8 Strategies To Reverse Skinny-fat Syndrome
“If I’m not overweight, do I need to become concerned about obesity and other health issues?” asks this week’s House Call. “Even though I drink soda and eat whatever I want, I don’t gain weight. Should I be worried?” The short answer is yes, and here’s why. One study published in the Journal of the American Medical Association found nearly one in four skinny people have pre-diabetes and are “metabolically obese.” In other words, about 25 percent of the population fit the skinny fat syndrome, also known as thin on the outside, fat on the inside (TOFI). Skinny fat means just what it sounds like: You look thin but inside you’re fat. You’ve got organ fat (the more dangerous type of fat) coating your liver, kidneys, and other organs. You are under-lean but over-fat, meaning not enough muscle and too much fat (especially belly fat). Most people assume if you’re overweight, you’re unhealthy; if you are thin, you are healthy. Unfortunately, the reality isn’t so simple. Yes, America has a big fat problem: almost 70 percent are overweight and many have diabesity, a condition I define as anywhere on the continuum between pre-diabetes and type 2 diabetes. Even though it might sound crazy, being skinny fat might become more dangerous than being overweight. Let’s say you go to your annual doctor visit and you are overweight or obese. He or she will probably run blood tests, become concerned about type 2 diabetes, and ask you to lose some weight. If you arrive thin, your doctor might not conduct those blood tests or otherwise acknowledge underlying issues. He or she might assume things are normal rather than checking under the hood for pre-diabetes and other problems that pave the way for detrimental repercussions. That’s unfortunate, since if you are Continue reading >>
Why Do Some People Stay Lean And Fit While Others Get Insulin Resistant?
Why are we lying about obesity? The answer to this and other questions – for example, why do some people stay lean and fit while others get insulin resistant? And how to measure blood sugar the best way? – in this week’s Q&A with Dr. Andreas Eenfeldt: Why do some people stay lean and fit on a CRaP diet while others gets insulin resistance? Dear Dr. Eenfeldt, My question to you concerns a question I in turn have gotten a number of times, when I’ve told people about why I fast and the tremendous overall health benefits of eating a LCHF/ketogenic diet. Why are some carb eaters naturally thin? I have many friends who eat a very unhealthy diet, with lots of sugar and other carbs, yet they are thin and look very healthy (on the outside). When I tell them about why I’m eating keto, and the effects on the body in terms of insulin spikes, the two-compartment model of carb vs. fat burning etc., it seems strange that their constant insulin spikes and excess calories of sugar and starches does not turn them fat? I am not overweight, but if I myself step off of my normal rather strict LCHF plus IF protocol, I gain weight (water + fat) rather quickly. Can I be more sensitive to carbs, or why is there this huge difference among people? I hope you can clarify this, as I feel that my arguments somehow “fail” when some people can eat unhealthy and get diabetes, while others can eat crap and still look fit! I would never go back to the CRaP diet 1 even if I “looked fit”, as I know how good it feels to live the keto lifestyle, but I would appreciate the help to sharpen my arguments! Thank you for all the great work everyone at Diet Doctor does! Kind regards, Martha Hi Martha! It’s very unfair, but there is a huge difference between individuals in how easily we get insul Continue reading >>
One-third Of Slim American Adults Have Pre-diabetes
Among normal-weight individuals, those who were inactive were more likely to have an A1C level of 5.7 or higher, which is considered to be pre-diabetic Among all the normal-weight inactive participants (aged 20 and over), about one-quarter were either pre-diabetic or diabetic When only those inactive people aged 40 and over were analyzed, the percentage rose to 40 percent Inactivity increases your risk of pre-diabetes even if you’re not overweight or obese By Dr. Mercola It's often assumed that in order to develop type 2 diabetes, you have to be overweight. While it's true that excess weight is clearly associated with insulin resistance and diabetes, it's the insulin resistance — not necessarily the weight gain — that drives the disease. As such, many people with a healthy weight are not metabolically healthy, putting them at risk of diseases like type 2 diabetes — even without being overweight or obese. One of the greatest risk factors, according to University of Florida researchers, is actually inactivity, which drives up your risk of pre-diabetes regardless of your weight. Inactivity Is Associated With Pre-Diabetes, Even if You're a Healthy Weight If you were looking for motivation to get moving, this study, published in the American Journal of Preventive Medicine, is as good as it gets.1 In a survey of more than 1,100 healthy-weight individuals, those who were inactive (physically active for less than 30 minutes per week) were more likely to have an A1C level of 5.7 or higher, which is considered to be pre-diabetic. Among all the inactive participants (aged 20 and over), about one-quarter were either pre-diabetic or diabetic. When only those inactive people aged 40 and over were analyzed, the percentage rose to 40 percent. The researchers suggested that peop Continue reading >>
‘obesity Paradox’: Why Being Thin With Diabetes Is A Dangerous Combo
Being overweight or obese is a risk factor for developing Type 2 diabetes, but it turns out that these heavier patients may have an advantage: people who are overweight when they are diagnosed with diabetes live longer than their thinner peers. The so-called obesity paradox, in which being overweight appears to be protective against early death, has been seen before in heart failure and chronic kidney disease. But, says study author Mercedes Carnethon, associate professor of preventive medicine at Northwestern University, that doesn’t necessarily mean that gaining excess weight is a healthy strategy; rather, it may be that people who are thin when they develop diabetes are already be vulnerable to worse health. “We hypothesized that their diabetes may be different,” she says. “They may have developed diabetes for reasons unrelated to obesity. Overall, about 85% of people with diabetes are heavy. Gaining too much weight is a major contributor to Type 2 diabetes, since excess fat cells can affect the way the body breaks down glucose and produces insulin, but some normal weight individuals can develop the disease as well. The elderly and people of Asian descent are more likely to be at normal weight when diagnosed, for example. (MORE: Doctors Should Screen All Adults for Obesity, U.S. Panel Says) For the new study, published in the Journal of the American Medical Association (JAMA), Carnethon and her team reviewed data on five previous studies that were tracking people for heart disease risk factors. The studies, which were conducted between 1990 and 2011, included 2,625 people who were recently diagnosed with diabetes, about 12% of whom were at normal weight. The lean patients looked metabolically similar to those who were obese, with the exception of their weight Continue reading >>
Think Skinny People Don’t Get Type 2 Diabetes? Think Again.
In the last article we discussed the complex relationship between body weight and type 2 diabetes (T2DM). We learned that although obesity is strongly associated with T2DM, a subset of “metabolically healthy obese” (MHO) people have normal blood sugar and insulin sensitivity and don’t ever develop diabetes. In this article we’re going to talk about the mirror reflection of the MHO: the “metabolically unhealthy nonobese” (MUN). These are lean people with either full-fledged type 2 diabetes or some metabolic dysfunction, such as insulin resistance. You might even be surprised to learn that skinny people can and do get T2DM. They are rarely mentioned in the media, and there isn’t much written about them in the scientific literature. Perhaps these folks have been overlooked because type 2 diabetes has been historically viewed as a disease of gluttony and sloth, a self-inflicted outcome of eating too much and not and not exercising enough. But the very existence of the MUN phenotype proves that there’s more to T2DM than overeating and a sedentary lifestyle. Remember that one in three type 2 diabetics are undiagnosed. It’s possible that a significant number of these people that are lean. They don’t suspect they might have T2DM because they’re under the impression that it’s not a condition that affects thin people. This is one of the biggest dangers of the myth that “only fat people get diabetes”. It’s well-known that high blood sugar can precede the development of T2DM for as long as ten years. It is during this time that many of the complications associated with diabetes – nerve damage, retinal changes, and early signs of kidney deterioration – begin to develop. This is why it’s just as important for lean people to maintain healthy blood s Continue reading >>
The Causes Of Insulin Resistance In Type 1 Diabetes, Type 2 Diabetes And Prediabetes (video)
Most people believe that people with type 1 diabetes are not insulin resistant simply because they are not overweight. This could not be farther from the truth. While insulin resistance affects many overweight individuals, many people with type 1 diabetes remain skinny their entire lives despite a large degree of insulin resistance (1–3). Over the past decade, I have helped many people with type 1 diabetes measure, track and reverse insulin resistance. In practice, 100% of all my clients with type 1 diabetes suffer from insulin resistance despite the assumption that they were insulin sensitive. By measuring their baseline insulin resistance, we were able to identify an impaired ability to utilize glucose as a fuel, and through dedicated diet modification and frequent exercise, some of my clients have reduced their insulin usage by as much as 60%. If you have type 1 diabetes, do not be fooled into thinking that you are insulin sensitive simply because you are skinny. Insulin resistance is a hidden condition, and affects both normal weight and overweight individuals (1–3). What Causes Insulin Resistance? Insulin resistance underlies all forms of diabetes, and is a condition which primarily affects your muscles, liver and adipose tissue. Many people think that diabetes is caused by an excess intake of sugar and candy starting from a young age. While eating artificial sweeteners and drinking soda can certainly increase your risk for the development of insulin resistance and diabetes, in most cases diabetes is caused by excessive FAT intake. The most important thing you can do as a person with diabetes is understand the following: Diabetes is caused by a fat metabolism disorder, which results in a glucose metabolism disorder. At the heart of all forms of diabetes is insu Continue reading >>
The Skinny On Insulin Resistance
For years weve been told to eat low fat foods, count our calories, to eat less and exercise more in order to lose weight. At Prolean Wellness, we hear over and over again from clients who have tried this and its not working for them. Some of them are actually eating less and seeing fewer results. What is NOT taken into consideration with calorie-counting weight loss programs is that the TYPE of food we eat makes a huge difference in our ability to lose weight. Many of the low fat foods we are eating to keep us thin have replace fat with sugar to make them taste better. When we eat foods with added sugars or high glycemic foods, they are broken down into glucose (or fructose, another subject altogether), which then travels in the bloodstream to cells throughout the body. Glucose in the blood, or blood sugar, triggers a release of insulin from the pancreas. Insulin is necessary to help our cells take in the glucose and use it for energy. So insulin is a GOOD THING right? Right! The problem comes when we put so much sugar into our body glucose, fructose, or any of those OSEs that taste so good- we are telling our body to produce more and more insulin. Soon our muscle, fat and liver cells stop responding to insulin. They become insulin resistant, and the little bit of insulin we should need doesnt do the job of getting the glucose into the cells, so the pancreas produces more. If the pancreas just cant cope with the demand, excess glucose builds up in the blood stream and weve just set the stage for diabetes. Many people with insulin resistance have high levels of both glucose and insulin circulating in the blood at the same time. Their pancreas is doing all it can to produce enough insulin to utilize the glucose for energy it just cant keep up. The reason we test fasting Continue reading >>
The Unhealthy Skinny-fat Phenotype
Obesity is a well-known health risk, contributing to cardiovascular disease, cancer, and diabetes, among others, but some people who are not overweight have the same risks. Those are people with the unhealthy skinny-fat phenotype. Obesity is associated with insulin resistance, and whether as cause or effect, insulin resistance is probably behind many of the adverse effects of health of obesity. The causes of both insulin resistance and obesity are hotly debated, but its also apparent that insulin resistance can appear in non-obese people, in whom it will increase the risks for disease just like obesity will. People who have the metabolic abnormalities such as insulin resistance but who are not themselves obese have been termed metabolically obese, normal weight (MONW). In more common language, these people are skinny-fat. Phenotype means simply the observable characteristics of an organism, resulting from the interaction of the organisms genes with its environment. Skinny-fat refers to a person with a normal body mass index (BMI), who has a low muscle mass and a high amount of body fat. In the case of a skinny-fat person, BMI does not capture the true health risks associated with that persons body composition , i.e. the fractions of lean mass and fat mass that make up his or her body. BMI is a rough-and-ready measure of where someone fits into weight categories, with their attendant health risks, but is actually a surrogate measure for the two most important body components. The real factors in the relation between body weight and health are I showed extensively in my book Muscle Up just how and why having a relatively large fraction of body weight as muscle, and a low fraction as fat, is extremely important for health. That doesnt mean you need to look like or be a bo Continue reading >>
Skinny And 119 Pounds, But With The Health Hallmarks Of Obesity
Claire Walker Johnson of Queens was a medical mystery. No matter how much she ate, she never gained weight. And yet Ms. Johnson, with a long narrow face, had the conditions many obese people develop — Type 2 diabetes, high blood pressure, high cholesterol and, most strikingly, a liver buried in fat. She and a very small group of very thin people like her have given scientists surprising clues to one of the most important questions about obesity: Why do fat people often develop serious and sometimes life-threatening medical conditions? The answer has little to do with the fat itself. It’s about each person’s ability to store it. With that understanding, scientists are now working on drug treatments to protect people from excess unstored fat and spare them from dire medical conditions. The need is clear. One in three Americans and one in four adults worldwide have at least three conditions associated with obesity such as diabetes, high cholesterol and high blood pressure — a combination of disorders that doubles their risk of heart attacks and strokes. In addition, 2 percent to 3 percent of adults in America, or at least five million people, have a grave accumulation of fat in their livers caused by obesity that can lead to liver failure. The detective work that led to this new scientific understanding of fat began with a small group of scientists curious about a disorder that can be caused by a gene mutation so rare it is estimated to affect just one in 10 million people, including, it turned out, Ms. Johnson. For much of her life, Ms. Johnson, 55, had no idea anything was amiss. Yes, she was very thin and always ravenous, but in Jamaica, where she was born, many children were skinny, she says, and no one thought much of it. She seemed healthy, and she developed Continue reading >>
Why Thin People Can Become Diabetic—and It’s Not Insulin Resistance
There is a blatantly illogical explanation in medicine about Type 2 diabetes being caused by insulin resistance. On one hand, it is claimed that weight gain in the form of excess fat causes insulin resistance, and other hand, it is also claimed thin people, who by definition, do not seem to have to extra fat, can develop insulin resistance, too. In my view, this is contradictory and points to yet another reason that insulin resistance as the cause of Type 2 diabetes does not make sense. Let me give you four reasons why it makes no sense biologically that insulin resistance occurs in both obese people and thin (lean) people and causes Type 2 diabetes: 1. In obese people, the current medical teaching is that the accumulation of excess fat causes insulin resistance as well as impairs insulin-producing cells in the pancreas. Meanwhile, to explain why thin people get diabetes, it is believed that these people suffer from a rare genetic “defect” characterized by a lack of fatty tissue. In other words, on one hand, excess fat causes insulin resistance while on the other hand insufficient fat can also cause it. 2. The amount of fat tissue a person has is actually a function of the number of fat cells and the capacity of each cell to store fat (also called triglyceride). The number of fat cells increases from childhood ending with about 50 billion in an average adult. Obese adults do not have more fat cells than they had before, but they have larger fat cells, up to 4 times the normal size, when filled to capacity with fat. When a person loses weight, the number of fat cells remain the same, but each cell loses fat. We know that obese people who lose weight can lower their blood sugar and even reverse diabetes. But this presents another paradox: Why don’t obese diabetics w Continue reading >>
Insulin Resistance: What You Need To Know
Measuring insulin resistance might be the key to stopping prediabetes from becoming Type 2 diabetes. If you ask the average person on the street to play a word association game with diabetes, the word “fat” will come up sooner rather than later. Links between obesity and Type 2 diabetes are well established. And yet, not all fat people have diabetes, and not all people with diabetes are fat. Like many things connected to diabetes, simple and ubiquitous explanations almost never work. According to the U.S. Center for Disease Control, 100 million Americans are now obese, with a Body Mass Index (BMI) of 30 or higher. At the same time, the CDC reports that as many as 80 million Americans were insulin-resistant, and since insulin resistance is a precursor to diabetes onset, the two numbers seem to support one another. The correlation breaks down, however, if one assumes that obesity and insulin resistance are always connected. They aren’t; some 12% of those who are insulin-resistant are thin. Since testing only overweight people isn’t a diagnostic solution, heading off diabetes Armageddon in the future boils down to identifying insulin-resistant people, regardless of weight, say diabetes researchers. Early identification of insulin resistance can have a major impact on the long-term prognosis of diabetes in patients, or help patients avoid the onset of diabetes altogether, but the window for early diagnosis of insulin resistance often is missed. Standard tests such as A1c percentages or fasting glucose won’t always identify the problem in time to allow prevention to work. sponsor How Insulin Resistance Begins Insulin resistance is a metabolic condition that causes the body’s cells to require a higher than normal amount of insulin to convert glucose into energy. B Continue reading >>
Thin And Type 2: Non-obese Risk Factors For Developing Diabetes
Emily got quite a surprise when she went for her annual physical exam. The lab tests taken showed that her blood glucose readings were in the range of someone with type 2 diabetes. Since Emily did not fit the usual appearance of someone with type 2 diabetes, her doctor ran the test again and checked for antibodies to insulin and her c-peptide levels, in case Emily was in the early stages of LADA (a slow moving version of type 1 diabetes). The test results were the same, however. Even though Emily, at 5 feet 2 inches and 115 pounds, had never been overweight in her life, she had type 2 diabetes. Emily was one of the 15 percent of individuals in the United States who develop type 2 diabetes even though their BMIs are squarely in the normal range (between 18.5 and 24.9). There can be a number of factors that come into play when a thin person develops type 2 diabetes. Genetics play a significant role in determining disease onset. A strong family history coupled with a sedentary lifestyle and poor eating habits can tip the scales in the wrong direction. So too can a previous diagnosis of gestational diabetes or the birth of a baby greater than nine pounds. Unfortunately for these individuals, their outside appearance is hiding a metabolic profile similar to overweight people who have type 2 diabetes. They are insulin resistant not from excess pounds per say, but from the places where some of their fat cells are stored, and often from a lack of exercise. Many normal weight people with type 2 diabetes have excess visceral fat. Visceral fat is the type of fat surrounding the body’s abdominal organs and is highly metabolically active, producing a variety of hormones that influence glucose and fat metabolism. Fat cells release fatty acids into the blood stream that can damage t Continue reading >>
Insulin Resistance: What Is It?
Insulin Resistance = Prolonged Sugar Addiction Insulin Resistance, Syndrome X or Metabolic Syndrome as its commonly knows is what happens in the body when the pancreas gets exhausted. The pancreas is the organ in that produces insulin, so when a persons diet is poor and constantly eating carbohydrates, sugars, grains, and convenience foods, the pancreas is constantly called into action. This is a huge problem for Americans today since the average diet is so poor. To see this, lets take a look at the progression of Type II Diabetes in the last hundred years. In 1900, the average person would consume around 3 pounds of sugar each year. Today, the average American consumes around 200 pounds of sugar each year, one coke and oreo at a time. It used to be that only an older adult would have lived long enough to consume enough sugar to manage getting Type II Diabetes. Today, however, we have begun diagnosing toddlers with the illness. Whats Really Happening? Prolonged Effects of sugar stress on the body! Heres the BIG IDEA! : A diet high in simple carbohydrates: sugars, grains, and high fructose corn syrup leads to INSULIN RESISTANCE that in turn leads to almost every other disease known to man. This chronic stress on the pancreas creates a cascading effect throughout the entire bodys systems. Insulin is considered to be the Mother Hormone of the body. It is the most powerful and most important hormone in the body. The body looks to insulin to see how were doing here. If its good, most other systems are good. If its bad, all other systems of the body begin to deteriorate. Insulin resistance can happen in almost any organ and attendant symptoms and diseases will eventually subside there. If it happens in the liver, then type 2 diabetes will begin. In the kidney? Renal failure. Continue reading >>
Get The Skinny On Insulin Resistance.
Weight gain results when there is an excess supply of glucose, which insulin is unable to transport into the cells for energy. The unused glucose rapidly converts to body fat, which is most often stored around the abdomen. Only a limited amount of glucose will be transported into the cells to be used for energy, the excess is stored as glycogen in muscle or liver cells and the rest is converted to body fat. A high carbohydrate, highly processed diet provides excess glucose and places a huge strain on the action of insulin. Over time our cells become resistant to insulin, making this type of diet one of the major contributing factors to weight gain and insulin resistance. The Link between Stress and Insulin Resistance Stress causes an avalanche of hormonal changes in the body, including elevating cortisol and norepinephrine and decreasing DHEA. When we are under stress our fight or flight mechanism tells the body to ignore the storage effects of insulin so glucose is available to provide energy to fight or flee. Unfortunately when it comes to chronic stress we send the signal out repeatedly, but we dont burn up the excess glucose, which is quickly converted to fat. Therefore chronic stress is a major factor in weight gain and insulin resistance. The Glucose Tolerance Test and Fasting Glucose are the standard medical tests for insulin resistance When you have been diagnosed with insulin resistance it is important to look at other risk factors for cardiovascular disease such as cholesterol levels and blood pressure. Inflammation can be a complicating factor for insulin resistance Hemaview Live Blood Analysis can detect inflammatory biomarkers Urinary Indicans Test can detect dysbiosis and leaky gut which is a major source of inflammation. Checking systematic acid/alkaline Continue reading >>
Can Normal Weight And Thin People Be Insulin Resistant?
Insulin resistance – if you’re of normal weight or underweight you’ve probably crossed it off your list of things to worry about. After all, insulin resistance only affects people who are overweight, right? Surprisingly, the answer is no. Insulin resistance is less common in people who aren’t overweight or obese but even thin people can have it. The Problem of Metabolically Unhealthy Non-Obesity You’ve probably heard about metabolically-healthy obese people, people who fall into the obese category based on BMI yet don’t suffer from the health problems associated with obesity like insulin resistance. In addition, they aren’t at greater risk for heart disease. Up to 20% of obese people fall into this category. Just as there are metabolically healthy obese people, there are a growing number of normal weight and thin people who aren’t healthy from a metabolic standpoint. They have the same metabolic issues, namely insulin resistance, that plaques overweight and obese people. These people fall into the category of “metabolically unhealthy non-obese.” Unfortunately, people in this category are at higher risk for health problems and most are blissfully unaware of it. They look at the number on the scale and assume all is well. After all, how can they be at risk when insulin resistance is so closely linked with being overweight and obese? Insulin Resistance in Normal-Weight and Thin People: What Causes It? As you already know insulin resistance is a condition where cells become less responsive to the insulin your pancreas produces. Your pancreas produces insulin to help get glucose into cells. When cells lose sensitivity to insulin, the pancreas has to pump out more. As a result, people who have insulin resistance have lots of circulating insulin in their bl Continue reading >>