A brief outline of how inflammation is responsible for the obesity epidemic and the idea that reducing caloric intake to lose body fat and get healthier is flawed.
2. What is the most basic principle of
weight gain?
3. 1st Law of Thermodynamics
ΔU = Q - W
Body Fat
=
Food eaten
-
Energy Expended
The amount of energy stored within a
system is equal to the amount of energy
put in minus the energy expended
4. The facts of life
• Starting point
• You eat more and
exercise less
• You put on fat
• As a result your
metabolism becomes
unhealthy
• Then you become ill
(metabolic diseases)
5. And here’s what happens
• You eat more and
exercise less
• You put on fat
• Your metabolism
becomes unhealthy
• You become ill
(metabolic diseases)
6. st
1
Law of Thermodynamics
ΔU = Q - W
Body Fat
=
Food eaten
• Q and W must be independent
• A calorie is a calorie:
• ΔU is unregulated
• Q and W are under conscious control
-
Energy Expended
7. Then
• You eat too much and
exercise too little
• You put on fat
• Your metabolism
becomes unhealthy
• You become ill
(metabolic diseases)
8. Metabolically healthy obese
• A healthy subset
– Similar metabolic health
to lean people
– Around 6%
• We don’t know why
they exist
– Fat distribution
– Genetics…?
• They still have higher
mortality
9. The metabolically unhealthy
non-obese
Fatty liver
– Alcohol
– NAFLD
– Fructose (HFCS)
• Handled the same way as alcohol
• Genetics/Race
– Lean Indian mean 3-4 time higher
incidence of NAFLD and inflammation
• Autoimmunity
– Type 1.5 DM
– ¼ lean diabetics produce the same
antibodies found in T1DM.
• Stress
– Chronically elevated blood sugar
11. What is metabolic disease?
Symptoms
• Obesity
– Abdominal
• Insulin resistance
– High blood sugar
• Dyslipidemia
• Inflammation
– IDDM?
– NIDDM
12. More symptoms
• Sugar cravings
– Not relieved by eating
sweets
•
•
•
•
•
Fatigue after meals
Frequent urination
Increased thirst
Difficulty losing weight
Sexual dysfunction
13. If it isn’t caused by eating too much or
exercising too little then what is the
cause?
14. Metabolic disease is an autoimmune, chronic
inflammatory disorder involving a pathological
expression of the innate immune system
• Innate immune system
– Non specific first line of
defence
• Inflammation
– Response of the IIS to
infection and trauma.
• What causes it?
16. How inflammation causes metabolic
diseases
• Inflammation precedes metabolic disease
– 1/3 of Hep C patients get diabetes
– Rheumatoid arthritis sufferers are at higher risk
• Inflammatory proteins cause insulin resistance
– Mice injected with inflammatory proteins develop
insulin resistance
– TNF-a causes insulin resistance
• Inflammation in the brain causes leptin resistance
• Inflammation in the gut leads to both leptin and
insulin resistance
17. How metabolic diseases cause
inflammation
• Fat tissue releases inflammatory cytokines
– Catabolic breakdown of fat
– Not been selected against
• Genetic up regulation of inflammatory pathways
– Macrophages increase in number
19. How metabolic diseases cause
inflammation
• Fat tissue releases inflammatory cytokines
– Local catabolic breakdown of fat
– Not been selected against
• Genetic up regulation of inflammatory pathways
– Increased number of macrophages
20. And it’s not all about carbs
• Three types of fat
– Triglycerides
– FFAs
– Phospholipids
• Mitochondrial overspill
• Lipotoxicity
– Storing fat, the bad way
21.
22. So let’s add some of this…
•
•
•
•
•
Refined sugar
Dairy intolerance
Sweeteners
Processed fat
No fibre
• Healthier or sicker?
23. 1st Law of Thermodynamics
ΔU = Q - W
Body Fat
=
Food eaten
-
Energy Expended
The amount of energy stored within a
system is equal to the amount of energy
put in minus the energy expended
24. Weight loss 101
A. Calorie Reduction
• Slower metabolic rate
• Increased hunger
• Reduced desire to
exercise
• Higher inflammation
B. Metabolic Overhaul
• Higher metabolic rate
• Healthier
• Lower risk of disease
• Fitter
• Lower inflammation
• Forcing thinness
• Encouraging leanness
29. Then all you need to consider with
calories is this:
Are you hungry?
Yes? Eat
No? Don’t
Editor's Notes
What is the most important principle of weight gain?It’s calories isn’t it? It’s what the whole weight loss industry is based around. It’s all about avoiding calories to reduce the amount of energy going in. After all it makes sense, if you reduce the amount of energy in and maintain or increase the amount of energy out then you will reduce the amount of energy stored. In the body stored energy is largely fat, but there are other stores of energy. Your whole body is combustible fuel, your bones can be digested and so can your brain!In this seminar I will present my argument that calorie reduction is not the most important consideration for weight/fat loss
This is one of the most basic laws of physics. As far as we know it is true and it applies to everything in the universe, even the body. I don’t disagree with this at all. I would be extremely stupid if I did.I don’t apply Heisenburg’s uncertainty principle to my lunch when I’m aiming my cutlery, and in the same way I don’t apply the first law of thermodynamics to weight loss.
Here’s what happens.Crap theory doesn’t take into account any unconscious regulation. It assumes that the only way you can become overweight is either sloth and gluttony (or a combination of both). It doesn’t acknowledge hormonal influences, gut health, illness, or your resting metabolic rate
When you have to much fat mass you lose insulin sensitivity, and therefore you put on weight
Healthy response to high blood sugarThey are not at higher risk of developing T2DM or heart disease but are still at higher risk of cancer and all cause mortality
Up until recently, type 1 and type 2 diabetes were seen as distinct entities. It was understood that type 1 diabetes (or insulin-dependent diabetes) was caused by autoimmune destruction of the beta cells of the pancreas, leading to decreased insulin production, whereas type 2 diabetes was caused by insulin resistance of the liver, muscle and fat cells.However, recent research has demonstrated that the line separating these two conditions may be much blurrier than previously thought. It is now known that type 1 diabetes, which normally begins in childhood, may slowly develop later in life. This form is referred to as latent autoimmune diabetes (LADA) or more informally as type 1.5 diabetes.
Let’s start from the top, what actually is metabolic diseaseMetabolicdiseases is a lifestyle disease, which is caused predominantly by the lifestyle you lead. It’s all that’s left when you take away the threat of bacteria and viruses as a cause of death. It is the final hurdle to living healthily until the end of your life, and dying a ‘natural death’.
The treatment in most cases is to reduce the calories and the fat, because it follows logically that if you want to reduce the amount of fat in your body you should reduce the amount of fat that you put in. This approach has clearly been a dismal failure. Diabetes is not a simple maths equation do to overexposure to sugarsDiabetes can be reversedNormal is not healthyYou can still get all metabolic diseases if you are not obese
Up until relatively recently, fat was considered an inert tissue with no biological activity. The idea was that it was just, well, there. It didn’t do much other than store excess energy.We now know, however, that fat tissue is a metabolically active endocrine organ that secretes hormones and inflammatory cytokines such as IL-6 and TNF-α. The metabolic activity of fat is the key to understanding its role in diabesity.
Up until relatively recently, fat was considered an inert tissue with no biological activity. The idea was that it was just, well, there. It didn’t do much other than store excess energy.We now know, however, that fat tissue is a metabolically active endocrine organ that secretes hormones and inflammatory cytokines such as IL-6 and TNF-α. The metabolic activity of fat is the key to understanding its role in diabesity.
In healthy people, FFAs are burned in the mitochondria soon after release (lipolysis) from storage forms of fat (triglycerides and phospholipids). But in the diabese, inflammation, leptin resistance and oxidative damage impair the mitochondria’s ability to burn fats. The excess FFAs then “spill over” into non-fat tissue like the liver, pancreas and skeletal muscles. FFAs damage these metabolically active tissues because they don’t belong there. This is called lipotoxicity. Lipotoxicity has been shown in several studies to cause insulin resistance and increase the risk of T2DM.
I don’t disagree with this at all. I would be extremely stupid if I did but it requires a few assumptions to practically apply to obesity:Q and W must be independentIn practice q affects w. If you eat more food then your energy expenditure will increase. 2. W must be a single form of work. In practice W is EAT and NEAT. In practice NEAT affects EAT and vice versa. If Q stays the same and EAT increases then NEAT will decrease to adjust. 3. A calorie is a calorie: Q affects W depending on macros. Protein requires more NEAT than carbs and fat. 4. ΔU is unregulated