Gut Health! Don't overlook the importance of healthy waistlines

Welcome back!  

This week we're looking at gut health!  We would be remiss to not explore the health risks associated with an unhealthy waistline.  Obesity alone carries many serious health risks, but experts have been telling us for decades that belly fat has unique risk factors if not in proportion to the rest of the body fat distribution in the body.  As the waistline goes up IN RELATION TO OVERALL BODYFAT, so does risk of serious disease risks, including heart disease, diabetes, many cancers and dementia.  But it may be a confusing message to digest, so let's explore!

Location, location, location

 What makes the midsection uniquely situated to increase those risks?  It has to do with two distinctly different locations of fat accumulation: 

• SUBCUTANEOUS - the fat the lies underneath the skin.  In terms of the midsection, it is between the skin and the abdominal wall. This is the type of fat that can be seen and felt all over the body.  Subcutaneous fat, while unhealthy in large amounts, is relatively benign, compared to it's ugly cousin:
• VISCERAL - visceral means "between organs".  This is the fat that accumulates deep within the abdominal cavity and pads the space around the PANCREAS, LIVER, and INTESTINES.  Remember, fat is metabolically active tissue, meaning it releases hormones, and ultimately acts as an endocrine gland.  Additionally, when these fat cells break down, they literally shower the pancreas with lipids and other substances,  and then infiltrate the PORTAL VEIN (the major blood vessel coming out of the pancreas leading to the liver)  in concentrated quantities.  This overload of fat cells (lipids) into the bloodstream can lead to blood LIPOTOXICITY​

Lipotoxicity disrupts production and sensitivity to insulin (the hormone that is produced by the pancreas to deliver glucose into muscle cells) and disrupts other normal regulatory functions.   Further, when these cells die, it incurs an INFLAMMATORY RESPONSE (by release of inflammatory cytokines - previously discussed in this BSNF blog post).   Inflammation alone further compounds the health risk with it's own long list of health risks!  This disruption in regulatory functions and inflammation, in a nutshell, is where the elevated health risk comes from.  

Measure up!

Waist measurements 35 or more inches for women or 40 or more inches for men, are the typical markers where increased risk is introduced, and chances are you’re harboring a potentially dangerous amount of abdominal fat.  Run a tape measure around the upper part of the ilium (hip bone).  Relax completely, and exhale before reading the accurate mark of the tape measure.

Facts are stubborn things

-John Adams

Here are some stubborn truths about visceral fat that may surprise you.  Be sure to read the GOOD NEWS towards the bottom of the post

• We are born with many biological factors contributing to visceral fat accumulation.  Genetics, birth weight, ethnic background, and gender can affect visceral fat accumulation. 
  • Native Americans, Pima Indians, Hispanics, and people living in India and South Asia have a higher likelihood of abdominal obesity (as well as type 2 diabetes).  
  • White men and black women tend to accumulate relatively more visceral fat compared with black men and white women. M
  • Menopause, and having children can contribute to female risk
  • Men have a higher tendency to accumulate abdominal visceral fat compared to pre-menopausal women,  and is mainly due to the higher dietary fat uptake by their abdominal visceral fat (sourced here).   Men create more, and bigger, transport modules called CHYLOMICRONS, and thus carry more fat to the visceral areas.  See the image below comparing male and female. 
  • As women go through their middle years, their proportion of fat to body weight tends to increase — more than it does in men — and fat storage begins favoring the upper body over the hips and thighs.
• Subcutaneous fat is far less metabolically active than visceral fat- it can even release some beneficial substances, including the hormone leptin (the hormone that indicates the FULL feeling when eating).  
• A common misconception is that beer consumption can specifically lead to belly fat accumulation. This misconception gave rise to the term “beer belly.”  Beer, like all calories, contributes systemic weight gain (sourced in this study)
• ​​You do NOT have to be overweight or obese to face these hazards if you harbor excess fat inside your abdomen. Even people of normal weight can accumulate harmful amounts of hidden fat beneath the abdominal wall.
• The mechanisms that create visceral fat can differ than it's subcutaneous counterpart.  This means that it may demand more rules to eliminate/prevent it's formation, than simply calories in/calories out!  Stubborn indeed!
• Of course,  no amount of sit-ups, crunches, or planks will address visceral fat.  Spot reduction is not a thing, no matter how much you might feel like it works!  It still follows the systemic mechanism as normal weight management (of course, possibly with different approaches)

 Male VS Female. sourced here

• It helps to know your shape!  The "pear shape" is healthier than an "apple shape", in terms of carrying bodyfat

Good news!  Lifestyle can overcome our predispositions!

Here are some ways to counteract our biological drives to create visceral fat.  This is especially important for those already dealing with a 

• Exercise.  Exercise. Exercise!  Both cardiovascular activities and strength training help slow down formation, and help manage healthy levels
• Limit carbohydrates, especially simple sugars, white rice, and starchy foods.  
• It has been shown that Intermittent fasting or time-restricted eating may also help improve your body's insulin response and reduce visceral fat.  Start with several days per week with the popular 16 and 8 rule (fast for 16 hours, and eat normal amounts within an 8 hour period)
• Spread out consumption of dietary fats throughout smaller meals.  Based on mechanisms highlighted in this study, spreading out the amount of dietary fat intake into several smaller meals should reduce the likelihood of abdominal visceral fat accumulation by reducing both the size and number of CHYLOMICRONS (those cells that carry lipids from small intestine to visceral areas)
• Move as much as possible, and avoid sitting for long periods
• DON'T SMOKE
• GET MORE SLEEP!  Can't state this enough.  A rested body is a healthier body!  You need 8 hours - this is no myth.  Yep, even you.

Thanks for hangin out with me as we discuss this very important topic!  This is EVERYONE's business, not just those already living with unhealthy waistlines.  Keep that gut healthy!

Until next time...