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Fat and Obesity Epidemic_Final

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>> Hi there, and welcome back. In this lecture, we're going to talk about a topic that might bring up a feeling of dread for your clients, body fat. While we often think of body fat as something we want to get rid of, it's important not to label all fat as bad. We can distinguish between two types of fat, the good fat that your body uses for survival and the kind that's bad for your health. What's the difference between the two? What does it mean for your health if you're obese? What does it mean to be skinny fat? We will answer all of these questions and discuss several theories on why fat can be so hard to lose. I encourage you to suspend judgment as we dive into this sensitive topic. This lecture is not a critique on body size. When we talk about the health issues that may be associated with obesity, this comes from a medically based standpoint. Being healthy is possible among all body types. When speaking with your clients on the topic of fat, be careful not to convey any judgments or negative messages about their bodies. With that said, let's talk about fat and how it's good for the body. Fat is a storage tank for energy. Your body stores fat in various ways. The fats that function as metabolic fuel are called triglycerides. These are stored in adipose tissue. Triglycerides contain three fatty acids that are linked to a glycerol molecule. There are also other fats in the body that serve various roles. Some fats help regulate body temperature, others make up our cell membranes, some are used to produce hormones, vitamin D, and myelin. Fat contains more energy than carbohydrates and proteins, but it's harder for the body to access. Sugar provides a quick spark, fat is like a slow burning fire. When adrenaline and cortisol are released in the body, one of the effects is lipolysis. This is the breakdown of triglycerides into fatty acids to be used by the heart, liver, and skeletal muscles. This happens for instance when blood sugar is low. Basically, the body is rounding up energy for use on quick notice when the stress response signals a potential threat. In the liver, fatty acids can be converted into acetyl coenzyme A or acetyl-CoA to be used as fuel. When a lot of acetyl-CoA is made, it forms ketone bodies. This is the process of ketosis which you've likely heard of if you've ever been on a low-carb diet. Ketosis is when the body runs off of fat for fuel instead of glycogen. In the short term, ketones are a fuel source when sugar is low, but too many ketone bodies in the blood may lead to complications. There are two types of fat stores in the adult human body, subcutaneous and visceral fat. Subcutaneous fat is the fat located right beneath the skin. It is the less threatening of the two types. Some clients may not like a little extra fat, but remind them that the body needs a layer of fat to be healthy. A person can have subcutaneous fat and still be very healthy. Subcutaneous fat keeps us warm and cushioned. When your body runs out of fuel, it turns to subcutaneous fat, since it stores more glucose than visceral fat. Visceral fat is a collection of adipose tissue found around the organs. It's that stubborn fat that's hard to lose. This is the type of fat that can cause health problems. It has less storage for sugar and is a bigger predictor of insulin sensitivity. Visceral fat is metabolically active. This kind of fat increases leptin, the hormone that signals fullness. When the body has plenty of energy but it keeps increasing leptin, it can become resistant to it. The signal telling the body to eat less is no longer reliable and more easily disregarded. Over time, the brain no longer registers leptin. High levels of visceral fat often go hand in hand with insulin resistance, increased cortisol production, and an overconsumption of calories, especially carbohydrates. The bad news about visceral fat is that it's hard to lose. Subcutaneous fat can be lost relatively easily by eating a healthy diet and being mindful of portion size. Weight loss must be slow and steady. Severe calorie restriction can also decrease subcutaneous fat, but it may actually increase visceral fat, another reason to avoid crash diets. We're going into this in more detail later on. This takes us to obesity. Obesity is now considered an epidemic. In the United States, anywhere from 34% to 37% of adults and up to 20% of children are obese. To put this in perspective, in the early 1960s, less than 15% of the adult population was obese. Obesity is linked to high blood pressure, diabetes, arthritis, and certain cancers. Obesity is roughly defined by the ratio of a person's height to weight. Obesity is considered equal to or greater than 30 kilograms per meter square. This is definitely a flawed measurement that doesn't take factors like muscle mass into account, but when taken with a grain of salt, it can be somewhat useful. Obesity or any amount of extra weight isn't so straightforward. As I mentioned earlier, being healthy is possible among all body types. Individuals who are overweight but exercise regularly and eat healthful foods are not necessarily more likely than a person of so-called normal weight to die young. Physical activity and social connection are more predictive of a longer life than being the "proper weight." A person can also be thin and in poor health. Have you ever heard the term skinny fat? A thin but sedentary individual who eats a poor diet is just as much at risk for health issues as a person who is overweight. This is directly related to the difference between subcutaneous and visceral fat. A person who is skinny fat typically has more visceral fat than subcutaneous fat and low muscle tone. A person's size doesn't necessarily indicate the amount of visceral fat they have. Again, the problem is when a person has too much visceral fat that's connected to a poor lifestyle. An excess of unhealthy fat can impact the immune system as the result of inflammation. It also can affect the gut barrier leading to leaky gut. Now that we've covered the basics of fat and the health risks associated with visceral fat, let's talk about why it can be so hard to lose. The set point theory is the idea that the body generally works to hold a stable weight. A set point for weight is determined by genetics and nutrition, in utero and shortly after birth. As an adult, it's also influenced by a person's level of physical activity, stress levels, and exposure to toxins. The idea behind this theory is that the body fluctuates between a negative and a positive energy balance, always trying to find its way back to the set point or a range where the body feels stable. When body weight increases beyond the set point, it sends a metabolic signal to decrease food intake and increase the body's energy expenditure. When weight decreases below the set point, there is a signal to increase food intake and conserve energy. These feedback loops are controlled by the nervous and endocrine systems, and particularly the hypothalamus in the brain. This theory could explain why dieting or calorie restriction usually fails in the long run. Weight loss triggers hunger and a slower metabolism. It may ultimately lead to abdominal weight gain due to the triggering of stress hormones that occur with caloric restriction. But the problem with set point theory is that it doesn't explain the steady rise in obesity that's been occurring over the past several decades. We see that weight gain can snowball into a pattern of overeating and sedentary behavior. It's possible that there are additional factors that interfere with the person set point. Another possible theory known as hedonistic theory, says the brain's reward center can drive weight gain without a change to the set point. The idea is that certain foods, like those that are processed and high in refined sugar can disrupt the reward centers in the brain, and this may influence long-term excess caloric intake. It's like how the brain reacts to drugs. Sensitivity to the reward, particularly from a certain food becomes reduced. As a result, more and more is needed to achieve the same satiated feeling. If you've ever polished off an entire pint of ice cream or found yourself unable to stop eating a bag of chips, you can probably relate. According to these two theories, there are two types of obesity, metabolic obesity, is where the set point for energy balance rises. This can be caused by dysregulation or desensitivity to hormones that regulate hunger and satiation. This can also be what's referred to as "skinny fat." Hedonistic obesity is when chronic intake of excess food, driven by the brain's reward centers overrides the set point. This is the concept I just explained where sugar and certain foods can have an addictive effect on the brain. In either case, when it comes to healthy weight loss, it seems to be more effective to focus on the quality of food rather than on caloric restriction. For instance, an increase in vegetables and other nutritious whole foods while crowding out nutritionally empty but calorically dense foods often yields the greatest success. This still leaves lots of room for bio-individuality within one's diet. Lastly, let's talk about the relationship between obesity and inflammation. Tissue inflammation is associated with obesity. The idea is that adipose tissue releases proinflammatory cytokines, but this isn't caused by eating fat contrary to popular belief. It has to do with the way the body stores fat. In fact, the rate of obesity has continued to rise while the percentage of calories from fat in the average US diet has decreased somewhat since the 1970s. In the meantime, the consumption of carbohydrates, especially sugars and refined flour has increased. So it doesn't add up to blame the increase in obesity on high fat consumption. It may be that the typical Western diet, high in both poor quality fats and refined carbohydrates could be responsible for inflammation. These foods negatively influence the microbiome which can lead to inflammation. Processed carbs also spike blood sugar and insulin levels resulting in both inflammation and weight gain. If a person becomes insulin resistant and they try to control the problem by adopting a low fat high carb diet, this will add further insult to injury. Inflammation can cause weight gain and weight gain can cause inflammation. There are several ways that inflammation can influence weight, including leptin resistance and insulin resistance. Leptin is the hormone that signals to us that we're full. When this signal doesn't register, this can lead to overeating. Insulin resistance causes the body to store more fat. And as I mentioned, obesity can cause inflammation. Excess weight causes an over production of proinflammatory cytokines. One theory is that the body reacts to the excess fat as it would to a pathogen or invader. When bacteria in the microbiome are inflamed, this promotes obesity. Modern research is finding that bacteria do play a role in our weight metabolism. But remember, we can change our bacteria by changing our diet and lifestyle habits. Now let's recap, fat is necessary, it's a source of fuel for the body. But too much visceral fat can lead to a variety of health problems. This type of fat is difficult to lose and may cause inflammation. There are several popular theories that exist regarding how the body loses and gains weight. Regardless of which theory you subscribe to, eating a healthy diet and exercising regularly can do more good than calorie restriction. Blood sugar, weight gain, and inflammation are all connected. The problem isn't they were eating too much fat, rather the quality of our foods and the amount of refined carbs and sugars that we eat may be the real issue. A healthy lifestyle can go a long way when it comes to promoting physical wellness. What has been your experience working with overweight clients who struggle with weight loss? Have you ever considered their blood sugar or inflammation when coaching them? How has this conversation gone with your clients? Share your experiences in the Facebook group so we can get a great discussion going. That's it for now, I'll see you soon.

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Duration: 12 minutes and 46 seconds
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Language: English
License: Dotsub - Standard License
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Views: 7
Posted by: ninaz on Mar 27, 2018

Fat and Obesity Epidemic_Final

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