How Many Notches in Your Belt?

I had planned to read a magazine to pass the time at my CEU meeting on Monday. Instead, I found myself taking pages and pages of notes and actually learning a great deal about fat cells and disease. And it scares me to death to think what is happening to our collective health. Here is another subject where most folks are willfully ignorant–until it’s too late.

Being obese is not just about carrying too many pounds. We all know in a vague sort of way that as the pounds add up, so too do our risks of insulin resistance and diabetes, heart disease, sleep apnea and metabolic syndrome. And your risks correlate quite closely with your VAT.

VAT–Visceral Adipose Tissue: the fat deposited in–not over the top of–your abdomen. (In the greater omentum and mesentery of the intestines, if you must know the details.)

As your gut fat goes, so goes your health. Why? Because THIS particular fat population has a limited capacity to accomodate fatty acids in your blood. Past a certain critical point (which we don’t yet know how to measure or predict) your VAT sends fat out to the muscles, the heart, the pancreas and liver. This increases the likelihood of changes in insulin receptors body-wide, making insulin less and less effective at getting sugar into the cells. (Insulin resistance)

Currently held rule of thumb–or of girth, perhaps–from the American Heart Association: you have reached (and already been living with increasing levels of disease risk of VAT) if your waist reaches 40″ (guys) or 35″ (gals).

SCAT–subcutaneous adipose tissue–is what you wear under the skin, in your hips and thighs, for instance. It metabolizes fat differently, and can even make more fat cells to accommodate for a high fatty acid load in the blood.

You are at much less risk from a big butt than a big gut. Hence, the “apples and pears” body shape understanding of disease risk from obesity.

Understand too that fat tissue is not simply so much lard. These are living cells, and collectively we know now that adipose tissue is an endocrine organ: it secretes very many hormones not even known when I was learning my human biology in the Pleistocene: leptin and ghrelin (produced by the gut) are hormones that regulate hunger and satiety in the brain (and are involved in the relationship between obesity and sleep!); and adiponectin, a powerful metabolic protective hormone that comes from fat, but paradoxically diminishes as one becomes more obese.

The too-obvious everybody-knows take-home message: avoid adding those extra inches under your belt. It could save your life. If it’s too late for you, for gosh sake, don’t let it happen to your kids or grandkids.

For the truly nerdly, this is a great article from Nutrition and Metabolism on the differences between VAT and SCAT. Send it to a medically-oriented person you know.

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Fred First holds masters degrees in Vertebrate Zoology and physical therapy, and has been a biology teacher and physical therapist by profession. He moved to southwest Virginia in 1975 and to Floyd County in 1997. He maintains a daily photo-blog, broadcasts essays on the Roanoke NPR station, and contributes regular columns for the Floyd Press and Roanoke's Star Sentinel. His two non-fiction books, Slow Road Home and his recent What We Hold in Our Hands, celebrate the riches that we possess in our families and communities, our natural bounty, social capital and Appalachian cultures old and new. He has served on the Jacksonville Center Board of Directors and is newly active in the Sustain Floyd organization. He lives in northeastern Floyd County on the headwaters of the Roanoke River.

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  1. The sleep thing is very interesting. I wonder if that means there is a relationship between the thought-to-be-hormone-related insomnia suffered by many menopausal women and the tendency to put on weight more easily than before at that time of life. One of those things it’s interesting to know, but perhaps important to contextualise as just one factor among many. Lying awake in the middle of the night thinking ‘this is making me not just tired but fat’ is clearly not a useful way to go!

  2. Ironically, of course, the NY Times published this article today saying:
    “Linking, for the first time, causes of death to specific weights, they report that overweight people have a lower death rate because they are much less likely to die from a grab bag of diseases that includes Alzheimer’s and Parkinson’s, infections and lung disease. And that lower risk is not counteracted by increased risks of dying from any other disease, including cancer, diabetes or heart disease.”

    It’s disheartening (no pun intended) to think of how many people will misinterpret this one scientific study…

  3. You are so right, Jes. I haven’t read the article yet, but being “overweight” (HOW MUCH overweight?) and having excess VAT may be two different things, and if they didn’t segregate subjects in the study according to abdominal girth or body type, the results are suspect in my book.

  4. I watched a PBS show with Dr Roizen MD. I also have his book “You Staying Young”. It’s all about the omentum, and how dangerous it is to be fat around the middle, (or inside the abdominal cavity). And that’s exactly where I have a tendency to carry fat.

    I have decreased some of the oemntum, with diet and exercise, over the past couple years. Diet doesn’t mean eating less, it means eating right. Meaning lots of whole grain, which seem to attract some of the fat and remove it with the fiber from your body. Lots of fruits and veggies and substitute olive oil for butter, and other cooking oils. Actually Bertolli Extra Light Tasting Olive Oil is a very good sub for butter. I now dip my toast in Tasting OO instead of butter and my bagels in Tasting OO instead of cream cheese. And I actually think it taste better. I also cook with OO.

    I eat Cheerios, the orginal plain ones. Avoid the flavored ones, they have High Frucose Corn Syrup. If you must have some sugar, use Sugar in the Raw. It’s less processed, not good for you, but a better choice, and a little isn’t bad, it’s overuse that hurts. I use whole grain bread sometimes instead of regular bread. Haven’t quite found one I like as well as good old white bread, but I’m still sampling. I think Roman meal 100% whole grain is probably the best yet. Keep in mind it must say “Whole Grain” on the label. Whole wheat or multi grain, does not necessarily mean “Whole Grain”. It also has no HFCS (High Frucose corn syrup) which is another thing to AVOID. And it has no killer trans fats, that includes hydrogenated oils or partially hydrogenated oils.

    You really need to become a label reader. I have a list of words I look for that includs all the ones mentioned above, and if I find any one of them, the product goes back on the shelf. I even email those manufactures and complain about that ingredient being in their product.

    The next thing is exercising the abdominal muscles. The best one I’ve found is the Suzanne Somers Abdominal Track exercise. I don’t have her equipment, but I use a hand weight with the weights loosened enough to use as wheels. Get on your knees, hands in front of you holding each side of the weight bar and roll out away from your knees until you’re almost parallel to the floor, then using only the abdominal muscles pull yourself back to the starting postition. Don’t use your arm muscles. Make the old abs work. This is a great abdominal work out and it will work. Start out doing only 10 reps, wait a few days, to allow really sore muscles to recover then repeat. Adjust from there as suits you.

    And do weight training, to tighten flab and develope muscle. Start with 3 to 5 lb weights. Muscle burns more calories than fat which means you won’t regain fat as easily. Muscle won’t make you bulky Ladies, just tight, toned and shapely.

    I didn’t mean to write a book, but I happen to know a little about this subject and thought it might help someone. Another good sorce of info is, and

  5. Interesting. To apply that to our livestock, primarily pigs on our farm, they have very little of the VAT fat. It is almost entirely in the muscles (marbling), between the muscle layers (bacon) and SCAT (back fat). So that’s healthy.