Fitness - Inside and Out, Illness and Conditions

Metabolic Obesity: Redefining Fat

When many of us think of fat, we picture folds and rolls that jiggle. The fat that the health and beauty industries market toward is that which is under the skin, otherwise known as subcutaneous fat. It’s the same fat that puckers through weak connective tissue grids creating what we call cellulite. While this fat is concerning from both an aesthetic and health oriented perspective, there is a far more insidious kind of fat not always visible on the outside who is responsible for a host of diseases in the long term. This fat is not assessed by volume like those caliper pinching tools used to tell you your overall body fat %, but by location. This is your deeper fat reserve – your visceral fat.

The how to of measuring one kind of fat…caliper in action

Visceral fat (also known as brown fat or metabolic fat) gets its name because of where you find it – nestled deep in the abdominal cavity surrounding organs (i.e. viscera) like the liver, intestines, pancreas and kidneys. It’s there as an energy back up for your vital organs as well as to cushion and protect them. Your body is hardwired to maintain this fat, unless there is a deficit (i.e. starvation or intense exercise). In fact, even when not starving, this fat produces substances that affect insulin levels and communicate with the liver to influence blood fat content ensuring that the vital organs always get fed. In a famine, this fat will be the first to go before your body resorts to breaking down surface fat, muscles and organs for fuel. Now, imagine that you have more than what you need of this highly active fat? It pumps out pro-inflammatory cells into your blood stream, since it has a tight relationship with a major blood vessel to the liver and heart. These cells cause insulin resistance which is the precursor to Type II diabetes as well as promote the development of heart disease, atherosclerosis (hardening of the arteries) and cancer of the bowel. Research even suggests that visceral fat increases production of the stress hormone, cortisol, and reduces levels of feel-good endorphins, leaving you feeling low on so many levels.

Being that it is so metabolically active, plentiful visceral fat is not the easiest to get rid of. This is also why people who have excess are now being termed metabolically obese regardless of whether they look lean or large. The tell tale sign of this excess in most people is the gut. While the gut is more prevalent in men who tend to have more fat stores in their belly region due to their hormones, menopausal women can also display this type of distention. Waist circumference will give you an inkling as to whether visceral fat is high; 35 inches or more in women and 40 inches and above for men. Another factor that affects visceral fat accumulation beyond gender and hormones is heredity/ethnic background. If people in your family tend to be apple shaped, meaning that more of their fat resides in the upper body, chances are your visceral fat is going to be higher. Following patterns amongst ethnic groups, it was found that excess visceral fat pops up in white men, African American women, Asian Indian and Japanese men and women most often. In addition, certain environmental factors play a role such as smoking and the consumption of compounds in food that mimic estrogen. Known as xenoestrogen or “foreign estrogen” they enter the body through the eating of plants and meats that have been exposed to or naturally contain these compounds and wreak havoc on hormonal levels which mess with visceral fat accumulation. However, many people suffer from metabolic obesity, as I noted earlier, without any outward sign of a large tummy. In fact, they might look pretty lean to the naked eye and register BMI’s that are in normal range.  The only way they find out their visceral fat is high is through an MRI or CT like scan, where the fat’s location can be clearly seen, as demonstrated in the below image. Of course, this is a costly test that is not always accessible or covered by insurance.

MRI Scan done in Britain of an outwardly thin person, who clearly has a large amount of visceral fat, as seen in the white regions of his abdomen (http://www.telegraph.co.uk/news/uknews/1536556/Get-in-touch-with-your-inner-fat.html)

 

So now that your perception of fat is altered, what can you do to reduce excess visceral fat? A 2007 study indicated that High-Intesity exercise was most effective when done at least 4-5 hours a week. Another added bonus for some of the individuals taking part in this study, when combined with dietary tweaking, was an overall reduction of their subcutaneous fat % thus putting BMI levels in normal range. I can’t think of a better prescription than food and exercise. Of course, the best people to consult with for said script would be a nutritionist or registered dietician and a personal trainer. The former for an overhaul of your diet and eating habits and the latter for the right training regimen. My personal feeling with respect to trainers is to do your research and look for someone who has a strong background (cumulative experience and/or degree) in exercise physiology or kinesiology to construct a program of exercise that best suits your body, fitness level and individual goals. Physical therapists and doctors that specialize in sports medicine can be great sources for referrals of this kind.

 

Fitness - Inside and Out, Massage Techniques Explained

Premenstrual fitness

I never miss a training day. My exercise schedule is rigid; conducted with a NO EXCUSES attitude. That is how I roll. No one has to cajole me out of bed, push me out of the house or leave threatening messages on my phone to scare me into fitness. When it comes to exercise, I have always been self-motivated. Twice a week, I do a combination of High Intensity Interval Training (HIIT) and strength/weight training with my trainer. Another two days of the week, I do some form of cardio mixed with cross fit and strength band/weight training on my own, either at home or at the gym. Everyday of the week, I manage to fit in at least 45 minutes to an hour of walking, stair climbing or overall hustling intermingled with my work as a massage therapist, which is a tremendous core strength builder. It’s fair to say that I’m tired by the end of my day, but the only time I truly feel the affects of all my activities is the few days prior to my period known as premenstrual syndrome or PMS for short. To say I am pooped would be an understatement. My body feels like it is made of lead. My balance and coordination are a joke; I can barely do a one legged squat without tipping over, which my trainer finds highly entertaining being that I have that martial arts/dance background and what not. My nutrition becomes spotty, as I crave the saltiest of salty and chocolatey of chocolate things, but get so nauseated that I end up eating less than what my body needs. Worst of all these symptoms is my emotional state, which fluctuates from absolute rage to bottom of my soul sadness. The former makes me want to break someone’s face and the latter, like I am falling to pieces mid-workout.

Training like a Spartan may not be the intuitive thing to do.

The 7 to 10 days prior to the arrival of the menstrual cycle and the first two days of the cycle itself can be unbearable for many women. Men can make all the snide comments and PMS jokes in the world; however hormones are powerful movers and shakers of a body’s state of balance a.k.a. homeostasis. These chemical messengers regulate many functions and processes; too little or too much of a particular hormone and things go haywire. Take for example human growth hormone, which ensures our bones, muscles and tissues grow us into adulthood and beyond. Having an over production causes Gigantism, where a person will grow to heights above 7 foot. Having too little will cause Dwarfism, a condition where a person is extremely short (well under 4′ 10″) with proportional body parts. With respect to PMS, it is the shifting of estrogen and progesterone that cause its symptoms and determine how acutely one experiences them. My clumsiness (aforementioned falling over during my workout), low tolerance for noises (I can’t take it when weighted plates and dumbbells get dropped after people finish their sets), difficulty concentrating/confusion (no, no you meant my other “left”), fatigue (lead body), aggressive behavior (god bless boxing and muay thai) and craving for excessive sleep are all symptoms that challenge my ability to workout and work effectively. Rather than ignore and try to push through, I found that I had to modify my definition of what would be effective fitness for this period of time (pun unintentional).

I loved Xena, my pseudo Greek warrior princess!

While sparring relieved some of the aggression I felt, trying to take someone’s head off left me vulnerable to shoulder injury. Hence, know when to use 20% of your strength and when to go full on. Instead of taking a 4 second break between sets, I grab my water bottle more often and take the time to breath through whatever meltdown I am feeling coming on; therefore getting it out of my system before continuing.  Again, I am avoiding injuring myself by pushing my body, but without sacrificing the level of workout I have set out to do. I also found that increasing my cardio (i.e. aerobic exercise) during this time helped me to get my appetite in check and jump-start my cycle without as much muscular cramping as I felt when I did more strength training and aggressive exercise. Since every body is different, it is super important to pay attention to what your symptoms are telling you and then, try modifying your activities to see what works for you. Ultimately, PMS should not be a reason to shy away from fitness. If anything, it will help put those hormones back in their bloody place (that one was intentional 🙂 ) per the American College of Obstetricians and Gynecologists.