As Iʻve mentioned before, Iʻve been reading The Obesity Paradox by Lavie, and itʻs been quite interesting! One of the things many of you probably already know is that inflammation is a possible indicator of illness and disease, and keep us metabolically healthy [no disorders such as diabetes, high blood pressure, or the like]. Interestingly enough, there are many people who are classified as obese according to the body mass index [BMI], but do not develop such diseases and they are called metabolically healthy obese, and make up as much as 35% of the obese in the U.S. In fact, studies have been conducted that have shown that metabolically healthy people had lower levels of several inflammatory markers, whether obese or not. Thus, those with ʻgoodʻ inflammatory profiles also tend to have healthy metabolic profiles.
In a study reported in Diabetologia, researchers suggest that one reason for those who are obese but do not have metabolic disorders is that these people may have better functioning mitochondria. People who are obese and also metabolically unhealthy tend to "have impaired mitochondria and a reduced ability to generate new fat cells" (p. 51). And, those with impaired mitochondria and problems with fat cells may explain "why fat cells in unhealthy obese individuals balloon to the point that the cellsʻ internal machinery is impaired and they die off" (p, 51-2). This leads to inflammation and accumulating fat where it is more problematic: heart, muscle, and liver where it damages those organs. While fat cells in obese people who are metabolically healthy can make new cells to store excess fat and it tends to go under the skin where it is fairly harmless. So, one question researchers are exploring is whether it is the damaged mitochrondria that leads to inflammation or inflammation that leads to damaged mitochrondria.
More research is being done on understanding the role of exosomes, which are small sacs produced by fat and other cells. These exosomes may go to other parts of the body and induce disease-triggering mechanisms.
So, researchers, and thus the public, is learning more about metabolic health, as well as the role that different organelles, such as mitochondria and exosomes, play in obesity and metabolic health. Lavie also mentions that while belly fat has been said to be the worst kind of fat to carry, mainly because it is involved in inflammation compounds, it may be, as Lavie states, that "when it comes to fat real estate, location matters. But, itʻs not everything" (p. 53). More on that to come!