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As a matter of fat...

Dear friends,

I finally got around to reading  Fat Chance by Robert Lustig MD over the holidays.  It's one more vindication of allowing good fats in our diet vs sugar and processed carbs.  It should put to rest, finally, any adherence to a low-fat diet as good for protecting against anything, esp heart disease and cancer.

Not only does it matter what type of fat you eat, it also matters what kind of fat you have in your body.

This topic is lengthy so I'll do it in bits, with a few short emails on specific aspects of this topic.

Whenever we step on a scale we are measuring 4 different body compartments, only one of which is bad for us.

1.  Bone  (the more bone, the longer you live)
2.  Muscle (more muscle is better for your health)
3.  Subcutaneous ("big butt") fat:  This makes up about 80% of our total body fat. Believe it or not, more subcutaneous fat is better for your health. (not a typo)
Several studies show that the size of the subcutaneous fat depot correlates with longevity.
4.  Visceral fat;  the only compartment of the four that is consistently bad for us is our visceral fat (aka abdominal, ectopic, or "big belly " fat.)  Remember the old "apple vs pear" shape analogy?  Apples die sooner; pears have longevity.  Visceral fat is fat where it doesn't belong: inside your abdomen and inside your organs (e.g., liver and muscle) Visceral fat, only about 20% of our total body fat, is the fulcrum on which your health teeters.

Bottom line: you need your fat. At least you need your subcutaneous "big butt" fat, which provides a bucket for extra energy to keep you alive and healthy. With rare exceptions, your subcutaneous fat contributes very little to the development of chronic disease. Twenty percent of morbidly obese adults have completely normal metabolic status, no evidence of disease and normal longevity.  In fact, the smaller your subcutaneous fat compartment, the faster you die.

When it comes right down to it, it's all about your middle. This whole obesity/health/longevity question centers on your abdominal, visceral, or big belly fat, at least statistically.

Why? This one compartment which is only 20% of your total fat and 4 - 6 % of your total body weight, translates into about 15 years of life.  Visceral fat depots are more metabolically active than subcutaneous fat depots and they drive inflammation. 

Visceral fat causes insulin resistance and that, in turn, promotes diabetes, cancer, heart disease, dementia, and aging.  While the populace is more worried about subcutaneous fat (because it's unsightly) this fat is much less prone to being lost; in fact it is rarely shed unless you go on a caloric restriction or starvation diet which is rarely sustainable.

The good news is that visceral fat is the first fat you lose when getting a grip on this killer. And here's how you can determine how much you have (without a lot of fancy, expensive, tests):  divide your waist by your hip measurement.  Have someone help you find these spots, otherwise the test is useless.  (doctors rarely do this psychologically sensitive test) If the ratio is greater than .8, you have some visceral fat to get rid of to save your life, or at least extend it.

(BYW, a BMI is not helpful b/c it does not distinguish between subcutaneous fat and visceral fat)

More on this topic in the days to come.

Tip:  stop eating all forms of sugar, for starters.   (I decided not to write this article before or during the holidays :-)  Now is the time to git a grip and get started towards a healthier you.