Is All Fat Bad?

The Crucial Role of Adipose Tissue in Health and Disease Prevention

What is adipose tissue?

Adipose or fat tissue is often seen as a negative, but body fat is normal and healthy. Adipose tissue is thought of just as a storage organ; however, our fat tissue is an essential endocrine organ secreting numerous hormones, including leptin (one of the un-hungry hormones) and a very important adipokine (cell signaling molecule) adiponectin. Adiponectin is a potent anti-inflammatory molecule only secreted by fat cells and helps relax our blood vessels, among other functions. The problem comes when our fat cells don't work correctly, a core bodily dysfunction seen in the chronic disease of obesity. 

As we obtain lipids (fat) from our foods, droplets of lipids are usually stored in our adipose cells for later use. If we have a surplus of lipids, our adipose cells should multiply to manage this excess. However, in many people, the fat cells grow in size instead. When the cells grow in number, they continue to function normally, but when they grow in size, they begin to outgrow their blood supply, causing a lack of sufficient oxygen and cell malfunction, leading to the fat cells being "sick." These sick fat cells secrete proinflammatory factors, induce insulin resistance, inappropriately activate our immune system, and increase the chances of cancer cell growth. Once these sick fat cells can no longer store more lipids, these lipids start to deposit in and around our organs, slowly causing the organs to fail. The scale cannot tell how well fat cells are functioning; this is one of the reasons BMI and weight goals are very simplistic metrics and don't tell the whole story. 

How can you tell if your body fat is sick?

One method is to understand the distribution of fat. Fat around the hips, buttocks, and thighs is generally protective and does not pose health problems. In contrast, fat around the arms, abdomen, and organs (visceral fat) is dangerous, especially the latter. Waists of 38 inches or more have a 22 times increased risk of developing diabetes. This danger is partly due to the fat cells not responding to normal signaling. Usually, when we eat and intake sugar or dietary fat, our fat cells should stop releasing free fatty acids (free-floating lipids) and focus on extracting nutrients from food. Visceral fat is resistant to all these signals, continuing to release lipids, which then further deposit into organs, especially the liver. Measuring waist size or using a body composition machine are two ways to help figure out if the adipose tissue is unhealthy by seeing if and how much is located in concerning areas of the body. Because visceral fat is the most dangerous, liposuction procedures will not help with metabolic health risks since that fat is left behind. 

Excess body fat connection to other conditions 

Fat in the liver causes inflammation, oxidative stress, and the release of VLDL, which is bad cholesterol. Fat depositions in the liver will also lead to insulin resistance, meaning that the liver will not sense a sugar intake and continuously make more of its own sugar, as if in starvation. As more fat builds up in the liver, it can cause the liver to scar and eventually fail, leading to cirrhosis. In the pancreas, fat deposition causes insulin resistance, beta-cell dysfunction, which are the cells responsible for producing insulin, and even more inflammation. In the kidneys, fat deposition will cause high blood pressure, kidney stones, a high risk of kidney cancer, and kidney failure, eventually leading to dialysis. Lastly, fat buildup in the muscle cells will prevent them from metabolizing sugars and lipids normally. All of these issues together lead to metabolic syndrome, diabetes, high cholesterol, and heart disease. For every 1 kg (2.2 lbs) of excess weight, the risk of diabetes increases by 9%.

Why is it so hard to lose fat?

Insulin resistance, a common consequence of dysfunctional fat cells, can lead to a vicious cycle of further fat gain. This is because insulin not only brings glucose into cells but also acts as a growth factor, causing more cells to grow in the body, including fat cells and even cancer cells. Understanding this can help us realize the importance of managing insulin resistance for our overall health.

Conclusion

In conclusion, it is important to understand the role of adipose tissue in the body and its impact on overall health. Recognizing the dangers of unhealthy fat distribution, particularly visceral fat, can help individuals make informed decisions about their health. Managing insulin resistance and promoting healthy fat cell function is crucial for preventing various health conditions associated with excess body fat.

If you want to learn more or are concerned about your abdominal fat, schedule a call.