“When we eat so much and work so little that we repeatedly generate reactive compounds at levels normally reserved for emergencies, we treat our own cells like invading microbes.”
–Carl Nathan, Cornell Medical School
Most people think the worst thing about being obese is how it makes you feel and look less than your best. In fact, the most dangerous thing about excess body fat is how it fuels chronic inflammation and disease.
There are two types of inflammation in the human body:
1) Acute inflammation is life-promoting, helping to fight infection or heal a wound.
2) Chronic inflammation is life threatening, killing cells and mutating DNA throughout the body. This is the type of inflammation that occurs with obesity.
In order to get a handle on the obesity-inflammation connection, it’s important to understand the biochemistry of body fat.
Fat cells in the human body are called adipocytes. There are two kinds of fat cells: Subcutaneous and Visceral fat cells:
1) Subcutaneous fat is below the surface of the skin and can be pinched with fingers, or calipers when measuring body fat.
2) Visceral belly fat is inside the abdominal wall, below the muscles and can’t be measured with calipers. It is the fat that makes up the “beer belly,” and is associated with the “apple” appearance in which people are large around the waist but leaner in the legs and arms.
Losing visceral fat will decrease your waist circumference and make you look much leaner around the middle, but it won’t get rid of fat at your belly button—that’s subcutaneous fat.
Visceral fat is a big problem because the cells are metabolically active, functioning in a similar way as endocrine organs like the pancreas or adrenals, releasing hormones. Additionally, Visceral fat often gets stored inside internal organs including the liver, kidneys, and heart.
The unfortunate thing about visceral fat is that unlike other hormones that tend to have a beneficial biological effect, visceral fat produces compounds, known as adipokines and cytokines that harm cells throughout the body.
As adipokines interact with cells, they cause inflammation and disrupt the ability of your organs to function properly. For example, when adipokines interact with blood vessels they cause inflammation in the arterial wall, which leads to hardening of the vessels and heart disease. Adipokines also go after the pancreas, harming the insulin-releasing cells, resulting in diabetes.
No organs get away free from harm: Your muscle, liver, kidneys, and central nervous system are all impacted by adipokines. For example, certain compounds cause dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, impairing your ability to respond to stress properly. This can lead to an elevated cortisol curve, which is linked to weight gain, fatigue, racing mind, and imbalances in other hormones.
Why Does Obesity Trigger Inflammation?
The process is not entirely clear, but one theory behind obesity-mediated inflammation is that when the body suffers an overload of nutrients it induces intracellular stress:
When you overeat calories, the body must store that excess energy in fat tissue. As fat cells “fill up” (known as hypertrophy), fat cells will multiply (known as hyperplasia), leading to a greater number of total fat cells. During hyperplasia, immunity is altered and fat tissue begins to secrete cytokines and adipokines that negatively affect the entire human body.
When adipocyte fat cells get overloaded, the immune system responds. Cytokines and adipokines set off alarm bells in the central nervous system, leading macrophages to infiltrate and harm tissue. Macrophages are inflammatory immune molecules that are lifesaving when they are the result of an acute injury, but harmful when they are chronically targeting healthy tissue.
Another factor is that as adipocytes enlarge, there is a lack of oxygen reaching body tissues (known as hypoxia), which activates immunity and stimulates inflammation.
How Does Inflammation Impact Metabolic Function?
In a lean person, hormones are carefully balanced. You eat and blood sugar rises, stimulating the pancreas to release insulin so that cells can use the energy from your meal. Insulin gives a message to the brain of satisfaction, telling you to stop eating. A few hours pass, blood sugar drops, your stomach empties out, and cortisol begins to rise to maintain blood sugar.
Cortisol along with other metabolic hormones, like ghrelin, stimulate hunger, telling you to eat again, and the insulin—satiation cycle happens all over. In an ideal world, you’d get just enough calories to keep you at a healthy, lean weight, without excess hunger.
Unfortunately, this process is easily disrupted by diets high in refined, nutrient-poor foods, especially processed carbs and fat. It’s easy to overeat these foods and they spike blood sugar and insulin. They also stimulate areas of the brain linked to pleasure and compulsion, leading you to seek out these foods even if your energy needs are topped off.
The excess calories from overconsumption get stored as fat, and over time, high blood sugar levels result in cells becoming less responsive to insulin. High insulin makes the body more likely to store calories as fat, but it also predisposes you to eat more: Remember that elevated insulin combined with high blood sugar (the response you get after eating a meal) has a satiating, hunger-reducing effect. On the other hand, high insulin and low blood sugar increase hunger and cause cravings for high-carb foods. At the same time, cortisol is often elevated, further stimulating food intake and fueling overeating and obesity.
At this point you are experiencing metabolic derangement and the excess body fat you have accumulated starts to secrete adipokines and cytokines, which target organs all over the body. Cytokines like C-Reactive Protein (CRP), Tumor Necrosis Factor (TNF), and Interleukin-6 (IL6) circulates in the blood, interacting with cells and DNA to spark inflammation. They harm blood vessels and impair insulin sensitivity, raising risk of heart disease and diabetes.
As insulin resistance develops, metabolic function is further degraded, leading to a cascade of negative effects. For example, the brain can develop a resistance to the hormone leptin, which is generally considered a beneficial adipokine because it blunts hunger in the brain. When leptin resistance develops, satisfaction from food becomes elusive and people are more likely to overeat, furthering fat gain and the obesity—inflammation cycle.
How To Stop The Obesity—Inflammation Cycle
Since your life depends on breaking the obesity—inflammation cycle, it’s worthwhile taking a radical approach. We’re going to go step-by-step through the process of adopting an anti-inflammatory diet that incorporates lifestyle habits and exercise to help you make it happen:
Create an energy deficit: Adopt a nutrition plan designed around whole foods that favors high-quality protein, healthy fats, and lower glycemic complex carbs.
Plan every meal around protein and a leafy green vegetables: Pair salmon with sautéed kale, chicken breast on a salad, or steak and cauliflower.
Eat healthy fats: Nuts, avocado, coconut oil, olive oil, or olives can increase your healthy fat intake depending on needs and preferences.
Avoid energy-dense foods that are easy to overeat: Eliminate refined carbs, other processed foods, and junk food, which drive up insulin, triggering inflammation.
Eat the rainbow: Get as many colorful fruits and vegetables to neutralize inflammation-causing adipokines and sensitize cells to insulin, helping to regulate blood sugar: Leafy greens, red and purple fruits and vegetables, berries, peppers, cruciferous veggies, kiwis, cherries, beets, radishes, citrus, and plums and other stone fruit, etc.
Avoid added sugar: Sugar consumption stimulates pleasure centers in the brain, while spiking blood sugar and leading to the release of free radicals that drive inflammation.
Cook with spices: Turmeric, ginger, cinnamon, cloves, and chilies can help you re-train your taste buds if you need help shifting away from processed foods, and they contain antioxidants that sensitize cells to insulin and help the body eradicate inflammation.
Avoid excessive alcohol: The process of metabolizing excess alcohol causes significant damage to the liver, which often leads to an increase in visceral fat in the belly.
Eat more omega-3 fats: The essential omega-3 fatty acids EPA and DHA from fish are associated with better body composition, less inflammation, and lower cortisol.
Replace omega-6 fats: In large quantities, corn, soybean oil, etc., stimulate food intake and lead to an increase in compounds called eicosanoids that mediate inflammatory responses. Instead, favor healthy fats from fish, avocado, nuts, olive oil, and butter.
Train with weights: Strength training maintains muscle during fat loss, while also lowering inflammation and resetting the HPA axis that regulates hormone release in the body.
Reduce stress: Create a schedule, do yoga, try a martial art, perform mental imagery, get a counselor or coach, seek out pleasurable, relaxing experiences, etc.
Meditate: A great tool for coping with stress, mindfulness activities like meditation or deep breathing improve the HPA axis and balance hormone release for lower systemic inflammation.
Take care of your gut: Compromised gastrointestinal health directly leads to elevated cortisol and visceral fat gain. Eat a probiotic food like sauerkraut, kim chi, and fermented milk or yogurt every day.
Get adequate sleep: If rest is a problem, opt for an early-to-bed, early-to-rise sleep schedule because this has been linked to less visceral fat and lower inflammation.
Eat foods that improve insulin sensitivity with higher carb foods: Vinegars, citrus, spices, and antioxidant-rich plants (blueberries and kale) all help store carbs as muscle glycogen instead of as fat.
Do sprint intervals for cardio. Intervals raise metabolic rate and help sustain muscle during fat loss. For example, try cycle sprints of 8 seconds each interspersed with 12 seconds rest for a total of 20 minutes.
Supplement with depleted nutrients: Lack of certain nutrients can fuel inflammation and lead to overeating: Vitamin D, magnesium, melatonin, fish oil, vitamin C, and alpha lipoic acid have all been shown to have anti-inflammatory effects in research.
Use curcumin: Found in the spice turmeric, curcumin can counter the inflammatory response associated with diabetes, cancer, and heart disease.
Be active in daily life: A sedentary lifestyle is linked to obesity and inflammation even in people who exercise regularly. Get your body moving throughout the day with frequent walks, stretching, stair climbing, and active transportation.