The Body Fat You Want To Keep
If you struggle with excess weight you needn’t feel alone. Seventy percent of Americans struggle right along with you, with thirty-six percent of them carrying more than 35 pounds of extra weight. Unquestionably, obesity has become epidemic in the United States. A fact that is particularly alarming when you consider that extra pounds have been linked to heart disease, diabetes, cancer, Alzheimer’s, kidney disease, arthritis, asthma, auto-immune disease, and early death. But does obesity itself mean you’re unhealthy?
While two-thirds of overweight people do develop weight-related health problems, one-third do not, and they don’t appear to be at an increased risk for health problems either. One cannot help but ask; what is different about the one-third of overweight people that keeps them healthy? While time and research will provide more clues, what we do know is the answer has a lot to do with diet and, most importantly, the health of their body fat. Traditionally, fat cells have been viewed as metabolically inactive storage units for extra calories. But newer research reveals that fat cells are much more complex and actually metabolically very active.
While the full scope of the effects of body fat on health are just now beginning to be understood it is apparent that body fat acts like a major organ similar in importance to the heart, kidney, or liver. Fat cells produce hormones that control a host of body functions, particularly appetite, metabolism, and body weight. What determines a person’s health may have less to do with the number on the scale, and more about how well their body fat functions. Healthy fat cells regulate body weight by secreting several hormones. One, called adiponectin, is released when calories from food enter the blood stream. Adiponectin speeds up metabolic rate, helping burn off calories. Fat cells also release grenalin and leptin which work together to decrease hunger and increase fullness.
Fat cell health appears to be dependent on the quality of our diet, and in particular on the type of fats we eat to maintain function. Most likely what determines whether overweight people are healthy or unhealthy is the quality of the food they eat. Health problems connected with obesity are thought to be caused by poor dietary habits and the inflammation that it causes to body fat which disrupts appetite, metabolism, etc.
Scientists often refer to dietary changes that have occurred over the past 100 years and the affect it has had on the dramatic rise of obesity and health as “The Perfect Nutritional Storm.” Similar to Hurricane Sandy, which gained its power by just the right combination of environmental factors and caused catastrophic damage, The Perfect Nutritional Storm refers to the devastating health effects caused by a combination of dietary shifts that began early in the 20th century.
During the industrial revolution food manufacturers sought methods to make convenient new foods. Starches like oatmeal and rice were processed into quick cooking instant cereals. Flour was refined to increase shelf life. Grains were ground, and flaked into breakfast cereals that quickly became an American staple. When they discovered the technology to create a cheap source of sugar from corn meal (high fructose corn syrup) manufacturers began adding it to everything. Soda and novelty drinks containing large amounts of sugar became popular and replaced water. Traditional fat sources like lard, olive oil, nuts, seeds, grass-fed animals, beans, and wild fatty fish (all high in the essential omega-3 fats) were replaced with grain-fed meats and foods high in vegetable oils like corn, soybean, safflower, Crisco®, and margarine (all high in the omega-6 essential fats.)
After 100 years of this new way of eating, American diets looked very different. The average servings of fruits and vegetables decreased from eight to less than two servings a day. Intake of vegetable oils (omega-6 fats) increased (by 109%) and intake of omega-3 fat rich foods decreased (by 78%). Calories from protein, fat, and fiber dropped (by 40%) and were replaced by calories from refined sugars and starches. White breads, pastries, baked goods, chips, and soda pop now contributed 70% of daily calories. Daily intakes of sugar went from ½ teaspoon to a half pound and the average person was eating about 500 more calories every day.
Processed foods are a health problem because they foods digest and absorb into the body differently than natural, whole foods. Traditional carbohydrates like beans, whole grains, fruits and vegetables are naturally high in fiber and protein which helps curb appetite. Calories from these foods enter the blood stream slowly, providing a steady source of energy for many hours. On the other hand, processed foods are much higher in calories per serving and the mechanical grinding and dissolving that is part of processing makes them absorb much faster. Take for example a small blueberry muffin, which typically equals 350 calories. That is equal to the calories in six cups of blueberries. The muffin can be eaten and digested in less than 30 minutes. Six cups of blueberries take much longer to eat, are more filling, provide greater nutrition, and take four times longer (120 minutes) to digest. Most importantly, you are far more likely to eat more than one muffin, and far less likely to eat more than six cups of blueberries at a time.
When processed foods absorb rapidly, blood sugar and insulin levels increase quickly and much higher than would happen when eating whole foods. Most people are not active enough to burn calories as fast as processed foods can supply them and these calories are then stored as fat. As fat cells fill to capacity, the body produces more new fat cells. Health problems arise when calories enter the blood stream more quickly than new fat cells can be made. When this happens, fat cells will become over-full. Normal healthy fat cells are round in shape, but when they become over-stuffed they lose their shape and become oval. This stretching of the fat cell damages the way their ability to regulate hormones. Overfull, stretched fat cells lose their ability to make the hormone adiponectin which decreases their ability to increase calorie burning. There is also a disruption in their ability to regulate the appetite controlling hormones leptin and grenalin, which causes appetite to increase. These hormonal changes causes the regulation of body weight to go amiss and people tend to gain weight.
But gaining weight is not the only problem. Damaged fat cells leak out fluids meant to stay inside the cells. This triggers the immune system which attacks the damaged fat cells. In the same way that the immune system creates swelling and redness around a wound, the immune response to damaged fat cells causes inflammation around the fat cells. Because fat tissue is distributed throughout our body, this can lead to inflammation throughout the whole body, even inside the major organs, tissues, arteries, etc.
The shift to eating more vegetable oils (high in omega-6 fats) accelerates the inflammatory process because omega-6 fats make hormones that promote blood clotting, inflammation, and new (fat) cell growth. When combined with a diet very low in omega-3 fats, inflammation goes unchecked because omega-3 fats are necessary to produce the aniti-inflammatory hormones EPA (eicosapentaenoic acid) and DHA (dexahexenoic acid). These hormones work together to turn off inflammation and restore balance to the immune system.
Chronic inflammation inside of our body produces a cluster of symptoms physicians often refer to as Metabolic Syndrome. These symptoms would include:
- Increased body fat especially around the waist. (Women > 35 inches, men > 40)
- Low levels of HDL or “good” cholesterol (< 50 for women, < 40 for men)
- High blood triglycerides (> 150)
- High blood pressure (>130/85)
- High blood sugar (> 100 fasting).
Since metabolic syndrome is determined more by the quality of the diet and not as much by the pounds of extra weight, inflammation can occur in someone carrying as little as 15 to 20 extra pounds (particularly if the fat is around the waist) and can be significant even when the blood values are only mildly elevated. Chronic inflammation can also lead to a host of other medical conditions. It can adversely affect the pancreas and its ability to regulate blood sugar levels, often leading to diabetes. Inflammation in the arteries and heart is linked to plaque build-up, clot formation, increased blood pressure, and increased risk for heart disease. Additionally, the initiation of several types of cancer has been linked to inflammation; particularly liver, colon, lung, esophagus, and cervical cancers. Around the bones, inflammation leads to joint pain and can aggravate some forms of arthritis. Inflammation of lung tissue worsens asthma and allergies and, in the brain inflammation is linked to depression, dementia, ADD, ASHD, and Alzheimer’s disease.
It is possible to recover from metabolic syndrome. Strategies for recovering include:
- Increasing activity levels to help burn off incoming calories.
- Strength training to promote fat burning in the fat cells.
- Eliminating refined foods and eating a whole food diet rich in fruits and vegetables.
- Greatly reducing the intake of vegetable oils.
- Increasing food sources high in omega-3 fats.
- Taking omega-3 EPA/DHA supplements.
The OPTIFAST® Weight Management programs at Kaiser Permanente help people to make these dietary and lifestyle changes. Using liquid OPTIFast meal replacements, the program helps people gain rapid results in improving their health. Seventy four percent of people with type-2 diabetics, who complete the program, are able to achieve a remission and discontinue all diabetes medication. Two-thirds of participants who begin the program with elevated blood pressure are able to discontinue or greatly reduce their blood pressure medication. Those with elevated blood cholesterol levels experience an average drop in total cholesterol of 81 points; allowing many to either greatly reduce or discontinue blood cholesterol medication. In addition many people experience relief from allergies, asthma, migraines and joint pain.
The good news is even small amounts of weight loss are beneficial and Kaiser Permanente offers many resources to help. The best way to learn about all of these options is to attend one of the free information sessions held weekly at the Positive Choice Wellness Center (see website or call for dates and times). You can view program fees and details by clicking on the Download Weight Program Information icon on the lower right corner of our home page. Weight loss and maintenance are certainly not easy, but your health is worth the effort. Never hesitate to have a conversation with your medical provider about how weight loss may benefit you.
OPTIFast® Weight Management Programs These multi-disciplinary, medically supervised weight management programs provide intensive nutrition, fitness, and behavioral intervention for the recovery from obesity and inflammation, as well as support for the psycho-emotional aspects of over-eating and obesity. People lose weight using liquid meal replacements.
Slim Down Naturally This program combines fitness, mediation for stress management, and a food plan based on whole, natural foods to promote weight loss.
Ask-A-Dietitian/Fitness Forum Dietitians and exercise physiologist guide you into a whole food diet incorporating healthy fats. This service is free and offered at the Positive Choice Wellness Center Monday through Thursday from 5 to 5:30 p.m. and Tuesdays 11:45 a.m. to 12:15 p.m. Walk-ins are welcome.
Wellness Coaching by Phone – This service is for Kaiser Permanente members who prefer support on the go with flexible appointments. Receive wellness coaching over the phone for weight loss and healthy eating. You must be a Kaiser Permanente member to participate in this service. Call 866-862-4295.