLIN, CD68, CD14, CD31 and vWF) and were more likely to release fats into the bloodstream (a process called lipolysis).
  • Women with larger subcutaneous fat cells also had a worse ability to manage blood sugar, higher inflammation, lower adiponectin levels (not good–leads to diabetes) and more lipolysis.

While this sounds complicated, the bottom line is that larger fat cells, regardless of location in the body, was far more dangerous than having more, but smaller, fat cells.

This is consistent with what we know about fat cells being the storage for extra calories.  Too many calories, super-sized fat cells and not enough blood flow to support the cells and you get a revolt and uprising.

Cold laser has been known for years to fight this situation by increasing blood flow and decreasing inflammation.  It fits in very well with our experiences with laser lipo for patients who have abdominal fat that has reached this state of inflammation.

 

The OTHER Organ You May Have That You Don’t Know You Have

by

 

Ask any high school kid to list the organs of the body and you’ll get the typical responses: Heart, liver, brain, kidneys, stomach. Maybe even an adrenal If he or she stayed awake in biology.  But some organ systems are created, not provided in the womb.

Sure, some consider the bacteria in the gut as its own organ system.  After all, it detoxifies, protects from invaders and releases hordes of chemical signals.  Despite the poor overall knowledge of this organ system, it’s not the one I’m talking about here.

This particular organ system is not present in everyone, although, unfortunately, it is present in far too large of a percentage of today’s population.

It produces a very large number of hormones that drive your risk of diabetes, heart health, inflammation and other conditions, all bad.  Worse, the weight of this organ may constitute up to HALF of your body weight.  That’s a big organ.

It’s the (or YOUR, if that’s the case) adipose tissue.  Most notably the gut.

Yes, the gut.  And you just thought it was there to keep you from checking out your toes on a regular basis.

Here’s the current theory.  The fat cells in your gut begin as extra calorie storage locations.  Adipose tissue in other areas of the body, like around the heart and thighs, although have this duty, but it’s the gut we normal point to as the greatest reservoir of extra calories.

That’s fine and dandy for a while.  Or, if you plan on hibernating and need the calories while you sleep through football season, then this is okay as well.

But gather too much extra tissue in that abdominal region and blood flow becomes an issue.  After all, the fat cells need nutrients in and waste products out as well, and if this process becomes congested, your fat cells are going to get a little upset with you.

This kick off the survival mode of your little abdominal buddy, leading to the production of hormones referred to as adipokines with names like visfatin, adiponectin and resistin.

These hormones are bad enough on their own, but there’s another problem brewing.  The adipose tissue contains a large number of stem cells, referred to as hematopoietic cells.  These cells can differentiate into immune cells that can be a major driver in inflammation.

This particular review gets a little more specific, stating that a single gram of adipose tissue can contain up to 5 million stromal vascular fraction (SVF) cells.  About half of these cells (not counting the fat cells themselves) are white blood cells.

If you do the math and the Metric to English measurement conversions, that’s an awful lot of immune cells available to affect the rest of your system.

I’ve become very adept at explaining this concept recently because our office has begun using a laser liposuction device.  Laser, from a musculoskeletal-sprain-strain-pain based standpoint, has been known for decades to lower inflammation and increase blood flow.  Kind of a perfect salve for this inflamed, hypoxic organ too many of us are carrying around our middles.  (You can read more about this laser lipo procedure by on our website by clicking here)

Overall, though, the take home message is that the lump around your middle does not just affect the way you’re going to look in that Speedo, it drives a very dangerous and damaging organ that catapults you towards chronic disease and an early death.

 

Relation with dietary fatty acids, plasma lipid profile, serum insulin, and central obesity – (11-08-01)

by

Site-specific differences in the fatty acid composition of abdominal adipose tissue in an obese population from a Mediterranean area: relation with dietary fatty acids, plasma lipid profile, serum insulin, and central obesity

Quite a long title…This study begins to identify why abdominal fat is the type of fat that increases risk of certain diseases as opposed to peripheral fat. Abdominal fat contains higher levels of omega-3 fatty acids, generally considered to be anti-inflammatory and protective against all sorts of diseases known to man.

AJCN — Abstracts: Garaulet et al. 74 (5): 585

Read entire article here

Abdominal Fat Measurements = Heart Fat

by

There is nothing good about visceral fat.  Many just worry about the aesthetics of it, but the reality is that visceral fat wreaks havoc on long term health.

The current model of visceral adipose tissue puts this type of fat as its own organ system.  The only problem is that this organ system, instead of working with your body, is an invader trying to survive.

Here’s how it goes:

  • Fat has always been a storage tissue for extra calories.
  • Lord knows we got enough of these in today’s society.
  • The fat begins to accumulate.
  • For awhile this is ok, but past a certain point these fat cells begin to run out of an adequate blood supply.

After all, these cells need nutrients just like every other cell, but there is only so much blood flow to go around.  Once the fat cells don’t have the nutrients they need, they get pissed off.  Pissed off fat cells begin to generate pissed off hormones called adipokines that drive inflammation and damage elsewhere in the body.

This is how visceral fat leads to poor blood vessel health (heart attack, stroke, dementia) and other problems like cancer.

While we generally think of fat accumulated around the abdominal region, it also accumulates around other organs like the heart, termed epicardial fat.  The problem with epicardial fat is that it is so close to the heart that the hormones released can have a greater effect.  The way we usually look for epicardial fat is through an echocardiogram, but this isn’t exactly practical for routine use.  Enter this particular study.

Researchers looked at whether we could use the sagittal abdominal diameter as an indirect marker for epidcardial fat without the hassle of an echocardiogram.  The sagittal abdominal diameter is measured by a set of calipers, measuring the distance from the small of the back to near the belly button region while lying down.

The findings in this study suggest that measuring the sagittal abdominal diameter is a pretty darn good way to indirectly measure the amount of fat surrounding your heart.

I found this study pleasantly rewarding since our office recent implemented the use of a “laser liposuction” unit (you can read more about this service by clicking here).  I realized quickly that the patients seeing the most dramatic results were the ones with the most inflammatory belly fat.  Since laser has been known for many years to increase blood flow and decrease inflammation, this makes complete sense.

Using laser to calm down inflammatory body fat, according to this study, is also highly likely to lower the fat accumulated around your heart as well.  Not a bad bang for your buck.