Shall we take a look at fat, as a noun and not as an adjective? What is fat? Unfortunately, we are witness to more people, especially kids and young adults, who carry much fat. We also know that these beings are at a much higher risk for many preventable diseases. Diabetes is primarily related to too much fat. So why is this? If fat is simply more bulk, then shouldn’t one who carries this mass suffer primarily from muscular-skeletal issues? In fact, they do but it becomes the least of their problems. What do fat cells do that is so harmful?

Fat tissue is mainly composed of fat cells. Imagine multiple clusters of grapes hanging on a vine, held together by thin fibers (connective tissue) and throw in small nerves and blood vessels. Fat cells would be the juicy grapes. Fat tissue is one of the largest organs in the body. For men, it makes up 15 to 20% of body weight and for women, 20 to 25%. While most of the fat is visible, that is, close to the skin, a good amount also is present internally around various organs.

A fat cell can be seen as an energy storage tank composed of triglycerides. When there are more calories taken in then expended, triglycerides are formed and stored in the fat cell. When energy output exceeds caloric intake, triglycerides are released into the blood stream for energy consumption. This part of the equation is relatively simple and easy to comprehend.

When we look at a chubby kid or an obese adult, do they have more fat cells than a lean person or do they have larger fat cells or perhaps both? This becomes an important issue for the following reason. During early infancy, a large number of fat cells are formed only to decrease to a static number around the first birthday. Hence many infants are cherubic and so huggable. If the caretakers unknowingly overfeed the infant (and there may be genetic and other predisposing factors), additional fat cells are added and they also enlarge in size. This is the key point: the increased number of cells don’t go away, they remain the same or even multiply throughout childhood and adolescent life. The lean child, on the other hand, maintains the same cell count until adolescence when there is another growth spurt with the possibility of adding additional fat cells. For the obese child or the adolescent, with proper diet, the volume of the fat cells will shrink, but the numbers don’t change. This probably explains why, for these individuals, it is so easy to gain weight and so much effort needs to go into losing weight.

Just imagine, parents having this information. They could spare their children enormous amounts of future grief not to mention the cost our society pays for lost wages and health expenditures for many chronic diseases associated with obesity.

75% of obese children grow up to be obese whereas only 10% of lean kids grow up to be obese. Fat cells, much like many other cells in our body, have a certain life expectancy. Each year, there is an 8% turn over of fat cells. That is, about 8% die off, being replenished by newly formed 8%. This rule also applies equally to obese folks, which explains their weight maintenance.

To return to the original point, what is it about these fat cells which cause so much harm? Fat cells aren’t just warehousing triglycerides. Fat tissue happens to be an endocrine organ. That is, it manufactures hormones. Hormones, specifically coming from fat cells are called adipokines. Fat cells are active participants in regulating physiologic and pathologic processes, including immunity and inflammation. From an evolutionary biological view, fat cell turnover would have been designed as an on going peak and trough event (eat as much as you can now and store fat because you never know when you will eat again). Our body was not designed to carry a large amount of fat, all the time. The hormones coming out of our fat cells are many in number. They not only do direct damage to various tissues through their inflammatory actions but also recruit certain immune mediated cells which also cause harm. For example, insulin resistance develops causing diabetes. Diabetes in turn, affects virtually all the organ systems in the body since it alters the blood vessels which bring nourishments to every cell. We are only beginning to realize the vast array of chemicals spewing out of our fat cells, their actions on other cells, on genetics, other hormones, lipids and metabolism. That is, obesity is the cause of various endocrine and metabolic abnormalities rather than the victim of these abnormalities. Fat cells don’t just hang out, they play and they play rough because they were designed to store fat, then destroy or clean up the surrounding tissues during lean times.

Take home message: 1) please, keep your kids lean. The number of fat cells they create will never decrease throughout their life time; and 2) carrying much fat isn’t a cosmetic issue; these cells do much harm.

Eat consciously and move more.
Dr. Philip Bhark M.D., FACC

Also of interest… Dr Bhark will be blogging on www.ExpatNewsletter.net | Thailand’s Fastest Growing Community Website…

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