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“Avoid Fats!” “Eat a low fat diet!” “Decrease your fat intake!”
For the past 40 years that has been the mantra for preventing heart disease and staying healthy. We have built entire industries on low fat foods. “Low fat” or “Fat Free!” is now a major food marketing strategy.
But for more than 25% of the adult US population, a low fat diet may actually increase their risk for heart disease, diabetes, high blood pressure and even some cancers. The accepted wisdom of avoiding fats at all costs may actually be killing you.
Part of the problem is that a “low fat diet” may not properly distinguish between bad fats that you should limit and healthier fats that may actually be beneficial. But there is an even more dangerous way that reducing the fat in your diet can harm your health. It has to do with what you substitute in place of the fat.
Let’s assume you are an average adult male and take in about 2,500 calories per day. You decide to go on a low fat diet and cut your fat intake by a third. If 30% of your daily calories were previously coming from fat in your diet (about 750 calories per day), eliminating one third of those fat calories would drop your daily intake by 250 calories.
Taking 250 calories a day out of your diet would translate into a weight loss of about ½ lbs per week. Of course, you are not going to starve yourself and waste away to nothing for your low fat diet. So naturally, you end up substituting other sources of calories for the lost fat calories. Most protein sources tend to come with fat, such as meat and dairy products. So most likely, the source of the replacement calories will be carbohydrates. Low fat diets tend to lead to a high carb diets. And here is where the risks start to increase for many of us.
Dietary fat tends to satisfy the appetite longer than a comparable number of carbohydrate calories. So a high carb diet often means you are hungrier and eat more calories per day, contributing to gradual but steady weight gain.
Even worse, many of us carry a genetic predisposition to problems with how our bodies handle carbohydrates . Your genes load the gun but it is your lifestyle that pulls the trigger. Combine that genetic predisposition with weight gain, increased carbohydrate intake and the typical American lack of physical activity and you start on a dangerous downhill spiral.
The process starts by developing a condition known as Insulin Resistance. It ends with increased abdominal fat, hypertension, Type II Diabetes, premature heart disease and strokes and cancer.
Every cell in the body requires energy to perform its functions. The body’s primary fuel is glucose, the sugar in your blood. After you eat, the level of sugar in the blood rises. How fast it rises and how high it will go depends on how much and what kind of carbohydrate is in the food you eat. In response, the hormone insulin is produced to tell your cells to transfer the sugar from the blood into the cells for storage and the production of energy.
Individuals with insulin resistance make insulin without a problem, but their cells’ response to the insulin is impaired. Their cells, especially the fat cells in the area surrounding the internal organs (the so called “visceral fat” and the liver), and to some extent the fat surrounding the skeletal and heart muscles, become “resistant” to the actions of insulin.
If your cells do not respond to insulin your body reacts by “pushing even harder on the pedal” and producing more insulin to overcome the resistance. With insulin resistance, the circulating insulin levels are elevated. In the early years of the condition, the higher levels of insulin may be sufficient to keep the blood sugar within the normal range. But the downhill spiral has begun.
High levels of insulin may be damaging in many ways.
One of the most dangerous is that it leads to increased deposition of Visceral Fat, the fat around the internal organs inside the abdomen. Fat deposited under the skin, Subcutaneous Fat, is actually a benign form of calorie storage. While you may not like the way it makes you look in a bathing suit, Subcutaneous Fat does not increase your health risks.
Visceral fat is truly evil. Visceral fat is metabolically active. It increases the production of inflammatory substances in the bloodstream. It converts testosterone into estrogen in men. In women, it converts beneficial forms of estrogen into types of estrogen associated with increased breast cancer risk.
Even worse, the more Visceral Fat you have the more you become insulin resistant. And the more insulin resistant you are, the more your insulin levels increase. The higher your insulin levels, the more Visceral Fat you accumulate.
As the insulin resistance worsens other problems start to appear. Your triglycerides go up. Your HDL, the good type of cholesterol, goes down. Your blood pressure starts to rise. At this point, the condition is referred to as Metabolic Syndrome. By now, your risk of developing coronary artery disease has already increased 2- to 4-fold.
Ultimately, no matter how much insulin you produce it can’t overcome the resistance and your blood sugar starts to rise out of control. The American Diabetes Association defines a normal fasting blood sugar (that is a measure made usually in the morning after an overnight fast) as <100 mg/dl and a fasting blood sugar above 126 mg/dl as diabetes. It may have taken you 10, 15 or 20 years to make this journey but what started with the best of intentions and a typical American lifestyle has now caused your blood sugar to hit 140 and you are officially a Type II Diabetic.
Type II Diabetes was once considered a disease of old age. But with childhood obesity on the rise, and high carb diets becoming the norm, Type II Diabetes cases are now found at almost any age. The only common factor is that 80% of Type II Diabetics are overweight and physically inactive.
The good news is that Insulin Resistance is both treatable and preventable. The most important step is early detection.
Unless you have a CT scan or MRI, you cannot know for sure how much visceral fat you have. You can get an approximation by measuring your waist. A waist measurement over 35 inches for women or 40 inches for men may be a warning sign of excess Visceral Fat and developing Insulin Resistance.
Other warning signs can include high Triglycerides or low HDL levels in your blood tests. Hypertension can also be a warning sign.
Fortunately, Insulin Resistance can dramatically respond to simple modifications in lifestyle. The therapy for Insulin Resistance often needs to be highly individualized.
Specific exercise programs can be implemented based on measurements of muscle mass, function and aerobic fitness.
Dietary modification is key. A low glycemic index, low carbohydrate diet coupled with an individualized plan for appropriate caloric intake is usually best.
Several nutritional supplements can also be used to help reduce insulin resistance.
Reducing Visceral Fat is a critical step in stopping the spiral. Dieting alone is usually not sufficient. An overall, integrated approach is the most effective to prevent high blood pressure, lower cholesterol values, return fasting and non-fasting blood sugars to normal or near normal ranges, and to reduce the risk of heart and vascular disease more significantly than any known drug prescribed by your doctor.